Swelling or Bone Misalignment After Nose Surgery?

Question

I had a Rhinoplasty with Tiplasty, Septoplasty, Turbinate reduction on March 25. I had a large dorsal hump which I hated. When the cast came off, my hump was perfectly flat and looked perfect. Since then (cast came off two weeks ago), the hump seems to be getting larger. Is this swelling or are the bones out of alignment? My 2-year-old knocked me in the nose once on April 8th and it hurt but not extremely painful. Could this have caused it? Should I tape the hump? I'll see my doctor in a week, but I'd like to know if anything can help now. Thank you.

Ali Sajjadian, MD, FACS · Answer

Thank you for your question!

It is understandable that you are
concerned especially with the nasal bump. Changes after rhinoplasties vary with
every patient and what you are experiencing is normal especially that swelling
takes time to subside as it masks the results of your surgery.

Without pictures, surgical details and the inability to perform a physical exam it is not
possible to provide you with a definitive medical answer.

It is important to keep in mind that it
is early to pass a judgment. Usually, a year is required before formulating how
your nose will be, but longer with a thick skin. Even then, your nose will keep
shaping itself to complement your face for better results in the years to come.

My best recommendation at the moment is
to be patient, allow nature to take its course and edema subsides for better
results. There is no doubt that once the swelling resolves, more definition and
shape will be achieved and you should be happier with the results.

Also, it is important that you keep
communicating with your surgeon and work as a team together to achieve the best
results possible.

Congratulations on your surgery and
please remain positive!

Ali Sajjadian, MD FACS

Richard W. Westreich, MD · Answer

It is not uncommon for the profile appearance to change dramatically during the first few weeks following reduction Rhinoplasty. Significant swelling is present in the skin and muscle overlying the bony and cartilaginous skeleton of the nose. Bone also heals through a process which involves a thickening or swelling, which then remodels over the next few months. Although early trauma after surgery can be a concern and should be discussed with your plastic surgeon, the other changes you describe are quite typical.

Michael M. Omidi, MD, FACS · Answer

Its best to see your surgeon sooner if possible.  It is difficult to give any suggestions without pictures.  Generally, the majority of swelling subsides after 6 weeks and remainder over 6 months to a year.    Best of luck. Dr. Michael OmidiAn in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

William Portuese, MD · Answer

It is important to make sure that your nose does not look crooked after you got hit in the nose two weeks after your surgery. Taping the nose will not hurt it or help it. The bump on the nose will be more swollen the first month, and it does take some time to settle down and go away. Be patient with the swelling as it subsides over the next year.

Keith Denkler, MD · Answer

Early trauma is always a danger after rhinoplasty. Trauma can disrupt the healing tissues. The fine difference between swelling and tissue disruption from trauma is best analyzed by your doctor. Try to see him or her this week for a check-up.
Good luck!

Francis R. Palmer, III, MD (retired) · Answer

I think that you should be honest with your Rhinoplasty surgeon and tell him about getting your nose knocked 1 week after having the cast removed and 2 weeks after your Rhinoplasty where it sounds like (since a large dorsal hump was removed) that your nosal bones were broken. When the nasal bones are broken, they are very susceptible to moving with any significant impact. This may have shifted the nasal bones. If so, taping will most likely not move the nasal bones back. You mighty want to call the office and tell them before a month visit.

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