Hi I read your article on nose surgery post operative recommendatios/expectations which was insightful. I have recently had some revision to my tip about 2 months ago and prior to this closed rhino r/t a fx’d tip cartliage 4 years ago. I still fill like my tip is very bobuluos but it is also very firm so I think alot of it is edema my Dr has me massinging the tip a couple of times a day, but do you have any recomendations to speed this process ie Anarca or any thing in your years of exp. that speeds this process of recovery

Hi, I had an open rhinoplasty with the correction of a deviated septum 1 month ago. Do you recommend any manipulations of my nose that I should do to imprive the4 final result and aid with decrease of swelling? My dr gave me some instructions but he has since left the country, I would like to know what you recommend too.
thank you!

I had rhinoplasty surgery 6 weeks ago. My nosed was reshaped slightly smaller bringing the bridge down and thinned slightly to give it a more feminine look. My doctor is one of the best in the area. I want to trust him, but I thought by this point in my recovery, I’d start to be happy with what I’m seeing. Instead, my nose does not appear symmetrical from the front. The two side look different. The left side is swollen and a little bulbous looking at the tip with a slight indentation where the bridge and tip meet on the side. While the right side does not appear very swollen and there is no indentation, flows beautifully from tip to bridge. I’ve looked at dozens of pictures and even my doctor’s portfolio of 1 month post rhinoplastys. They appear swollen yes, but symmetrical, unlike mine. I’m so disappointed after 15 years of wanting this, the pain, and now I’m embarrassed. I’m even a little depressed. My doctor says that it’s just swelling. That my surgery went perfectly and that it will heal well in the next few months. I don’t understand how an indentation will suddenly fill itself in. How will it ever look all the same as he’s saying it will? Help?

Hi, I had rhinoplasty about 3 weeks ago. I just wanted to ask if its common to still feel as if I have a stuffy nose at this point. Its driving me crazy!!!

Hi, i just got an open rhinoplasty about two weeks ago, and i had reduction to the witdth of the nose in the bridge, the bump straitend out from a profile shot and the tip lifted and defined, although most of it looks like its going smothly i feel like the width in the bridge is stil very thick and the left side is alot more swollen and hard with bumps it almost looks crooked, im quite worried and i was wondering if this was normal or if i should be worried?

I had osteotomy done almost 3 weeks ago. I had to wear glasses 2 weeks after the procedure for about 2 hours. Im nervous now that this caused the bones to fracture inwards more. Is this a likely possibility? and if so, is there something i can do to help the bones stay put?

Hi,
I had a rhinoplasty about an week ago, and yesterday i accidently hit myself in nose, very gently, cause it didn’t hurt but i just felt it a little bit… and i still have a metal overlay… is there a chance to have some consequences?? thanks a lot…

Hello, I had a closed rhinoplasty done about 7 months ago. I feel like there is still signficant swelling, and there is still tenderness around the bridge between my bridge and my eyes (painful to touch on both sides) and I still have “nose days”, some days swollen, other days better. In addition when i squint for example, i still feel pressure under my eyes and at tip of nose. My nose still seems like it is changing. I had a very englarged bridge and it was drastically reduced, so I assume this might be why. Generally, is there anything I can do to help myself with more consistent/faster healing? In addition, the left side of my nose seems to be more swollen still, and in certain lighting is significantly more puffy at the tip. Any tips doc?

Hi,
I would like to know what “manipulations” are and how to do them post op. I had a septo-rhinoplasty 3 weeks ago and have been looking online for post op instructions. Should I be squeezing the bones together? Should I be close-pin squeezing the cartiledge? Please help!!

hello, my friend had rhinoplasty 5 months ago. she keeps telling me that there’s a problem with it and she wants it to be revised. i told her to be patient and wait atleast a year to make a revision because that’s what most doctors advise. Her rhinoplasy consisted of a silicone implant that was placed on the bridge of her nose to add some height and definition at the tip and there was no reshaping done to her nasal bones. but the problem is, the tip of the silicone implant between her eyes does NOT seem to be firmly attached to her nose causing a slightly obvious bump. She said she can slightly “wiggle” that end of the implant and she feels a small space underneath the implant at that tip. She knows this beacuse when she presses on that tip, the bump goes away. I told her that i think it was the ice pack she put after surgery that caused the implant to not firmly attach itself during post surgery on the bridge of the nose. She put ice over and between her eyes (this is where the unatached tip is) to minimize swelling. Please help, if you have any comments on this matter. Thanks.

Hello Doctor,

I had a closed rhinoplasty approximately 7.5 months ago. I still sense a great deal of swelling and have pain between my eyes and my bridge (which was removed), as well as tenderness inside and on the nose. The nose also looks flat and swollen at times, whereas before it was long and pointy. Is this type of swelling still normal? They say swelling may last over a year, but does the nose really continue to change over a years time at the same rate?

