9 months post rhinoplasty and nose is still swollen. Will this improve or will I need another procedure? (photos)

Question

I have had a rhinoplasty 9 months ago now. However the swelling on my nose has not reduced. I do have thick skin so I’m not sure if this due to this. It is very undefined from the side and front. I am wanting to know if this will improve or will I need any other procedures

Mark McRae, MD · Answer

You really have to wait at least 12 months in order for swelling to resolve after rhinoplasty. In terms of definition of the nasal tip- your skin thickness does ultimately limit the definition that you can achieve. The good news is that over the years as we age the nasal skin does thin and you will likely continue to see more definition. There are medications such as accutane that can help very sebaceous skin to achieve more definition. You absolutely need a physician to prescribe and follow you on a drug like this with significant side effects. Speak to your plastic surgeon about alternatives such as steroid injections that may help the swelling come down sooner. Revision rhinoplasty does have risks associated with it and likely not a simple solution if your skin is thick. Thinning the skin surgically can be done but must be very conservative and therefore the result not too dramatic. After 12 months take a good look at your before and after photos with your surgeon. You will likely see significant changes from pre operative photos and hopefully you will be happy even if you did not achieve the level of definition that you were looking for. If not your surgeon can advise you on next steps, and what a revision can achieve if you choose that route.

Lexie Wang, MD · Answer

Hi Exquisite. Without seeing your preop photos, it is hard to know what your evolution may be. In general, patients with thick skin do take much longer for swelling to come down, and it may be 9mo-1 year or even longer. However, I personally do not think that your nose looks undefined; I think it actually looks pretty good from the front and side, esp for a thick skin nose. I would consult with your surgeon to see if she actually thinks it will get any better or if this is about as good as it will get. Hopefully you were adequately counseled at the beginning of the process about hte limitations related to thick skin. Good luck!

Celal Alioglu, MD · Answer

Hello for now you do not need a second surgery you need to wait 1 and half year to see the final result.

Eric M. Joseph, MD · Answer

You have a nice result, and I suspect your nose will become more refined over the next 3-6 months. Consider Re-asking your question with before and after photos. Thanks! Dr Joseph

Zamir Paez, MD · Answer

Persistent swelling at 9 months is common, especially in patients with thick skin, as this type of skin takes longer to adjust to structural changes. Definition often improves gradually within the first year, but it can take up to 18 months for swelling to fully resolve.
If you’re still unhappy with the results after that time, a follow-up consultation with your surgeon can help determine if additional procedures are necessary. In the meantime, continue following post-operative care instructions to optimize recovery.

Robert Ciardullo, MD · Answer

Is your nose still swollen? swelling and scar issue resolution takes at least a year in average skin patients. People with thick skin will take significantly longer. So I think the definition of your nose will improve with time. I would be cautious about using any steroid in the supratip area, since it appears that your nose already is somewhat scooped and angled high. Steroid injection might exaggerates that look and make it look too “piggy“, so be careful about the use of steroids.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Thanks for the questions and photos. At 9 months, there is still time for swelling to improve. I would wait a minimum of 12 months - especially in thick-skinned patients. Steroids, taping, and compressions at the tip can really help reduce swelling. If the results are still not what you want, revisit with your surgeon to discuss options. Hope this helps!

9 months post rhinoplasty and nose is still swollen. Will this improve or will I need another procedure? (photos)

Answers (7)

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