Is This Just Supratip Swelling After Rhinoplasty?

I had rhinoplasty about 7 weeks ago. I know that it's still really early in the healing process but I'm somewhat concerned about my results. My old nose had a huge bump and hung over quite a bit. Now I have no bump but the tip is kind of strange and still overprojects/droops down. My nose is still hard in the supratip area but it never was very "squishy" even before surgery. What's going on? P.S. My right nostril is higher than the left but it was like that before surgery.

Doctor Answers 10

Supratip fullness

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this is a  common occurence after a closed rhinoplasty with dorsal hump reduction and no tip work done. yu will need further refinement with a tip graft and some dorsal crtilaginuous reduction at the supratip area. I would wait until the tissues have healed before undertaking a revision. it will require an open approach with a columellar incision. good luck

Boca Raton Plastic Surgeon

Inadequate tip projection

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It looks like yoyu have inadequate tip projection which was present before surgery and was not improved upon during surgery.  Lifting the tip and applying surtures +/- a graft probably would have helped.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Supratip Swelling after Rhinoplasty

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You are only 7 weeks after rhinoplasty, but at the present time you have supratip swelling and inadequate tip projection. Hopefully this will improve as swelling resolves. We call this a pollybeak deformity when permanently present; a revision would be necessary. If you choose to have additional surgery, raising the hanging columella would be helpful.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

7 weeks post-op

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Seven weeks post surgery is still very early for you to judge the results of your surgery - having said that you may need a revision to establish tip support and correct the hanging columella

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Tip swollen after Rhinoplasty

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The tip can be swollen for several months after a Rhinoplasty but since none of use know exactly what was done to your nose and tip during your Rhinoplasty, the best person to answer this question is your Rhinoplasty surgeon.  Ask him/her to show you how your nasal tip was made smaller and more refined.  Hopefully, this will ease your mind during the post op Rhinoplasty phase.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

7 weeks after rhinoplasty

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7 weeks is way too early to make a final judgement. You still have significant amount of swelling that can take months to resolve. Having said that you should certainly keep in close touch with your surgeon. Tip rotation may not not be sufficient, supratip swelling (or excess cartilage...."beak" deformity) might be an issue, but overall be patient.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

The fullness above your tip 7 weeks after Rhinoplasty Surgery may be swelling or residual cartilage.

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I read your concern and reviewed your photos. It is conceivable that the bulge above your tip is just post-surgical swelling that will subside with time. You should see your surgeon and ask if a triamcinolone acetonide injection (steroid for swelling) might be beneficial for you.

All the best from us in NJ.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Your nose can look better

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I am not sure if your first set of picture are before pictures but I guess they are. You have inadequate dorsal reduction and not enough tip projection. The other point is the tip rotation and width. It is early for revision.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Rhinoplasty appearance seven weeks after surgery

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Healing takes time, and healing of the tip of the nose takes a lot of time.  It can easily be over a year before you see the final result of rhinoplasty at the tip of the nose.

At seven weeks, it is too early to see the final result here.  It is difficult to know how much improvement you may ultimately obtain.

Let your surgeon know about your concern - they know exactly what they did, and what healing course you can expect.  It may also be helpful to get extra "before and afters" even this early, to compare with the result in a couple of months.  If you can see the swelling going down in subsequent photos, that may help calm your fears.

On the other hand, if the swelling does not start going down after a couple more months, then additional improvement may require surgery.  Most of us recommend waiting at least six months for most revisions, so that is probably the timeframe to work with.

But the progression of changes over time will tell you whether this is swelling or a permanent problem that will require more surgery, and the photos will answer that question.

James Nachbar, MD
Scottsdale Plastic Surgeon

Adequate tip projection is necessary for a straight profile

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You may have read about "adequate tip projection".  Tip projection--the ability of the tip to hold itself up, independent of the height of the bridge,  is necessary for a straight profile.  The good tip shape that results from adequate projection also turns the tip up.

Before surgery your tip hung from the bump--it was inadequately projecting, and unfortunately still is.  However, the correction, which cannot be undertaken till you are healed, is straightforward, and involves better tip support --I use tip grafts because they are the most anatomical.  There are many examples on on my and other surgeons' websites.

You live in a very beautiful part of the country.  Find a surgeon experienced rhinoplasty whom you trust, even if you have to travel, so that you will have a better experience next time.  Good luck.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.