Dr.
I have had 2 previous rhinoplasy and greatly dissatisfied with the work….During my healing time i had IPL done on my face could this have affected my nose results. Can you recommened a revision doctor in or near Toronto Ontario
Thankyou so much nicole

Hi.. I had a rhinoplasty 7 months ago. I’m concerned because from a profile view the nose is curved downward; this is even more pronounced when I smile. I’m really holding out hope that this is just swelling. In addition, my surgeon informed me that when the tip cartilage heals, the tip will eventually heal to have that nice ‘attractive upward turn’ which I’m just not seeing yet. I’ve looked at lots of healing photos online, and I’m not seeing anything that looks quite like my healing progress… I’m really worried that I have a “dropped tip” and will need a revision.. should I be concerned, or is this the normal healing progress?

I do have to say that I see a slight improvement over the last month or so. I hope it continues.

Thanks

Hello.
I just recently had closed rhinoplasty (1 week today). I am healing fine and feeling well. Neverthless, my main concern is that one nostril is slighlty bigger then the other nostril. I know that swelling plays a major part in the recovery months but could this be a symmetrical problem? Any advise is helpful! This website is great.
Thanks

Hi,

I had closed rhinoplasty surgery 1 week and two days ago. I got the splint and the packing removed two days ago and my doctor basically said it was okay for me to exercise, blow my nose… just about all normal activity. He did not tell me that I had stitches inside my nose, so I was pulling out what I thought were fibers left over from my packing, which I realized were probably stitches. My nose is bleeding now and it seems to be wider than it was when the cast first came off. I’m afraid that I ruined everything. What do you think? Could I have messed up the tissue? Is there anything I can do to decrease swelling?

Thank you!

Hi i had rhinoplasty 6 1/2 years ago. It was an open rhinoplasty. My friends son hit me on the bridge of nose 6 months ago. I have a red mark on my bridge still. Will this go away, or should i be concerned about this?

Hi.
I had rhinoplasty about 6 weeks ago.Im devistated with the results as ive ended up with a “ski slope” nose.Its very turned up and has a bulbous tip.I went to see my surgeon about this and he said he wasnt happy with it either and it wasnt the nose he intended on giving me a not what i asked for.I understand that its still swollen but is it possible for a surgeon to make such a big mistake and is it common?
Could you also advise me how long im going to have to wait for a rivision?I cant bare to stay looking like this for another minute!
Thank you

Dear Elizabeth,
I wanted to let you know that I recently had a rhinoplasty and am very uncomfortable with it. It takes a lot of patience to get through such a tough time.
Just wanted you to know you are not alone.
Frankie

Hello dr palmer,
I’ve had a septo-rhinoplasty two months ago and the last 15 days i’ve noticed a supra-tip deformity, just like as described in bibliography as a parrot’s beak deformity. i’m concerned about this fact a lot lately so i’m wondering if, in fact is a complication of the surgical procedure or it’s just supratip swelling of concentration of soft scar tissue and if this tissue is prone to augmentation or will it subside by the time (and for how many months should i wait till the final result?) is there a hope that my nose tip finally will be elevated? thanks a lot..

with respects, anthony g.

I had the surgery about a month ago. after the 1st week and the cast came off the docotor advised me to “mold” the nose. I had a broken nose from boxing and my nose was crooked to the side. dr advised me to take my fingers and press the sides in 2-3 times a day ( and the more i do it, sure the better he said). I didnt really do it at all until i met him the 2nd week and advised me to do it again, then i was crazy about it. one side of my nose seems very fine and the other rigid. in the mirror it looks ‘ok’, and straight, but in pics i take at home it doesnt look symetrical on both sides of my face. as if my cheek bones on my right side go right down into my face and the left seem raised. right side seems to have too much of a reduction. im worried my “molding” and pressure i put on my nose ruined it.

i had my nose done nearly 3 weeks ago, and im really worried. the last week i have noticed that one side of the bridge of my nose looks flat, like its dinted. Ive spoken to the company that did it, and they said dont worry, and just booked my apointment for the end of this month. but i feel really emmbarased. does this sound like normal healing proces??

I had open rhinoplasty 1 week ago. The doctor tried to make my nostrils the same size, so there are stiches in between my nostrils. I can’t smile/grin/eat easily with them. How long until these scars heal? A few more days, weeks or months? This was my first rhinoplasty and I am 22 years old. The scars have shown minimal progress since the surgery and are very visible. Thank you.

another quick question….i box and go mixed martial arts, reason i broke my nose in the first place and had the surgery. well its been 6 weeks, my nose looks better…my question is how long do u recommend until i can start wrestling again and boxing, without worrying about damaging my nose? thanks

Hi there, I just had open rhinoplasty done less than 2 weeks ago. My cast and stitches have been taken out and my PS put tape on my nose and told me I could take them off in 5 days. It has only been 3 days, and the tape has peeled off…is this something I should be concerned about?

Hi, I had an open rhinoplasty 7 weeks ago. My nose has a bump in the bridge. My doctor says that it will go away after a month more or so. My question is: Is it possible for the bone to be still swollen after 7 weeks. And if so will the bump in the bridge go down? Thamk you.

Hi Dr. Palmer,
Is it possible for each nostril to heal in a different time frame after rhinoplasty? I mean, can one nostril look normal while the other is more swollen after 3 week? Why would the same nose act differently on each side? shouldn’t the swelling go down on the nostril at the same time?

