4 Weeks Post Open Rhinoplasty - Still Hint of Former Dorsal Hump? (photo)

   At 4 weeks, a subtle remnant of a hump is likely swelling.  The after photos demonstrate a much improved profile.   Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

4 weeks is still soon after your surgery, and there is swelling present that will affect the appearance of your nose. Swelling can lead to:

1) Asymmetry
2) Irregularities
3) Bulbous nasal appearance

It is too soon to judge the final result, and the bump may be due to swelling. Your body would not try and reform the bone. And if you lightly bumped your nose on a door, it will not likely affect the outcome of your surgery. I would recommend waiting a bit and see how you heal before judging the final outcome. It can take up to a year to see the final result. In the meantime, please consult your surgeon with any questions. I hope this helps, and I wish you the best of luck.

Hello. At thirteen days you are nowhere close to your final results and for a full year after your procedure your cosmetic appearance will continue to improve. Just try to be patient. Much of this is do to swelling.


Jaime Perez, MD
Rhinoplasty Specialist
Plastic Surgery Center of Tampa

An easy way to determine whether it is residual swelling or something else is to press on it gently with your finger.  If the bump disappears, then it is likely just residual edema.  Your surgeon may suggest maneuvers to help speed the resolution of the swelling.  Taping, digital massage, and injections of steroid or 5-FU are commonly employed to modulate wound healing.  

As an overall response to you photos I would say you are healing well with the usual swelling. Specifically, it is common to have some residual swelling at the mid-dorsal region as this area is where the cartilage part and bone part of the nose meet. When your surgeon finished your operation this area probably felt perfectly smooth. Both your dorsum and tip will change over the next 6 mos so patience is in order and try not to hit your nose as this can cause damage not immediately seen.

It is amazing that patients either do not obtain an informed consent prior to surgery or do not fully understand it. At 4 weeks still VERY early in healing phase to be unsure of if there still is a hump or not. What did your surgeon tell you?? WAIT! I bet, for 4 to 6 months than be re examined. But comparing the before and after you have a great result at this early stage! 

Usually the skin over the bridge is thinnest and the swelling resolved by four weeks in this area. There is a hint of a bump on your photo. If you can still massage the area flat, then it is likely to resolve after further healing. If not, it just may be there to stay.

The skin is thinnest over the hump area and swelling will resolve the quickest in this area after rhinoplasty. Despite the edema resolving quickly in this area, it still does take a few months for all of the swelling to go away (compared with up to a year for the tip of the nose). I agree that there is a subtle hump still present and this should be noticed by your surgeon. Early manipulation should be up to the discretion of your surgeon and may depend on whether the bones were broken during the rhinoplasty. I would check in with your surgeon if you concerns about this residual hump.