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.
Inevitably, you will face swelling after rhinoplasty. However, one thing many patients complain about is uneven swelling after rhinoplasty and during the recovery and healing process. Obviously, this can be an unpleasant and concerning situation. But there is nothing to be fearful of, uneven nostril swelling after rhinoplasty can easily be brought under control.
What causes uneven swelling after rhinoplasty can be the uneven inflammation pattern as the body’s natural response to a major trauma like surgery, different surgical techniques, different amounts of work done on different parts of the nose, and climate effects.
In this article, we will focus on the reason for asymmetrical swelling after rhinoplasty and ways to overcome it. So, if you are worried about the same problem, stick around until the end of this article to learn what to do about it.
Uneven swelling can occur after rhinoplasty. Here is why!
It is not uncommon for one side of the nose to be slightly different from the other. In fact, uneven swelling after rhinoplasty is very common, regardless of the type of rhinoplasty. The nose is the central feature of the face. Asymmetrical swelling in this prominent feature following nose surgery is a great concern for patients. The amount of swelling can even vary greatly, and this is depending on several factors. These factors include:
Differences in surgical trauma
Differences in soft tissue and cartilage removal
Differences in the body’s natural healing response
- Differences in the weather
The most common part of the nose to show asymmetrical inflammation is the nostrils. Dissimilar inflammation on the tip and nasal bridge are also quite common. However, you don’t need to worry about uneven nostrils after rhinoplasty as the majority of swelling will subside. Within 3 weeks after the surgery, you can see the initial results but for the final result, you need to wait a bit longer.
Another thing to point to is that swelling continues to grow and reaches its maximum on the third day following the surgery.
- Swelling peak point: on the 3rd day
Differences in surgical trauma
One important factor for rough swelling after a nose job is the techniques and approaches the rhinoplasty surgeon uses. Obviously, the trauma to the body following the surgery differs based on surgical techniques, thus resulting in different inflammation patterns following this surgical procedure.
This is because when a body part is injured or exposed to trauma, different cells in the body migrate to that area to start the reconstruction process. Alongside cells, body fluids also go to this region. This fluid accumulation ends in swelling. The more a nasal structure was altered during the operation, the more severe this fluid retention can be.
Usually, the open rhinoplasty approach is associated with more swelling as it is a more invasive approach. Due to the incisions and the trauma imposed on nasal structures, irregular swelling occurs. Revision surgery is generally associated with more swelling especially asymmetrically, due to the fact that the surgeon tries to fix the initial unbalanced nasal structures and breathing issues caused by the primary rhinoplasty.
Differences in soft tissue and cartilage removal
Another reason for asymmetrical nose swelling after nasal surgery lies in the differences between soft tissues, bone, and cartilage structures. Cartilage removal from the nasal septum can cause more asymmetry after surgery in regard to swelling and inflammation. Nasal bone fracture during the operation results in more inflammation, especially around the cheeks and below the eyes.
Reducing the size of wide nostrils is also associated with uneven inflammation as they are mostly made of cartilage. Asymmetrical nostrils are seen after this intricate procedure. Once the swelling goes away, your nostrils will have perfect symmetry.
Differences in the body’s natural healing response
The second phase of healing starts in 3rd month, the swelling usually goes down in an uneven way. The initial swelling is subsiding two weeks after the surgery. Different parts of the body might heal at an unsteady pace.
For example, in an average person, the tip of the nose might take slightly longer to fully recover, while the nasal dorsum can heal faster. This period might last longer in patients with thicker skin due to their nasal skin texture and the way it attaches again.
This non-matching recovery speed results in unequal bloating of the nose. In the following weeks to months after surgery, this residual swelling will start to fade away and the facial harmony will be restored again.
Differences in the weather
Interestingly, the weather can have quite an impact on the swelling and inflammation after rhinoplasty. Warm weather, and especially exposure to sun and excessively hot weather can elongate swelling. This is because it can cause water retention in different body parts, especially the recovering nasal area. Since the pattern for this water accumulation is not always symmetrical, it can end up in uneven swelling.
On the other hand, cold weather can act as a soothing factor for post-op swelling. It will shorten the inflammation period and result in less uneven nose bloating.
Winter or fall are the times of the year for nose surgery. Spring weather can also work in favor of the recovery process unless you have a seasonal allergy.