I can tell everyone this…….I’m on my second rhinoplasty..And healing can take along time………My first one took almost 2 years to heal…Right now I’m in my third month on my second one.And it still taking it’s sweet old time……I just pray and hope for the best!

Hi Dr. Palmer,
I had gore tex put into through my right nostril to elevate my bridge about a month ago. For the past few days my right nostril has been stuffed with mucus and constantly running. There is sometimes very little dark colored blood mixed in with the mucus. I’ve had no other problems up until this point. Would this be considered normal?

Dr. Palmer,

Thank you for providing insightful information on your web site. If you would be so kind to offer me your expertise I would sincerely appreciate it.

I had my first-ever rhinoplasty done exactly one year ago. I eliminated a hump, a hook on the tip, as well as (supposedly) trimming down excess cartilage on both sides of the tip of the nose. The hump is gone, as well as the hook, however, the nose around the tip and tip, look the same, and still appears puffy and big–not sleep. One side of the nose is puffier than the other. In close pictures with flash, you can easily see the oddly shape front a front shot. One of the cuts of the nostrils, is actually more high-cut than the other, where there is also a scar visible from just looking from the outside. I have been so patient and non-obsessive at all, because I understand rhinoplasties take a long time to heal. My physicial told me the right said was still swollen (because it is evident that it is bigger);however, it has been an entire year.

Is it possible for this area (the cartilage around the tip of the nose, and the round tip bc my nose has no point now) take this long to heal? Should I expect that this really is the final result of my surgery and perhaps my surgeon is not being realistic with me leaving me with the idea that it will still get smaller? Or is possible that it take longer than a year to settle?

How soon is it recommended to get a revision rhinoplasty after the first one?

Thank you so much for your help. I really appreciate it.

Hi There

I am currently 2 years post primary rhinoplasty. I will be having a closed revision rhinoplasty to remove excess scar-tissue in the supratip area.

I have been told that as the procedure is closed, the swelling this time around will not be as bad as my primary, which was open. Is this usually the case?

In addition, the surgeon says he will use Cortizone injections to prevent a re-occurence of scar-tissue buildup. I know some surgeons are against the use of such injections – why so?

Thanks for your time.

Dear Dr. Palmer,

I had closed rhinoplasty 9 weeks ago and I still have dark circles under my eyes. While most of the bruising has faded, what remains is not fading and is noticeable. Is this permanant or common?

Thank you,
S

Hello Dr.Palmer,

I am 4 weeks post op and was wondering if there is anything that can be done for the tip to keep it up instead of coming down? why do surgeons in the first week leave that little tape that holds the tip up and then remove it? if putting the same kind of tape to hold it up after 2 weeks will that make the tip less likely to descend? what exactly is done in the nose for the tip to stay elevated and after the surgery if I held the tip up with hand for a period of 30min will that cause a bad result? Thank you

Hello Dr.Palmer

Thanks very much for taking the time out to get back to me and thank you for highlighting these issues.

If the swelling is likely to be worse, I’m not sure I will want to go through that again – it has taken 2 years for the swelling to dissipate and I really wouldn’t want to have to deal with it to that extent, or even worse, once more.

Just a couple of questions on scar-tissue: naturally scar-tissue shrinks as it matures. Can I expect it to shrink any further over the next few years? In addition, would the use of kenalog at this stage be inadvisable?

Thanks again for the information. It has made me think long and hard about this revision and I’ll certainly have more questions to ask my surgeon when I see him next – unfortunately I had been led to believe that a revision would be plain sailing when clearly this is not the case.

Kind Regards

Thank you for taking time to explain my long-term bruising. This is the only place I have been able to get an accurate diagnosis. I am very appreciative.

Hello Doc,
It has been almost 2 weeks since my rhinoplasty procedure and I had just taken off the bandage that was on my nose and now my nose looks like as if theres a strange plastic blanket covering it, i just wanted to know if it is normal for it to look like this. It almost looks as if it’s all melted. =/ Please let me know what a nose is supposed to look like 2-3 weeks after the surgery

Thanks =]

Dear Dr. Palmer,

I just underwent an open rhinoplasty from a well known San Francisco plastic surgeon, so I feel like I should be in good hands. However, my first glance at my new nose was a bit disturbing. I understand that swelling is always an issue, but my concern involves the columella. I had an open rhinoplasty involving a slight revision of a drooping tip, and in my case the columella now actually appears higher than the bottom outside edge of my nostrils. When I look at a “normal” nose, if there is such a thing, from a side view the columella is lower than the lower edge of the nostrils. When my stiches are removed, can I expect the columella to descend somewhat? Needless to say, I am a bit apprehensive at this point. I feel like the orientation of my tip is backwards, giving it a piggy appearance…

Any insight you can give would be appreciated.

