Face swelling after rhinoplasty: Navigating facial edema after nose job

Face swelling after rhinoplasty is a topic that every rhinoplasty patient should know about. The swelling after rhinoplasty or ‘postoperative edema‘ is an aftereffect that manifests itself as fluid retention underneath the skin around the nasal area. The first thing you should know is that face swelling after a nose job is pretty common and it can be managed. The eyes, cheeks, nasal bridge, and tip are the most commonly swollen facial parts.

Understanding what it is and how to treat it is crucial for a successful healing process. Facial swelling after rhinoplasty has different representations. And in return, there are many different ways to deal with them. In this article, we are going to explore the many faces of swelling, its causes, how much time it takes to treat it, and how to get rid of it. 

Now as a curious reader, it is your time to take a glimpse into this fairly common phenomenon.

The many faces of swelling: Common areas affected after rhinoplasty

A swollen face is a typical scene for people who had rhinoplasty. It is the natural result of any rhinoplasty procedure. Then, why does the face swell after rhinoplasty? Swelling is the skin’s inflammatory reaction to the surgical manipulations done by the surgeon.

There are different types of facial swelling after rhinoplasty. Different parts of the face can get swollen depending on their closeness to the surgical site, which is the nose in this case.

  • Cheeks
  • Eyes
  • Tip of the nose
  • Upper lip
  • Nasal Bridge
  • Between the eyebrows

Now let’s take a look at them in detail. 

Swollen cheeks after rhinoplasty: causes and management

One of the affected areas after rhinoplasty are cheeks. Because of their nearness to the nasal area,  surgical consequences can branch out to the cheeks as well. Excess fluid retention under the skin and surgical trauma are the main causes of swollen cheeks after rhinoplasty.

But how long are the cheeks and face swollen after rhinoplasty?

Recovery from postoperative swelling usually takes about two months. However, it is not enough for a complete dissolution. Depending on the patient’s aftercare routine, it may take a year to heal fully.

Now that we’ve talked about the duration of swollen cheeks, let’s see how to get rid of swelling in the cheeks after rhinoplasty. The first 48 hours after the surgery is of great importance. During this time, patients should:

  • Apply cold compress
  • Avoid poking, or touching your nose
  • Sleep with additional pillows
  • Avoid bending over to reduce blood circulation
  • Stay away from severe exercises
  • Eat soft foods that are easy to chew and digest
  • Follow a proper rhinoplasty diet that is rich in protein and vitamins
  • Stay away from salty foods

Eye swelling after rhinoplasty: when to seek medical attention

Another facial area that gets swollen after rhinoplasty surgery is the eye. Blood vessels around the eye are affected by the surgery which ends up as swelling. Rhinoplasty eye swelling reveals itself in two types, which are periorbital swelling and eyelid swelling. Periorbital swelling is the type of swelling where the swelling occurs under the eye. On the other hand, eyelid swelling obviously appears on the eyelid.

Eyelid swelling has 4 stages that describe the severity of the swelling.

  1. In the first stage, the swelling is minimal.
  2. In the second stage, the eyelid slightly touches the iris.
  3. The third stage means that the swelling covers the majority of the iris.
  4. In the fourth stage, the eye is swollen shut completely.

How to reduce swelling around the eyes after rhinoplasty is the same as other types of swellings. Applying cold compresses and resting are the most effective way to get rid of the eye swelling. Swollen eyes after rhinoplasty should substantially disperse after 3-4 months. If the effects of swelling do not go away after the sixth month, you should definitely see your doctor.

Swelling in other facial areas: what to expect

Rhinoplasty swelling can occur in other facial areas depending on the proximity of the nasal area and the type of surgery. Apart from swollen cheeks and swollen eyesnose tip swelling, nasal bridge swelling, swelling on one side the of nose, swelling amidst the eyebrows, and upper lip swelling can also occur after rhinoplasty.

Because of its thick texture, the nose tip is more prone to swelling than other nasal areas. Usually, it takes more time for the nose tip swelling to heal completely.

The upper lip swollen after rhinoplasty is also completely normal. It generally happens when the surgery calls for a considerable amount of dissection. In an ideal recovery period, upper lip swelling should heal within 3 days.

It is nasal bridge swelling. Or in other words, nasal hump swelling is the result of surgical strikes on the bony structure which is totally normal. In order to get rid of it, a massage is applied after the first month. But it will take 3 months to dissolve completely.

Swelling of one side of the nose is a common phenomenon among rhinoplasty patients. It may be challenging for a deviated nose to set upon its new shape. In these kinds of situations, uneven swelling of the nose can get distinctively swollen.

Swelling between the eyebrows is a ramification of the swelling of the eye and the cheeks. It takes up to 2 weeks to disappear.

Understanding why your face swells after rhinoplasty

Let’s take a look at the science behind facial swelling during rhinoplasty and understand why do eyes swell after rhinoplasty. In a rhinoplasty procedure – especially in open rhinoplasty- surgeons make use of numerous incisions. Being exposed to these incisions, the nose can get traumatized and reveal complications such as swelling.

Swelling comes in two types, fast-healing or “acute” swelling, and slow-healing or “chronic” swelling. Fast-healing swelling generally disappears within the first month. The one that yields the most discomfort is the slow-healing swelling. Chronic swelling is the result of fluid retention under the skin around the nasal area. It may take up to 6 to 12 months to resolve completely depending on the skin type and the amount of care the patient gives. The extent of the surgery and the skillfulness of the surgeon are also determinant factors.

The duration of the swelling and the recovery from swelling may take almost a year.

◼ The first 3 days of your recovery time are when the face swelling after rhinoplasty reaches its peak. During this time period, it is of great importance that the patients use ice packs as often as possible. Sleeping with your head elevated is another effective way of reducing the swelling as well.

After the first week, all the nasal dressing like sutures and splints will be removed by the surgeon. The degree of swelling should have started to get better by now. This is also the time you get to see the first implications of your new nose. 

In the second week, you can feel free to get back to your job and get involved in social activities. You can see that the swelling gradually dissipates and your face starts to look better and better. At this point, the number of post-operative checkups is also minimized.

When the first month arrives, the post-operative swelling continues to diminish. You may also return to your workout routine according to your doctor’s instructions. The shape of your new nose looks more refined.

During the third to the sixth month, the post-op swelling disappears almost completely. Your doctor may arrange an in-office checkup to see the improvement.

Finally, when it’s the first year, the face swelling after rhinoplasty and the bruising are permanently gone. Now you are clear to enjoy your life fully and happily!

References:

Aldosari B. Is Nasal Skin Thickness a Prognostic Indicator to Postoperative Edema and Ecchymosis? Ear Nose Throat J. 2021 May;100(4):NP206-NP209. doi: 10.1177/0145561319868452. Epub 2019 Sep 29. PMID: 31566001.(Link)

Levin M, Ziai H, Roskies M. Modalities of Post-Rhinoplasty Edema and Ecchymosis Measurement: A Systematic Review. Plast Surg (Oakv). 2022 May;30(2):164-174. doi: 10.1177/22925503211003836. Epub 2021 Apr 22. PMID: 35572083; PMCID: PMC9096852.(Link)

Tasman AJ. Reducing Periorbital Edema and Ecchymosis after Rhinoplasty: Literature Review and Personal Approach. Facial Plast Surg. 2018 Feb;34(1):14-21. doi: 10.1055/s-0037-1617444. Epub 2018 Feb 6. PMID: 29409099.(Link)

 

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