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

Question

I've heard from other patients that postoperatively after rhinoplasty the nasal tip is a bit upturned, mostly due to swelling. As the swelling subsides, what factors contribute to the degree that the tip eventually moves down to the desired shape? And will it certainly move down to the desired shape as discussed preoperatively?

Jeffrey Epstein, MD, FACS · Answer

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.

Sam Naficy, MD, FACS · Answer

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

Paul L. Leong, MD, FACS · Answer

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

Steven Wallach, MD · Answer

Some swelling of the tip may cause slight tip elevation, but it should not be too significant.  Your concerns should be discussed with your doctor.

Francis R. Palmer, III, MD (retired) · Answer

There is always some degree of residual swelling, of the nose, with a Rhinoplasty however how much the nasal tip is rotated is not where that swelling occurs. Tip rotation is caused or more often a consequence of the particular techniques used in the Rhinoplasty to elevate the skin and thin the nasal tip. Some techniques cause large amounts of tip rotation and others none at all. This should be factored in when the Rhinoplasty Surgeon makes his/her selection of what techniques should or should not be used. The tip may settle and undergo some small degree of downward tip rotation within several months of the Rhinoplasty and if you are concerrned, it's best for you to ask your Rhinoplasty Surgeon.

Richard W. Fleming, MD (retired) · Answer

Post-op swelling can give the appearance of an over-rotated or unturned tip after rhinoplasty. This will depend on what was done during your operation and is most commonly seen during the first couple weeks after surgery. Share your question with your surgeon.

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

Answers (6)