Swelling from revision rhinoplasty is something that each person who undergoes surgery experiences. Unfortunately, there is no quick fix for the swelling that follows revision rhinoplasty surgery, however, your pain and swelling should lessen as each day passes. Despite postoperative swelling, my patients are generally able to see nice results as early as when the splint is taken off-the first-week post-op. I am known to say: “If it doesn’t look pretty good immediately, then it probably never will.”
It generally takes the body about 100 days to complete the essential repair work involved in healing so that it can absorb the majority of the swelling patients experience after revision rhinoplasty. When a wound is created (either through surgery or trauma) the tissues involved must complete three phases of healing. Although it is impossible to project the exact number of days that you will experience swelling, the timeline below will explain each phase of the recovery process and how you should be feeling following your surgery.
As the age-old saying goes, “Rome was not built in a day.” All things take time to create, and often great things can take a very long time. A great nose can be built in a day. However, before the masterpiece can be truly unveiled it will take weeks or even months for all of the revision rhinoplasty swelling to go down.
Revision Rhinoplasty Swelling – The Inflammatory Phase: 1 to 7 Days Following Surgery
The inflammatory phase of healing begins as soon as the wound is created or surgery is done. This phase can last an additional one to six days. During this phase, it is common for the wound to display warmth/heat, appear red or flushed and have swelling and pain in the areas surrounding the surgical site. While some redness and swelling are expected, it is important to note that an excess of swelling and pain may indicate an infection or other complications.
Although quite uncommon after any rhinoplasty, you should be on the lookout for a pus-like discharge, escalating pain, fever and excessive swelling, which are potentially indicative of infection. If you experience any of these conditions, it is important that you contact your revision rhinoplasty surgeon in Bergen County right away.
Revision Rhinoplasty Swelling – The Proliferative Phase: 1 to 6 Weeks Following Surgery
Generally, within one week post-surgery in northern NJ, the wound will continue to heal and the inflammatory phase will transition into the proliferative phase which typically lasts between three to four weeks. During this phase, your body is producing collagen (scar tissue) around the wound and within your nose. You may notice a visible thickening of the incisions and nasal tissues. Some wounds may also have a minor amount of yellowish drainage. The wound will likely remain painful and some tautness, pulling or tenderness will often still be present in the wound. Those minor symptoms should be stable or steadily improve each day.
As nerve function begins to return to the operated area, some patients may experience unusual sensations in the tissue that was operated on. Although it can be somewhat uncomfortable, this is generally viewed as a positive sign that nerve sensation is returning to the operated area. With time, these sensations will subside.
Revision Rhinoplasty Swelling – The Remodeling Phase: 6 Months to 1 Year Following Surgery
The remodeling phase is the final stage of the body’s healing process. This stage can vary widely depending on the extent of the revision rhinoplasty and whether or not structural grafting was necessary, and will last from six months to one year. During the remodeling phase excess collagen (or scar tissue) will start breaking down, and it is during this stage that a bold raised red scar will change into a small flat white scar and firm woody tissue will give way to a soft, pliable and sensate nose.
According to the timeline above, most patients will experience the greatest amount of swelling during the first week. Generally, by the end of week two to three, the majority of the bruising and swelling will have gone down to where a casual observer won’t be able to notice it. However, one must also consider that the patient’s nose will continue to look swollen/puffy to the patient for 3 to 4 months. It usually takes up to a full year for the residual revision rhinoplasty swelling to resolve and the final results to completely appear.
Tips to Help Minimize Revision Rhinoplasty Swelling
The following tips can help to minimize swelling and accelerate your healing process:
1. Do not smoke.
2. Drink plenty of water. Dehydration may actually cause you to retain water, so it is important to remain hydrated.
3. Avoid alcohol for the first 48 hours following your surgery.
4. Follow your physician’s instructions regarding bandages and dressings.
5. Rest is critical for the first 48 hours following surgery and you should have someone stay with you for the first 24 hours.
6. Avoid all strenuous exercise and extremely physical activities for 1-2 weeks following your operation.
7. Sleep upright at a 30-degree angle or on several pillows for the first two to three weeks.
8. Use frozen peas as ice packs for the first few days following surgery. You should also avoid excessive heat in the area of your surgery.
9. Your surgeon will often recommend and perform cortisone injections into affected areas.
Expect Gradual Improvement
The amount of swelling you experience after your revision rhinoplasty surgery and how long it persists can also be dependent on numerous factors unrelated to how quickly your body heals. Some of these factors can be the skill and technique employed by the revision rhinoplasty surgeon, the open versus closed approach, whether or not the nasal bones were broken, the number of prior nasal surgeries and the usage of structural grafts. These factors can introduce variability into the healing process but nonetheless not preclude a revision rhinoplasty.
Often times we are unaware of the healing process our bodies go through when they are damaged. Generally, as soon as we stop feeling pain, most people we begin to believe that the process is complete. However, as you can see from the timeline above the process isn’t complete when the pain subsides. It is not uncommon for a revision rhinoplasty patient to become concerned about not seeing the final results quickly enough. It is impossible to know your body’s exact healing schedule, which is why your physician can only give you a ballpark range for when your revision rhinoplasty swelling will fully subside. If you ever have any questions or concerns during your healing process don’t hesitate to speak with your Bergen County surgeon to discuss what you are experiencing.
Always remember that although it does take patience and resilience to deal with revision rhinoplasty healing, it is an investment that when handled properly will pay dividends for a lifetime.