Swelling or Scar?

I had my third rhinoplasty three months ago which focused on removing scar tissue from the right side of the supratip and pushing the right bone in towards the center. After the cast came off, the nose looked absolutely perfect. Two days after, it expanded a lot on the right supratip (and along the right bridge) where the scar tissue was removed, and since then, it has only slightly decreased in apparent swelling. It feels tender and there is some slight pain when pressing. Is this swelling?

Doctor Answers 4

Swelling or scar?

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When your cast comes off, your swelling is right near its peak. Even at three months, you are still swollen and the nose may still feel tender to the touch.  In general, the final result of a rhinoplasty may not be evident for 18-24 months following surgery. 70% of the swelling resolves after the first three months, and the remainder goes down over time. Swelling is most directly influenced by thickness of the patient's skin, whether the procedure was a revision, whether tip work was performed, and whether or not the procedure was open or closed.

Since your procedure was a revision, you will be considerably swollen. As more revisions are performed, each subsequent case is more difficult. There will be more scar tissue built up following each surgery. In general, the difficulty of a revision is related to the three-dimensional healing and shrink wrappage of the skin. The use of 5-Flourouracil is a great way to soften and possibly reduce scar tissue from previous surgeries when performing a revision rhinoplasty. You can combine it with kenalog, and it yields a fantastic result. You can use this combination post-operatively to help reduce swelling. There are some possible side effects that may occur such as white spots on the skin and indentation. But I have performed hundreds of these injections with no complications. I would recommend speaking with your surgeon to see what he/she advises to reduce some of your swelling. Thanks and best of luck with your recovery!

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Swelling After Rhinoplasty

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In cases similar to yours, this is most always certainly swelling and not a scar, however, because you're so early in the recovery process, you'll need to wait several more months to be sure. As you continue to recover, your swelling will decrease, allowing you to see the final results and whether or not you will be left with a scar.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Swelling, or Scar?

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The third option would be to make sure you do not have an infection. Scar tissue can not be completely removed during surgery, so you will still have some and may create more after your last surgery. However, you have had three surgeries and you are only three months out from your surgery, which means that most likely you have swelling. 

Follow up with your doctor to make sure it is not an infection, and be prepared for prolonged swelling due to the number of surgeries you have had.

Best of luck,

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 113 reviews

Swelling after revision rhinoplasty

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It is important to be patient at this point.  IYou will not notice the final appearance of the nose for 9-12 months after a primary rhinoplasty. A second or third procedure will result in even more swelling.  If an open approach was used, this swelling is often worse.  It is not surprising to hear these concerns after only 3 months.  It is important to communicate your concerns with your Plastic Surgeon.  Best wishes!

Jarrod Little, MD
Louisville Plastic Surgeon
4.9 out of 5 stars 22 reviews

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.