After Rhinoplasty, How Much of an Upturned Nasal Tip is Due to the Swelling?

It is not necessary at all for the nasal tip to rotate upwards during
rhinoplasty, unless this is a desired outcome of surgery.  When in fact
this upward tip rotation is achieved, it is common for there to be some
settling of the tip, so that it drops by as much as 3 to 5 degrees, but
this often can be minimized when desired to just 2 or so degrees.
 

It is extremely common for the nose tip to appear up-turned in the first few weeks after rhinoplasty due to stiffness and swelling of the tip and columella

Thanks for your question Christopher,

The tip of the nose can be modestly upturned as a result of swelling after a rhinoplasty.  This swelling can take a good while (up to a year) to fully resolve.  However, it is not certain that the tip will rotate downward as healing takes place.  In some cases the tip can actually rotate upward slightly during the healing process.  While the reduction of swelling is certainly a factor, the contraction of the soft tissue of the nose over time also contributes to how the tip evolves.  How exactly this contraction impacts the nose depends on the particular anatomy of the nose and the specific surgical manuvers that were taken.  I know this is not a very definitive answer, but this is a realistic description of a complex surgery like rhinoplasty.

Hope that helps,

Paul Leong MD

Facial Plastic Surgeon