What could be causing swelling to appear 2 years post rhinoplasty? (photos)

Question

I had a rhinoplasty two years ago and my nose appears to be very swollen. Its feels very tight and stiff around the tip of the nose and looks way bigger than it has before. Any suggestions what could cause this or how the issue could be fixed? First photo is before swelling occurred and second is swelling

Randal Haworth, MD, FACS · Answer

It is possible that the swelling you are experiencing is a result of scar tissue formation or unresolved inflammation following your rhinoplasty surgery. Swelling can persist for up to a year or more after surgery, but if it has been two years and you are still experiencing significant swelling, it may be worth speaking to your surgeon about potential options for addressing this issue.

Some options may include steroid injections or revision surgery to address any underlying issues that are contributing to the swelling. However, it is important to consult with your surgeon to determine the cause of the swelling and the best course of action for addressing it, as every case is unique and requires personalized attention.

Best of luck !

Eric M. Joseph, MD · Answer

If the swelling of your nose 2 years after surgery is persistent, it could be because your surgeon used non-dissolvable permanent sutures. A very small percentage of people are sensitive to permanent suture material. In general, when people's bodies don't accept permanent suture material, it tends to come to the surface, become red, and extrude. Frankly, at 2 years postoperative, if there is no foreign body in your nose, the relationship between your rhinoplasty and nasal swelling may be negligible. Thankfully, you appear to have a nice result. Please consider discussing these concerns with your surgeon so you can get further advice. Thank you for your question. Sincerely, Dr Joseph

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photos you provided it looks like your nasal bridge is wide and your columella is hanging a little bit. I would need more information to make a proper evaluation (did your surgeon use ear/rib cartilage during your first surgery ? How was your nose before the surgery? ) ... 
Best regards!

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  It is not uncommon for someone to have delayed swelling in her nose months or years after their rhinoplasty.  I would initially start with a low-salt diet and restart night taping.  I developed a device called "Noseperfect" that compresses the nasal tip and works really well in the circumstances.  You can purchase it online.  If the nose noninvasive techniques do not work, then I would consider a steroid injection to your nasal tip.  Best wishes to you.

Zoran Potparic, MD · Answer

Before you have a chance to make follow up visit with your surgeon, you may try to tape the nose overnigt from above the tip towards nose root; 3-4 1/2" tape will do. Hope this helps. Good luck.

Robert Ciardullo, MD · Answer

Tip swelling after rhinoplasty: after rhinoplasty, the tip takes the longest to fully heal. There is a layer of scar tissue that forms which  can take 1 to 3 years to resolve. how long it takes depends on the type of surgery that was performed in the tip area and how much scar  issues the patient forms, and the thickness of the overlying skin. patients may experience some swelling of the tip during the first few years following rhinoplasty which may be episodic and may relate to salt intake, position when sleeping, premenses, etc. ingesting a lot of salt may cause more swelling. Sleeping face down may cause more swelling. And some women experience more swelling when they are premenstrual.when  the problem is significant some surgeons may use a steroid injection to reduce scar tissue, assuming there is no foreign material present that is causing inflammation, Your tip does not appear that swollen to me in the pictures you show, so I am not sure just from the photo whether you would need a steroid shot or not. But it does not look like you do.