What is the Difference Between Swelling, Scar Tissue,& Bulbousness? 3 Months Post-op--will my Nose Go Back Down?

Question

I had rev rhino w/ a trimmed Medpor implant/tip elevation/narrowing. At 6 wks, the 1st day I saw the final shape (in the evening, when the nose is usually unswollen),I sustained a minor injury.The nose admittedly was warm/painful/swollen,but went back to normal color in a week. Now I am 3 months post op & the nose is twice the size it was that day, is hard, & bulbous around implant. Saw surgeon; implant is intact/grown in, but he said it is too dangerous to give kenalog. Advice for best outcome?

Kenneth Hughes, MD · Answer

This early after rhinoplasty, it is premature to be concerned about the final result.   The swelling is going to be very prominent at this early stage.  I would follow with your surgeon.   This may take the full year or more to resolve.                                                                                                                                                                                                                                                     Kenneth Hughes, MD
	Los Angeles, CA

Roy A. David, MD · Answer

Your doctor, after examining you, should have a fairly good idea if this is swelling(which should resolve) or something else. It may take several months for skin to completely settle down around an implant. Good Luck!

Shepherd G. Pryor, MD · Answer

3 months post op the great percentage of what you are seeing is swelling. Typically and traditionally 3-6months is a common period to have tissue swelling thus your final result has not been born out yet. Scar tissue has finished being laid down at 2 months but will be remodelled from 2-12 months....thus the one year time frame quoted for final results from rhinoplasty. Bulbousness is truly more a defining of the residual cartilagenous framework. That would not change in the long run...but again...you're not at the moment where this is well defined yet. So don't fret!

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

Bulbous tip usually comes in 3 varieties: Fibro-fatty tip, cartilaginous tip and iatrogenic or surgery induced ( scar tissue , wrong implant) . I think you fall into the 3rd category. You may have some scar tissue but I think you bulbous tip is being caused by the medpor implant. I don't think it will change with time. Medpor implants are typically too bulky and large making the tip even more bulbous than before. I would not recommend kenelog.

Best,

Dr.S.

What is the Difference Between Swelling, Scar Tissue,& Bulbousness? 3 Months Post-op--will my Nose Go Back Down?

Answers (4)