Sincerely yours,

Debbie

Hi Doctor Palmer,
I am a 33 year old female who has had several rhinoplasties over the last 14 years to try to correct problems (e.g., sleep apnea, severe sinus problems) resulting from an accident that seriously damaged my nose when I was a child. The second rhinoplasty had to be done to correct problems from the first rhinoplasty (cleaning out a lot of scar tissue and moving the septum back into place. It has slid over to the right and was blocking my right nostril). However, after the second rhinoplasty, I had to wear tape for a month because the septum was trying to lean back over to the right. We were able to get it straightened with the tape, but a third rhinoplasty had to be done last month (seven months after the original procedure) because the doctor had not put any cartilage on the top of my nose, which resulted in a major saddle deformity and caused me to start having some minor breathing problems again, as my airways were a little constricted. This time, the doctor put cartilage grafts on top of my nose. However, when we took the splint off, the graft had slid over to the right side of the nose and seemed to have +�G��+�bunched up+�G��-� toward the top of the nose. We are using tape again to try to correct it, but my doctor is already talking about having to operate again.
I have several questions resulting from this rather traumatic experience. The first is +�G��G�� what is causing my septum and its cartilage to do this? Is it something the doctor is not doing right, or is there something structurally wrong with my nose? The second is +�G��G�� how long should I wait to get this fixed? Should the doctor go back in ASAP, or should I wait for a year or so before we work on this again?

Thanks for any help you can provide!

Leigh Steele.

Hi Dr. Palmer,
I forgot to mention in my previous, lenghthy post, that the cartilage used was ear cartilage. Sorry!!

Thanks,
Leigh Steele

Thanks for replying so quickly, and thank you for the good advice. My first two rhinoplasties were open, actually, but this latest one was closed. I have decided to wait 6 – 12 months before I try to do this again, and I will mention your suggestion about using something sturdier on my bridge like a silicone dorsal implant.

Thanks again,
Leigh

Hi, Dr. Palmer, I’m concerned about the healing pocesss of the bolbus. I’m 2 weeks in from from my rhinoplasty, and the bolbus appeares to be enlarged. I know it’s swollen and takes time to heal, however what should I expect within the year as far as healing on the bolbus of the nose.

Thanyou, Mike Jacobe

It’s been 10 months since my surgery. It was closed, my doctor took a hump off and slimmed the bulb of my nose. Everything looked great until 6 months now where my hump was is an indentation and at the middle of my nose is a bump. Should I wait a few more months? I would love my nose if it weren’t for the new bump in the middle of my nose. It still feels fuzzy to the touch. My doc said since I have allergies it may take longer for the swelling to go down is this true? I’m getting worried the closer I get to a year and the bump still has not gone down. Thank you.

Dr. Palmer,

It has been 4 weeks since my open nose surgery. On the 7th day I began to bleed a lot from my right nostril. I believe it was due to me bending over to put my son in a car seat.
In my 4th week of recovery, I noticed that the bony part of my bridge (close to under my right eye)is still very swollen. It feels very hard to the touch, like it is bone. I am scared that the bones are healing incorrectly and wanted to know if it is possible for the bone to be swollen? As I mentioned it does not feel like tissue.

Adrienne

Hi Dr Palmer,

I had an Open Rhinoplasty about 3 months ago but there is still a whole lot of swelling which makes my nose look big still. Is there anything I can do to help reduce the swelling under the eyes as well as the tip of the nose. My wedding’s in a month and Im really concerned, I was expecting the swelling to be minimal by then but it still a lot. Kindly suggest something..Thank you.

Dear Dr. Palmer,

I have consulted a plastic surgeon in London who did a simulation of what I could expect from a rhinoplasty. I was very excited. However, afterwards I felt strangely seduced, simply because it looked to perfect to be true (having seen several imperfect results from rhinoplasty).

So my question is the odd one: To what extend does a program like that actually mirror the result that you can realistically expect – if you indeed presuppose that you are in the hands of a surgeon who places himself among the top 5 percent in your infamous bell-curve of statistical fact?

Thanks in advance,
Joseph

hi Dr. Palmer

I have read your “beuaty principles” on you website and was surpriced to learn that the cheekbones play such an important role in defining the beauty of the rest of face. Also I wouldve have contributed the nose a more significant part in this matter.

now, my question concerns a different issue: You write that gravity “pulls the tissues of the face similarly for all individuals”. Now, I wonder if sleeping with your face in the pillow also does this to your face: that is, does it make any sense (as the saying goes) to sleep on your back to avoid pulling your facial tissues while sleeping?

Cheers,
Marc

Hello Mr. Palmer,

I think my other comment was not saved, so Ill try again:

I underwent cosmetic nasal surgery in Sweden 3 days ago. I am, of course, very bruised and feel significant pain at this stage.

I have noticed that one side of my face is more swollen than the other, and especially the one eye, which is completely closed and very red and swollen. Although I feel certain that is perfectly normal, I wonder why this is so: Why does one side of the face, especially around the eyes, get more traumatized from rhinoplasty than the other?

Anna

Hi again,

thanks for answering my question just above regarding swelling. I was thinking that maybe the difference in swelling from right to left could be caused my the way the surgery is performed. But I understand this is not the case then. Thanks again,

Best,
Anna

Thanks for your reply.

If sleeping with my head against the pillow will accelerate an aging face, as opposed to sleeping on my back, then I guess I will have to kiss my once belowed beauty-sleep byebye.

