Dr. Serhan Derin, born in 1982, is a seasoned ENT specialist who graduated from Ankara University School of Medicine. He completed his residency at Kocaeli University in 2010. Dr. Derin is a highly skilled surgeon specializing in functional and cosmetic nose surgeries, including Primary Rhinoplasty, Revision Rhinoplasty, Ethnic Rhinoplasty, Septoplasty, Septorhinoplasty, Nasal Valve Surgery, and Sinus Surgery.
After a rhinoplasty operation, you might want to have a perfect nose shape immediately, but that is not the case, we have rhinoplasty swelling stages. The timeline healing rhinoplasty swelling stages may vary and it involves bruising and bleeding too.
Swelling is the most common side effect of nose job surgery. It can disguise the actual shape of the nose for a certain time. During your rhinoplasty recovery timeline; there will be a peak point, a dissolving process, and lastly, all of the swellings will be reduced as you care about your nose.
You might be curious about the reasons behind these rhinoplasty swelling stages. Here we will talk about all of them in detail, learn how to tell if your swelling is normal, and up to what extent your nose can get swollen. Most importantly the biggest question of all, is how long does swelling last after rhinoplasty?
First, let’s check the timing.
When does swelling typically occur after rhinoplasty?
During the surgery, surgeons make lots of incisions and manipulate the cartilage and skin in your nose. Due to these maneuvers, edema or in other words, fluid retention starts to occur on your nose resulting in swelling during your rhinoplasty recovery process. So, when does swelling occur after rhinoplasty?
The answer is hidden in the question. Swelling occurs right after your surgery and lasts for a year. Of course, your nose does not look the same as the first weeks compared to a month later on. Usually, the stages of rhinoplasty swelling can be divided into 5:
You will see an improvement day by day during the rhinoplasty swelling stages, in which the tissues on your nose heal and settle. The only exception here is the first week after your surgery.
Right after the surgery
As we said before, rhinoplasty surgery involves lots of incisions making the nose swollen immediately. One can feel the swelling right after the surgery and it gets bigger until a point. During this time, since the nasal dressings and tapings will be on the nose, it will not be possible to see, but the patient can feel it. Besides, not just nasal but facial swelling is also expected.
Your surgeon might have prescribed you anti-inflammatory medications, given you a nasal drip pad for bleeding, and also a nasal spray to keep your nasal passages moisturized. Sometimes ice packs are also used to comfort you and reduce the swelling.
To alleviate blood pressure in the nose, you might be sitting and sleeping in a partially reclined position utilizing gravity during the first day. This can be followed in the next few days as well to reduce fluid retention. During this time you might have bruising and a little discomfort as well.
The first week is going to be a challenging task
During this first 1-week swelling will reach its peak point, and then slowly start to decrease. The maximum swelling occurs around the fourth day after surgery. It is possible that you may experience significant swelling in the morning. The reason for this is gravity evenly distributes blood flow throughout the body. Besides, sleeping on one side may cause uneven swelling on that side.
These are all temporary body reactions to the surgery and possibly after 5th day, the swelling starts to shrink. Your doctor might prescribe you some medications, tell you to get plenty of rest and avoid spicy foods and sun exposure.
At the end of the first week, your nasal cast and dressings should be removed and now you can see the improvement better. A slight increase after the cast and tape removal is also possible. There might be still some stuffiness in your nose but patients generally see a visible change a week later. For the first week, it is best to avoid normal activities and use this time for rest.
You need to be patient for about 2-4 more weeks
Patience is what you need and you will be generously rewarded thanks to that. In 2-4 weeks after rhinoplasty, your nose should have healed mostly. At this time your surgeon might allow you to do moderate exercise, though you should wait a little bit more before the weight-bearing exercises.
Most people get back to their daily life routines within 2 or 4 weeks without thinking about others’ opinions. You can still feel and see some swelling over your nose, but it will be harder for anyone else to say that your nose looks swollen. You better not blow your nose up to now.
It’s been months and you are almost there!
The surgery recovery process should be almost done after a few months. Your nose skin drapes better over your nose structure and all the visible swelling should have been gone. Strenuous activities and blowing your nose should not be a problem anymore. People usually see almost full improvement two months after surgery.
