A: It is very common for a nose not only to look big after rhinoplasty but even to look bigger than your original nose. This is because of the swelling.
Don't worry if your nose seems larger right after surgery
Swelling is a normal and expected part of rhinoplasty recovery and may last several days or weeks.
The reality is that many rhinoplasty and revision rhinoplasty patients can appear wider at 3 weeks out than they did before surgery. This can be especially noted if grafting was performed as part of your nasal reshaping process. Stay calm and allow the healing process to unfold.
It is not uncommon for patients to feel that their nose looks slightly larger after rhinoplasty. This can be somewhat frightening, particularly for patients whose primary concern was having a large nose to begin with.
Typically, the swelling will peak the second or third day after your surgery. Generally, it will be worse when you first arise in the morning—proof that it's better to remain elevated as much as possible. This is not serious, and is not an indication that something is wrong.
For many people, waking up with a puffy face stems from normal overnight fluid retention — but this may be more noticeable if a person gets too little or too much sleep. Lying down causes fluid to rest and collect in the face, and a person's sleeping position may also exacerbate this.
Four to six weeks after rhinoplasty, we observe occasional dropping of the nasal tip due to several causes [5]. Such causes may include scar contractures, weight of the nose, and the action of the depressor septi nasi muscle [5].
It can take a while for the skin to re-blanket the nose and for us to see the definition, especially if we are narrowing the tip. Because of that, the nose can look bigger. However, If the patient has thin skin and a very bony, structural nose, once we take down that structure, it immediately looks smaller.
One potential cause for bulbous appearance of the nose is the development of scar tissue at the nasal tip. This does not occur right away, but rather may develop over time. Sometimes injection of steroid may be of benefit. You may wish to consider consulting with your original surgeon.
As we age, our nasal skin becomes thinner, and the nose structure weakens and loses support. These changes cause the nasal tip to droop, making the nose look longer. Gravity will have the same effect on the nose as it does on facial skin around the eyes, cheeks, and jowls.
Sometimes, a nose will even look bigger the first few months after surgery than it did before the rhinoplasty. Rhinoplasty takes a long time to heal because it isn't just the skin that was traumatized: The bone and cartilage must heal as well.
“Will my nose tip get smaller after rhinoplasty?” The answer is, of course, yes. There are various reasons why people may want to alter the shape or size of their nose. For some people, it is simply a matter of not liking the shape, and how it affects their appearance overall.
Swelling during rhinoplasty recovery
For example, swelling may affect the appearance of each nostril differently. You can rest assured that your nostrils will return to normal size once your nose is fully healed.
Skin can only contract a certain amount, and it will contract to its own natural shape, not necessarily to the shape that the surgeon made. If the skeleton is too small, the nose becomes shapeless. The treatment is bringing the skeleton up to the skin because the skin can't tighten any further.
While swelling at the tip following a rhinoplasty can take up to a year to go away completely, 90 percent of the swelling is usually gone in about four to eight weeks.
A nose upturned after rhinoplasty is mostly due to swelling and should resolve as the nose continues to heal. Keeping the head elevated and limiting activities should help resolve the issue. If the nose is still upturned after a full year, you may need to revisit your surgeon for an assessment.
THREE MONTHS. After 3 months, around 80-90% of recovery is complete. The skin that was redraped over the nasal bone and cartilage will continue to shrink, fitting snugly over the newly sculpted nasal contours. Most patients can clearly see what their final results will be at this point in time.
Tissue injury, whether accidental or intentional (e.g. surgery), is followed by localized swelling. After surgery, swelling increases progressively, reaching its peak by the third day. It is generally worse when you first arise in the morning and decreases throughout the day.
Dr. Ronald Schuster, a board-certified plastic surgeon and experienced rhinoplasty provider in Baltimore, recommends nasal massage to his rhinoplasty patients because it effectively decreases swelling. It will not cause damage or negatively impact your results if performed properly.
A dropped tip happens because the nose surgeon did not allow for the drop and set the tip to the nose's profile, including the bridge. But highly experienced nasal surgeons know the nose tip will undergo some downward contraction because their incisions tend to contract while healing.
Changes in Blood Flow When You Lie Down
Lying down increases the blood flow to your head. The excess blood flow can cause the blood vessels in your nasal passage to swell. When the blood vessels in your nose become inflamed, your nose feels stuffy.
It is normal to have edema (swelling) of the nose after rhinoplasty. This can last for up to several months. I recommend that you discuss your concerns with your surgeon.
I notice that most patients' swelling peaks at one to two months. At this point, the tip looks a bit rounder than you would like, but still looks 'normal. ' (See image below) It is important to understand this is a normal part of healing.