Regarding your beauty-principels: I’m not sure I have fully understod your view that surgery should aim at creating a nose that is ‘neutral’ rather than a nose that is beautiful in itself. Could you perhaps clarify this?

I guess that you believe that other facial features play a more prominent role in defining the overal facial beauty than the nose? I find it rather impossible to define what kind of nose is neutral, beautiful or even strong or cute regardles of the rest of the face.

In my eyes, Angelina Jolie has a beautiful (or cute) nose, but it would fit would not look so cute on brad pitts handsome face. Would it perhaps be meaningful (though it’s not a very new principle) to say that a nose “should be in harmony with the rest of the face”, since the relation to the rest of the face is what defines the perception (and conception) of the nose – and vice versa?

Cheers,
Marc

Dear Dr Palmer,

I had a septo-rhinoplasty done 14 days ago. My surgeon said i had a saddle nose so he used a bone graft and it was a closed procedure. However, my nose is achy and my left nostril looks alot bigger than my right nostril. I am still swollen 14 days on. Will my nostril reduce in size in the forthcoming weeks? Also, the staff nurses havent educated me much on what i should do following the removal of my cast, when is it fine to sleep flat and touch my nose? Thankyou so much for your time.

Dear Dr. Palmer,

I underwent an open rhinoplasty two years ago come this August (The surgery was done in August of 2005). I had previously had a very small nose with almost no bridge, and the surgery basically built a bridge (with silicone) and elongated my nose. The doctor used ear cartilage for the tip.

I did this surgery in Seoul, South Korea with a very well reputable doctor.

The nose is fine and looks natural– no uneven spots or any droops or bumps. The tip, however, is unnaturally hard. I’m not sure if it should be this unyielding after so long. I heard that rib cartilage would have been better (making the tip softer), but the healing process would have been too long. Was doing the tip with ear cartilage a bad idea? Is that hardness still understandable after two years? Will it ever be softer? Is there a way to make it feel more natural to the touch?

Any insight you can give would be greatly appreciated.

Sincerely,
Elizabeth

Hello Dr. F. Palmer,

My sister had a rhinoplasty 3 weeks ago. She is very, very unhappy with it since it looks ‘turned-up’, and I agree. Sadly enough, she explicitly told the doctor that she wanted to avoid a turned-up nose. The doctor has said that the nose needs time to settle and that the tip will also come down a bit. Can this be true? One thing is the swelling, for weeks and months, but does it make sense that the tip may move downward as it heals?

/Sean

Hello Dr.,

I was wondering why you contribute less importance to the nose, when analyzing facial beauty, than to the cheeks and the eyebrows.

As a cartoonist at WB I can certainly verify that the nose is a type-changing feature. And more so than the eyebrows and the cheeks.

So perhaps, rather than dissecting beauty into percentages related to different parts of the face, it should be kept in mind that visual perception is a ‘gestalt’; a whole.

Seen as such, the nose contributes 100% to the beauty of a face, and so does the cheeks and the eyebrows.

Best Regards,
Kevin

Hi Dr. FRANCIS PAMLER
I had revised nose surgery as well as had my upper lip shortened. there is an incision along the top of my lip (base of nose) that after 4 wks of surgery feels like cement. it is difficult to even smile. is this normal?

thanks
shauna

Dear Dr. Francis Palmer

Reading your answer above to Kevin, I must admit that I tend to agree with him. A nose does make a difference. I do I know? I’ve seen thousands of them! If pretty simple: If a nose can be defined as ugly on a certain, then it can be pretty too.

Another expert

Dear Dr. Palmer,

I just had rhinoplasty here in LA, and Im really unhappy with it! I did my research and found a qualified plastic surgeon. He said he’s done more than a thousand noses, but when I had my cast removed today, it’s not straigt any longer! Also its way bigger than we agreed, but I know I have to patient – I just can’t imagine that it will shrink 20%. Im really just so unhappy, I look like an Alien with a potato. At least before my nose was huge in an ethnic way, had charisma

I called my doctor (he didnt even remove it himself, is that not a bad service?), but he said that the nose may well straighten up by itself, especially because I had an infection in my left eye for which he precribed Ciprofloaxacin Hexal, 500mg twice daily.

I don’t know why am writing you, you can’t really help. Ive been reading your tips and advices, so I knew about the site. I guess I just dont have confidence in my own doctor, he doesnt seem to care too much. I have an appointment with him in 6 months. I just hope that my nose will change 75% the weeks to follow, refinement is not what Im looking for here.

Please tell me something comforting,

Truly,
Melissa

Dear Dr. Palmer: I had revision rhinoplasty 3 months ago with Dr. Gunter in Dallas Texas. I flew 5,000 miles, because I was told he was one of the best in the world – and the “father” of the rib-grafting procedure. I paid nearly $25,000. I was very specific with what I asked for – when I came out of the surgery he said “it may be a little wider than we discussed” – He is a “perfectionist” and his bedside manner isn’t the greatest… (he definitely makes you feel like he has the last word on what is best for you) and I feel intimidated to tell him that this is not what I wanted. Any suggestions on how to approach that when I see him for my first post-op visit next month?

