When we perform a rhinoplasty we lift the skin off of the infrastructure, which is the cartilage in the bone. After we change that infrastructure, we re-drape the skin. The new contour emerges as the nose heals, but right after surgery the skin thickens and swells, particularly if the patient already has thick skin and big pores.
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.
How long does it take for your nose to look normal after rhinoplasty?
Not all rhinoplasties are the same. Some are first time rhinoplasties while some patients are on their first or second revisions. Some people have thick skin while others have thinner skin. Some patients are just looking for a tip revision while others have a bump on the bridge, a long nose, or wide nose. All of these factors contribute to the complexity of the surgery and the time to recover.
If a patient is having a revision rhinoplasty, the skin will thicken more post-surgery than it did after their primary rhinoplasty. That being said, it typically takes longer to see final results after a revision rhinoplasty. A patient with thick skin is coming in for tip definition, they won’t see results right away, whereas a person with a long bony nose will see changes rather quickly, even though the final result is not apparent yet.
When should I consider revision rhinoplasty?
Since it takes 12 to 18 months to see the final results from a rhinoplasty, and since the nose changes even more after that, you shouldn’t consider a revision rhinoplasty before a year to a year and a half. When I see a nose where too much cartilage has been removed in a prior surgery, I realize that this nose can continue changing for several years.
Because the nose continues to change, a second surgery can be avoided if the patient waits to see if they like their final result. On the flip side, some patients might be initially happy with their nose job, but over time they become dissatisfied. The nose might look okay for a year or two after surgery, but as it contracts over the years, it can become pinched or overly upturned. That’s typically when I see patients, but sometimes people become impatient and if their nose is not perfect when the bandages come off, they are unhappy.
I just removed the split off of a patient’s nose, and as soon as they looked in the mirror they said, “I’m already considering a revision”. What? This patient had large pores and that larger pore formation is going to prevent the skin from shrinking and re-draping right away over the new nose structure. I made sure the patient knew this before surgery, but many times my words are forgotten during the excitement of a patient seeing their new nose for the first time, but it’s important to remember that the nose will continue to get smaller over time.
The most common question that you will see on the Internet from those who have had a rhinoplasty is, “It’s three weeks after surgery and my nose looks too big. Will it get smaller?” Yes, it will get smaller. Will it be exactly what they want? I can never say that for sure, but I do know that it’s going to get smaller. It’s going to wound-contract and the swelling is going to go away.
If you have an issue from a prior rhinoplasty and you’re not particularly confident in what’s going on, I’ll be glad to talk to you. You can call or email me any time. I help patients that have had prior nasal surgery all the time. Give me a call.
Email Dr. Sykes at firstname.lastname@example.org
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About Dr. Jonathan Sykes
Dr. Jonathan Sykes is a world-famous expert plastic surgeon who performs all cosmetic and functional plastic surgery procedures on the face and neck. He is a past president of The American Academy of Facial Plastic and Reconstructive Surgery, and served on their Board of Directors for over 10 years. He is also a Professor Emeritus in Facial Plastic Surgery from UC Davis Medical Center, and the former Director of Facial Plastic Surgery at that institution.
He is known as the expert’s expert, and is often called to consult and advise other plastic surgeons in both Northern California and Beverly Hills. He has a special interest in eyelid and browlift surgery, facial rejuvenation surgery including facelifts, and rhinoplasty. He also has a particular interest in facial feminization surgery. Have questions? Email Dr.Sykes at: email@example.com