It can only last a little bit longer if you have thick skin. Besides, there are some other factors as well affecting your surgery recovery timeline like surgical techniques, the type of surgery, and biological differences. When all these are considered, around 6 months you should almost be set and ready.
The upper part of your nose should have healed nicely. However, the tip of the nose takes some more time to heal. Once again this is because of the thick skin, but this time it’s regional. Your nose skin is thinner on the bridge and thicker on the tip. This can affect the post rhinoplasty swelling stages.
You’ve made it! The last stage of swelling
Finally, after around a year there should be no swelling left in and around your nose. The nose should have been completely healed and the residual swelling of the tip should have been gone. You can tell the difference and see a dramatic reduction by checking your first and current photos of your nose.
In some cases not common but this residual swelling might still be there. It is once again related to the factors affecting the swelling like oily skin or getting a revision surgery. Especially, revision swelling stages might take longer the more surgery you had.
What should I expect to see in each stage?
You might wonder how your nose is going to look during the healing process. The nose tip swelling after rhinoplasty is common and usually, it lasts longer for the tip to heal. So you do not have to worry about the way your additional swelling on the nose, just be patient.
Nostrils and nasal bridge swelling after rhinoplasty do not last that long compared to the tip. These minor swellings can dissolve within a few weeks and should be completely gone in months.
Factors that affect swelling
The swelling occurs after rhinoplasty as a result of invasive surgical techniques. As the surgical procedure gets more invasive the chances of excessive swelling increase. Apart from that, the amount of swelling is also affected by your genetics and biological differences. Let’s take a look at all the factors one by one to see how they affect your nose swelling.
- Starting incisions: These are open and closed rhinoplasty approaches. Both will cut through your nose to get inside, and open one is a little bit more invasive (1).
- Osteotome: Your nasal bones are reshaped with osteotome techniques. Especially wide nose bridges are narrowed and these might cause swelling and bruising around your cheeks.
- Trimming: Generally, when there is a dorsal hump, surgeons reduce it down just like nail trimming. It can be a little traumatic for the nose causing swelling and bruising that heals nicely.
- Type of surgery: Ethnic, reconstructive, and revision rhinoplasty procedures are major surgeries that address more complex situations.
- Skin thickness: Thick-skinned patients experience prolonged swelling, while if you are thin-skinned excessive swelling might occur but for a shorter period according to research (2).
- Overall health: If you have diabetes or chronic disorders these can also prolong your swelling healing process.
- Biology: Every person's body is unique, depending on your unique body build, generally because of your genes, you might have a slower or lower recovery period on the swelling.
- Persistence: Another and generally the only thing you can change is, whether you follow every post-operative care instruction carefully or not.
How can I know if my swelling is normal?
Nose swelling after surgery is expected and normal up to a certain extent.
Your nose might look a little bit bigger on the tip and bridge. This swelling might restrict your breathing for 2-3 weeks after your rhinoplasty surgery, however, if it lasts longer than that you better contact your surgeon.
Another condition that you might experience is longer-term swelling stages. It has been weeks since you followed every instruction your doctor gave, and even though it does not bother you a lot, you might still have visible swelling. Rightfully you are wondering why hasn’t your rhinoplasty swelling gone down yet.
As we explained before, you might have been through an invasive surgery that includes lots of vigorous techniques with lots of changes. Or you might have thick skin which takes a longer time to heal. Lots of other factors are added up to this process, but if you have doubts just ask your plastic surgeon and ask for advice about the recovery.
References:
(1): Gupta R, John J, Ranganathan N, Stepanian R, Gupta M, Hart J, Nossoni F, Shaheen K, Folbe A, Chaiyasate K. Outcomes of Closed versus Open Rhinoplasty: A Systematic Review. Arch Plast Surg. 2022 Sep 23;49(5):569-579. doi: 10.1055/s-0042-1756315. PMID: 36159386; PMCID: PMC9507448.
(2): Erdur ZB, Öktem F, Inci E, Yener HM, Üstündağ A. Effect of Nasal Soft-Tissue Envelope Thickness on Postoperative Healing Process Following Rhinoplasty. J Craniofac Surg. 2021;32(6):2193-2197. doi:10.1097/SCS.0000000000007697