Dear Dr. Palmer, I had a revision rhinoplasty done 12 weeks ago. The left side of my nose had collapsed from a botched nose job 12 years earlier) and I couldn’t breath, the doctor used a ribgraft on my left nostril to open up my nose. I love the way it looks – much more even and he refined the tip as well…the “only” issue I have is that you can actually see and feel the hump/bump on the left. Others point it out. If that wasn’t there.. it would be perfect. It makes the bridge look unnatural and much wider and uneven. When I called he said that was because that was where they inserted the graft. My question is.. Will that go away? Can it? Does that “go down” along with the rest of the “swelling” you talk about? what are your thoughts? I’m a little vervous about it and trying to be patient…

Hey hey,

I love the beauty theme

+�G��-�+�G��-� differences of opinion+�G��-�. Well, I’ve been searching for a rhino-specialist for about 3 years now, and I still haven’t found one. Why? Because when I look at before/after photos, at least 2-3 photos out of a bunch make me think “what Godly principle of beauty what that surgeon thinking of?!”. So I have arrived at the obvious conclusion, namely that the fault is mine +�G��G�� or rather: Beauty is in the eyes of the beholder My own principle is that beauty is ‘broken’. I may envy a very big nose, I may love a very small nose (but probably not a neutral one). As far as I know, most principles of beauty change with time, Barbie+�G��G��s nose is not even the ideal any longer. Besides, how should you define a ‘neutral nose’ in the first place? What does it look like? What seems neutral in once face may appear vulgar in another. In the end, you will definitely want to go for a ‘beautiful’ nose, or at least one that fits your face beautifully. The question that remains is how to define this, how to communicate it and how choose a surgeon who shares your opinion!

Best wishes for all rhinos,
Mat

Dear Dr. Palmer,

Thank you for your words. I wrote my surgeon again and he asked me to come to his clinic. He requested that I do not eat for 12 hours before arrival, in case he needs to sedate me and straighten up the nose. ? I have no idea what he has in mind, is it possible that he may try to straighten it with his bare hands? Should I refuse this if this is his plan?

Truly,
Melissa

Hey hey,

I love the beauty theme

+�G��-�+�G��-� differences of opinion+�G��-�. I’ve been searching for a rhino-specialist for about 3 years now, and I still haven’t found one, bcause when I look at before/after photos, at least 2-3 photos out of a bunch make me think “what Godly principle of beauty what that surgeon thinking of?”. So I have arrived at the obvious conclusion, that the fault is mine +�G��G�� or rather: Beauty is in the eyes of the beholder My own principle may be that beauty is ‘broken’. Im into big noses, small noses, but probably not a neutral ones. As far as I know, most principles of beauty change with the course of time, Barbie+�G��G��s nose is not quite the ideal any longer. Besides, how should you define a ‘neutral nose’ in the first place? What does it look like? What seems neutral in once face may appear vulgar in another. In the end, you will definitely want to go for a ‘beautiful’ nose, or at least one that fits your face beautifully. The question that remains is how to define this, how to communicate it and how to choose a surgeon who shares your opinion!

Maybe you can clarify your principle or maybe we actually agree?

Best wishes for all rhinos,
Mat

ps, thanks for comforting my girlfriend, I share her frustration, and Im afraid is has made my own fear of surgery even greater :/

Mat

Thank you for your response Dr. Palmer… One last Quick question… is that something that can be “shaved down” after the “year of waiting”?? It would look strange (and I think you would agree if you saw it) if it were to “remain” like this?

Dear Dr. Palmer

I went to to see my doctor and he confirmed that I had a severe infection in my left eye which may have been causing my nose to turn a bit to the right in the healing proces. He removed as much of the bacteria as he could and said that the the remaing bump on the top of my nose were actually an infection and not a ‘left over’ from my original hump. I am to continue antibiotics and see him again in two weeks, then he may have to straighten out my nose with a small surgery. He said that would only take 10 minutes. I hope I wont have to wear a cast again.

Is this something you ever experience in your own practice?

Truly,
M

Dear Dr. Palmer,

Thank you for offering this service. Your comments are very much appreciated.

I had an open rhinoplasty 3 1/2 weeks ago. When the cast came off, the bridge of my nose much wider than my original nose. My doctor had to break my nose to removal a dorsal hump. My first question is, will the wide bridge become more slender and could this be due to swelling?

Additionally, my nose was straight as a board when the cast came off, over the past 3 weeks the hump came back and there is a lump on each side of the ridge of my nose as well. I’ve been instructed to put pressure on the lumps and firmly massage them, which temporarily helps, but does not competely eliminate the humps. This leads me to my second questions, if my nose was straight when the cast came off, will it return to the straight position with constant massaging? The bridge of my nose is so swollen, wide and has distinctive bumps in the middle and on both sides of the bridge, where he had to cut the bone. I also have a long bridge and thin skin, so this is a hard thing to live with for the time being. I look like I was on the loosing end of a fist fight. Any comments and words of wisdom will very much be appreciated.