- Best season for a nose job: cooler weather
When is uneven swelling most likely to occur?
Swelling and bruising are expected after this major surgery. The initial swelling starts right after the surgery. For example, many patients complain of uneven nostrils after rhinoplasty. As you already know, it is normal to have asymmetrical swelling not only on the nose but in all the surrounding areas such as the cheeks and below the eyes. The swelling pattern is not a linear one. It will get worse before eventually starts to subside. Uneven swelling 6 weeks after rhinoplasty is nothing to worry about.
A frequent question we get is “What if I have uneven swelling 9 months after rhinoplasty surgery?”
The healing process can take up to one year. Notice that the rhinoplasty recovery timeline is not the same for everyone and different bodies respond differently to the same situation. The asymmetrical bloating persists until the healing is completed. So, there’s no need to worry about it. Be at ease. Consulting with your surgeon to understand the situation better and ask for their opinion.
How long will uneven swelling last after rhinoplasty?
The complete healing time takes usually one year. However, there are two swelling stages after nose surgery.
The initial swelling will last for 2 to 3 weeks post rhinoplasty, peaking in 3-7 days.
The second stage or the long-term swelling might last for several months and even up to a year.
This type of inflammation happens due to fluid retention. Although long-term swelling lasts longer than the primary one, the severity is less than the latter. As a result, it is less noticeable. The patient might witness the bloating themselves, especially if it is a case of asymmetric swelling.
To wrap it up, we would like to tell you something that no one might say. There is no absolute symmetry or balance in the human face, with or without cosmetic surgery. The goal of a skilled surgeon who is an expert in rhinoplasty is to reach the optimum symmetry that is in great harmony with other facial features.
How to reduce uneven swelling after rhinoplasty?
In addition to aesthetic concerns, asymmetrical rhinoplasty swelling can have psychological effects as well. Even though rhinoplasty patients should wait at least one year to see the final result, some patients would like to take action as this asymmetry worries them. After all, the goal of rhinoplasty is to enhance their natural beauty, not to cause uneven swelling that can even affect facial symmetry. So how to help reduce uneven swelling after rhinoplasty?
That’s why we are here. To reduce asymmetrical swelling in the nose after rhinoplasty, there are several options that can actually help:
- Follow your surgeon’s post-op instructions:
- Apply a cold compress
- Elevate your head
- Hydration is crucial
- Follow a specific diet
- Arnica can help
- No nose-blowing or crying
- Don’t touch your nose
- Steroid injections
- Schedule your rhinoplasty in winter or fall
If the unequal inflammation persists one year after the operation, the doctor might inject steroids to alleviate it. Steroids have anti-inflammatory effects and will help with subsiding the unwanted uneven swelling after rhinoplasty.
Listen to what your surgeon says for post-op care. An experienced surgeon continues to care for results and your recovery process even after the operation. Continue taping your nose in the way your doctor has taught you for as long as they deem it necessary. Taping prevents extreme edema, especially during the first couple of weeks after surgery. As these nasal dressings are applied to all surfaces of the nose symmetrically, it is a good way to avoid or reduce uneven swelling.
You should avoid:
- Foods that are high in salt or sugar
- Caffeine beverages
- Alcoholic drinks
- Specific supplements and drugs can also affect your circulation and fluid retention
You should always remember that uneven swelling after nose surgery is normal and common. It takes time for the inflammation to subside, so be patient.
This has been our article about uneven swelling after rhinoplasty. Now you know why it happens, when and how it subsides, and what to do if the bloating continues. We hope this article has answered every question you had. If you still have more questions, do not hesitate to ask us. We will be beyond happy to relieve you of your concerns. We are here to help improve your nose shape.
References:
(1) Arias JI, Aller MA, Arias J. Surgical inflammation: a pathophysiological rainbow. J Transl Med. 2009 Mar 23;7:19. doi: 10.1186/1479-5876-7-19. PMID: 19309494; PMCID: PMC2667492.
(2) Kohl BA, Deutschman CS. The inflammatory response to surgery and trauma. Curr Opin Crit Care. 2006 Aug;12(4):325-32. doi: 10.1097/01.ccx.0000235210.85073.fc. PMID: 16810043.
