Swelling and Discoloration After Rhinoplasty

It is understandable that you are nervous about residual
swelling and discoloration from your rhinoplasty, especially because you have
had a nose job overseas. While swelling is completely normal after a
rhinoplasty, the symptoms you are describing- such as your inability to breathe
properly- are not normal. Maybe consider scheduling a Skype or other form of
video calling session to talk to your surgeon directly and show them exactly
what is going on in your recovery. It seems like your condition is somewhat
serious, so I would also recommend that you visit a professional, certified
surgeon in Scotland to get a closer look at your nose.

Discoloration after a rhinoplasty can result from several issues including:


Formation of blood vessels after the rhinoplasty procedure on the skin envelope- these should not be addressed by a LASER until patient is 100% certain of not needing an additional procedure.  additional procedures can lead to more aberrant blood vessels

Poor vascular supply-  Bluish and whitish discoloration can be seen in patients with poor vascular supply to the nose.  It is more common after multiple rhinoplasty procedures, especially in patients with columellar scars in 2 locations(but not always).  Rubbing and stretching the nose can encourage blood flow to the area.


Swelling after a rhinoplasty can occur and can be managed by a variety of maneuvers including Kenalog injections, taping, low sodium diet, etc.

The picture does not show closely what is going on with your nose. The steroid injection may give a small amount of improvement, but you should see a revision rhinoplasty surgeon in your area to examine your nose and advise you.

Swelling in your nose after a revision rhinoplasty has to do with the lymphatic edema that is trapped inside the nose due to altered lymphatic drainage from the nose. Exercise and heat and the time of the day can all affect the amount of swelling and fluid shift that occurs in the nose even after a year. This is especially prominent in the tip. Altitude, air pressure changes, and hormones can also affect the swelling. A low-salt diet will help. Steroid injections will help in the swollen tip area but not with a bluish or red discoloration

The key to your question is fluctuation. Whenever rhinoplasty is performed, the surgeon is lifting the skin and soft tissues of your nose to alter the cartilage and bony framework. By definition, this process involves disrupting the little nerves that provide sensation to the skin and the little vessels that allow normal drainage of fluid from your skin. Thankfully, this 'injury' heals and all goes back to normal. With each successive surgery though, this healing can take longer and it is not uncommon to have some of the symptoms you're talking about even at one year after a revision.
I am sure they are annoying for you, but the fluctuating nature of these symptoms is really a good sign. That means that there is still some healing to go and things will continue to improve. It may sometimes take another six months or, rarely, longer until you're seeing this go away completely. Steroid injections are meant to help you get there faster and can still help at your stage of healing.
Until then, it is normal to have flushing in hot environments, bluish discoloration in colder temperatures, and fluctuating swelling and congestion, especially when laying down for long periods or when exercising (when fluid collects in the area).
Wishing you the best for continued healing and for a great result.