Yes, fluctuations and swelling after nasal reconstruction are expected
The nose is extremely prone to edema (soft tissue swelling) after nasal surgery. Many reasons for this tendency exist. The most common reason for swelling in the morning after facial surgery is due to changing from an upright position during the day to a horizontal position during sleep.
This causes significant congestion of fluid, which is worst in areas that have been recently injured or operated upon. Simply sleeping with the head, neck and shoulders elevated above the heart can greatly reduce this morning swelling. Additionally, avoiding turning on one's side helps further.
Swelling in the nose after rhinoplasty can fluctuate.
After rhinoplasty, the vast majority of the swelling, perhaps 70-80% resolves over the first 7-10 days. At this point, the nose is usually quite passable and patients can return to work or social situations. The remainder of the swelling gradually dissipates over the course of 12-18 months, as the nose becomes increasingly refined.
You may have days, in particular in the morning, during which your nose appears slightly more swollen. I have found that a number of factors can contribute to this daily fluctuation, a phenomenon which can last for up to a year. These include: excessive sodium intake, alcohol, hot environments (saunas etc.), and flying (due to changes in cabin pressure). I usually advise my patients to avoid sodium-rich meals and alcohol for 1-2 days prior to a big event, such as a wedding or class reunion, if you want your nose to look as good as possible. On the night of the event you can eat and drink to your heart's content, as the swelling usually doesn't occur until the next morning!
Swelling after Rhinoplasty
Swelling and fluctuations in that swelling are common 2 weeks after surgery. This can be influenced by activity and position. Avoid strenuous activity for another couple weeks. Use 2 pillows under you head when sleeping; drainage of fluid causing that swelling will be more efficient.
Swelling Fluctuations After Nasal Surgery
It is normal to see fluctuations in swelling for weeks to months after nasal surgery. There are many factors that play a role: activity, temperature, humidity, allergens, pollutants, position, other metabolic parameters, and many we never identify.
Swelling can cycle after rhinoplasty surgery
Swelling can get better and worse after rhinoplasty surgery. i do not know what kind of dressings, etc you had after surgery. I place a nasal dressing, and splint on all nasal surgery patients. I fimnd that patients look pretty good on post-op day 1 and hit their max swelling on post-op day 2. After that their swelling seems to slowly subside. However, I take the splint off on Post-op day 5. When the splint comes off, I frequently notice that patients get a second round of swelling that lasts for 1-2 additional days. After this point, patients look pretty normal, but there is still swelling that prevents visualization of all of the detail in the tip, etc. This type of swelling takes months to go away completely.
Postoperative Swelling After A Rhinoplasty
Swelling is common after a rhinoplasty and can fluctuate. Their are several ways to minimize fluctuations and improve swelling faster. Some of these are as follows:
Avoid salty food
Taping nose at night- Nose tends to swell at night and taping at night can help decrease morning swelling
Avoiding the sun
Post-operative swelling fluctuation normal
Although most patients will find that their postoperative swelling gradual improves after surgery it is not uncommon to experience some fluctuation.
In my experience some things that can lead to an increase in swelling during the recovery phase are:
sleeping in a non-elevated position or with the nose in a dependent position (i.e., aimed down)
an increase in general activity or exercising (anything leading to an increase in blood pressure will cause the nose to swell more)
increased sodium intake
The later point about sodium intake isn't commonly discussed but I recommend to all my patients that they follow a low sodium diet (1000 mg a day) temporarily after surgery. It's one of the few things that you can do to help they swelling and It really helps to improve the postoperative edema.
Importantly, if you are also experiencing a dramatic increase in pain or a fever you should be examined to make sure an infection isn't starting.
Swelling after nose surgeryif
The swelling you describe is normal, but it would worry me that you may have an infection with the sudden swelling after 4 days. I would have your physician look up your nose to make sure that all is well. Fluctuations in swelling are common but one should not assume that its all OK unless you are examined.
Swelling Expected to Fluctuate After Nose Surgery
Yes, fluctuations in swelling are expected after nasal surgery. There could be a number of factors (such as activity, temperature, humidity, allergens, pollutants or position) that could affect swelling. Review postoperative care and direction with your surgeon to ensure that you are following correctly. Your surgeon will be checking you repeatedly after surgery to monitor that you are progressing appropriately.
Rhinoplasty and swelling fluctuations
It is common to have swelling fluctuations in the post operative rhinoplasty phase especially during the first few weeks. I would suggest keeping a low sodium diet, sleep with your head elevated with a few pillows behind your back, avoid smoking, alcohol and excessive heat when possible. This should help with the edema (soft tissue swelling) and as the recovery process moves forward you should start seeing less fluctuations in the swelling. Best regards!