Thank you,

Michelle

Dear Dr. Palmer – Thank you for creating a website such as this.. I think we are all in the same boat and just need some reasurrance.. this service that you provide is more helpful than you will ever know. If/when I need to have my “third” revision.. I am coming to you for sure!!
Although I live in the land of plastic surgery/surgeons – I went to the “best of the best” out of state 3 and a half months ago. I was very comfortable with my original surgeon.. but went for a “second opinion” just in case – he was very straight forward and told me that “If I was his wife” he would make me cancel my surgery with the original surgeon as he was not qualified to do the in-depth surgery needed for my particular case.. I took heed – and went to where I was advised. Clearly my surgeon is one of the best in the world.. no doubt.. And I can now breathe much better..(although I went in for purely cosmetic reasons) All I wanted was for it to be “straighter” at the end (which it now is).. but it is also MUCH wider.. and not as feminine.. I am desperately trying not to look at it every 5 minutes and be reasonable.. but I was attractive before.. and feel very unnattractive now and unhappy… I have my first visit with him in a month.. If he agrees that it’s not looking so great.. (although I am sure he will tell me I have to wait a year to see the “end result”)should I trust him to do it yet a third time? From your website alone I feel like you are more qualified and compassionate…I know you are professional and would never deter someone from another physician.. but don’t I need to trust the hands I’m in? Is it even realistic or possible that the nose will slim down that much in the next few months??? I have a friend who is a surgeon and he said you can go back and operate now if you want to – it’s more ifficult but “possible.” What are your thoughts? Would you ever consider doing that prior to the suggested “One year waiting period?”

Dear Dr. palmer Do you agree with the following? Isn’t it true that you can in fact re-operate 6 months after if it really isn’t the shape you wanted?

It’s important to wait one entire year after a
> rhinoplasty before making another attempt.
>
>
> The scar tissue that forms underneath the skin of
> the nose after a primary (first-time) rhinoplasty is
> hard at first, as is any scar. If you have a scar
> from an operation, such as an appendectomy, the scar
> starts out being quite firm; it feels like a cord
> underneath the skin. With time, the scar softens,
> so that eventually you can’t find your appendectomy
> scar by feeling for it — you have to look for the
> scar, because it feels just like the surrounding
> skin.
>
>
> The scar tissue in the nose starts out hard, and
> after a few months it starts to soften. You can’t
> feel much of the firmness, except perhaps at the tip
> of the nose, which might feel more solid than
> natural, but the firm scar tissue is there,
> underneath all of the nasal skin, until the scar has
> had time to soften. It takes about a year for the
> scar tissue to soften completely.
>
>
> If a surgeon attempts a revision rhinoplasty before
> that scar tissue has had a chance to soften
> completely, he is operating with one hand tied
> behind his back, because he is guaranteeing himself
> a difficult time trying to fight through the firm
> scar. Even after it has softened, the scar tissue
> makes a revision operation difficult, but before it
> has softened, it’s just impossible.
>
>
> Also, as the swelling in the nose decreases after a
> primary operation, the nose gradually looks
> different, hopefully better, and it’s important to
> wait until the swelling has resolved and the nose
> stops changing in appearance before attempting a
> revision operation. Scar tissue under the skin of
> the nose can also shrink as it softens, further
> helping with the appearance of the nose. If you
> operate too early, the surgeon may be operating to
> correct problems that would at least partially
> correct themselves as the rest of the swelling
> resolves. He doesn’t really know how much to do if
> he operates too early.
>
>
> Re-operating on a nose too early can be likened to
> building a house on a soil foundation that is still
> settling: you want everything to stop moving before
> you decide exactly what changes to make and attempt
> those changes.
>
>
> Finally, we have said that a revision rhinoplasty is
> much more difficult than a primary rhinoplasty. A
> third-time operation is even harder yet. You want
> to give yourself every possible advantage before
> having a secondary operation, to absolutely minimize
> the chances that you’ll need or want a third
> operation.

Dr. Palmer… if I am 4 months post -op of a revision rhinoplasty and have not been doing “manipulations” is it prudent or even worth it to start doing them now? Should I ask my surgeon about this?

Dear Dr. Palmer… How many “revisions” can one person have before the nose actually collapses? I heard that Micheal Jackson had 7 or eight… is it safe to have 3?

Dr. Palmer, I e-mailed my surgeon (also considered one of the BEST in the world…) re: the benefits of post manipulations on revision rhinoplasty.. and this was what was written in response.. ” I think he Dr. XXX is afraid that patients will get too overzealous and do more
damage than good. He has new grafts in place and manipulating your nose may dislodge or break them. Believe me, if he felt like you would benefit from doing it he would recommend it.

Dr Palmer, can you please tell me if septal cartilage on the dorsal area always dissolves, or loses its shape? and if so, how long after the surgery is this likely to happen?

Dr Palmer, i had septorhinoplasty just over four weeks ago, my nose still aches, im alittle concerned about how much activity i can do. I am still sleeping vertically amongst over things like not looking down. My plastic Surgeon has been vague regarding this. Could you please tell me how long it takes for the bones to set and can they still move out of place after 4 weeks. Thankyou.

