What is the Cause of Supratip Swelling?

Swelling in the tip is usually related to the tip work itself. Duration and severity of swelling can generally be influenced by:

1) Whether or not tip work was performed
2) The thickness of the patient's skin
3) If the procedure was open or closed

It can take up to a year before you see your final result, and this is due to swelling that is present, not necessarily scar tissue. From here, it is best to be patient while you heal and allow the swelling to dissipate. 5-Flourouracil mixed with kenalog works great to reduce the amount of swelling in your nose. I would recommend discussing this option with your surgeon and visiting them for a follow-up to answer any questions you may have. I hope this helps and good luck.

 Some supratip swelling is common after rhinoplasty, and after revision rhinoplasty the swelling is more common and  can last for many months.  Meticulous surgical technique with precise control of bleeding during the procdure minimizes the initial swellin.  If it is a problem in the early postoperative period, a steroid injection ( Kenalog) into the supratip area done monthly can be very beneficial, and I use it frequently, but only very small amounts should be used, avoiding injection to near the skin to avoid depressions.

Supratip swelling may be caused by differential compression post surgery.  If you feel that there is significant or excess fullness of the nasal tip, you may be a candidate for surgical rhinoplasty tip reduction. 

Supratip fullness and edema can be due to a number of reasons: edema, scar tissue formation from excess dead space, cartilage, soft tissue, or a combination of these.  If it is swelling causing fullness in your supratip, it can take months to resolve.  Sometimes injecting the area with 5-fluourouracil and kenalog can help to expedite the resolution of swelling.  

Since this is your second procedure, it is common to have some prolonged swelling.  There are several other factors that may be contributing such as the approach (open vs. closed), the thickness of your skin (thin or thick), and how difficult the dissection was.  It is encouraging that you are able to see the swelling dissipate after manipulation.  Be patient, but injections to nose with kenalog and 5-Fluoruracil can potentially help resolve the swelling faster.

It would be helpful if you submitted pictures of your nose so we can comment on your problem. Instructions regarding the views necessary for nasal evaluation can be found on my website.