Hello I have just had a rhino/septoplasty conducted 10days ago. I had my previously broken nose rebroken and a bony bridge smoothed over. Is it normal for my bridge to look broader and boxier than prior to surgery?? (as previously I had quite a narrow bridge and I am hoping this will go back to a similar size). Should I expect this to take a month or 2 to be apparent? Also you seem quite adament that post operative manipulation is important for aesthetic results. My Dr hasn’t given me any as yet. When do you normally advise they are started?? And are these mainly for tip manipulations or bridges as well?

Thankyou for your time, I have found reading your blog very informative and comforting in this horrible stage where I am quite impatient and concerned…… Even all the way from Australia!!

Thankyou Dr Palmer for your quick response, it has certainly eased my mind and given me renewed patience during this ‘recovery period’.

My surgeon has not requested to see me for 3mths but I think given some of your advice I will book in for a 1mth post-op follow-up to discuss ‘post-op manipulation’ with him.

As the results of my rhinoplasty are only going to be very subtle I want to ensure maximum aesthetic result, but I don’t want to disrespect my surgeons professional expertise, as I do believe he is an experienced plastic surgeon…
But, if he does not suggest anything would it be suitable to refer him to what you have said on your site and possibly have him contact you? Or me contact you?

Thanking you

Dear Dr Palmer,

I had a closed rhino 17 days ago. This was done to reduce the overall size and make my nose a little slimmer. I am pretty happy with the overall result and my PS, but have quite a bit of swelling on the bridge of my nose between my eyes. It doesn’t dip but almost feels straight even a little raised. The sides of my bride closest to my eyes feel lumpy (tiny lumps) what is this? Even my forehead hurts when I’m rummbing in my moisturiser. Will this settle and come down, how long before it does? Thank you for answering. Would have asked my PS but he is off on a skiing holdiay for two weeks!

Hi Lucie,

Have been keeping an eye on the blog after my rhinoplasty surgery also 17days ago today!! Just to provide some ‘me too’ empathy, I have also noticed some little lumps in the same areas and tenderness when I’m applying moisturiser etc, sounds like a fairly normal process…. so we’ll both have to continue the mantra “be patient, the swelling will take time!!!” Good luck

Dear Dr. Palmer – it has been exactly 4 onths since my revision rhinoplasty (with reib graft) I feel like the swelling seems to go up and down (one day less- one day more) is this normal at this stage?
Also – you can still visible see the graft – which was inserted to open up my breathing (which is fabulous now..) but I want to ask is that will also “disappear” while the swelling goes down? I know that i was told it could take a year to see the results (I am trying to be a patient patient) and I’m told the “waiting game” is the hardest part.. Would you please anser my two queries?

Thank you

Dear Dr Palmer,

I had a closed rhinoplasty in Delhi, India four weeks ago. The surgeon was competent but as I am far away from him I am suffering from anxiety in regards to tip swelling which is rather large and the upturned tip.

I live in the UK and just feel anxious about the healing process. Any comments would really be appreciated. Many thanks.

Hello again Dr Palmer,

My post op journey continues… a) I am finding that the appearance of my nose can change slightly each day, especially in the morning when it seems to have ‘swelled up’ again. Is this normal for the swelling to go a bit ‘up and down’? Or should it be a progressive move forward? b) Also it is 3weeks after my op and I was advised I can fly for work trips, should I expect a little swelling after a short air flight? And c) The area above the tip of my nose, I think you refer to as the supratip, is not showing any real signs of reduced size since my op? Is this area paerticularly stubborn, or should I be concerned thatit hasnt really gone down? Thanks again for your advice.

Hi Dr. Palmer,

I just had a rhinoplasty done 5 days ago in Seoul, Korea from a very reputable PS. I did my research (and liked his aesthetic judgement) but I am getting very concerned.
I have almost no brusing or swelling but my nose looks very, very unnatural. I know that he put in a silicone implant and lessened the width of my nose using stiches (invisible…) but I cannot move my nose at all and cannot make any expressions with it, making it look extremely awkward.

Also, the nostrils are not “round” as it should be –it simply doesn’t look right. I am Asian and my nose looks too small to be proportional. I know as the “swelling” comes down that the size of the nose gets smaller…This would not be ideal because my nose is smaller than it should be.

I have no idea what to do–Any words of advice would be appreciated….. (esp. the manipulation techniques–I am having language problems here because I am not 100% fluent in Korean. They simply told me to hold my nose together when I sneeze or yawn so the nostrils would be the same size….)

Thank you so much–hope to hear from you soon

Hello Dr. Palmer,

Thank you so much for your assurances and posting a reply so quickly. This comment does not need to be posted up on this website, but I do have a question.

I am departing Korea on Monday to head back to Atlanta and today will be the last time I will go to the PS Clinic. I am getting extremely anxious because I will be 8000 miles away if there is a problem or if my nose does not improve.

I am becoming mostly extremely anxious at the thought of going back to school next Tuesday because the transformation on my face is too dramatic….

Is it possible to send over a picture to you for a very quick assessment of whether something went wrong with my surgery? The clinic is not offering any help and I have no idea whether I look like this because something went wrong or whether this is expected.

How much is the nose expected to change in the course of the healing process? The width of my nose is very small and therefore unproportional to my face….I would be so incredibly grateful for your help–

Sincerely,

Jen

Hello Dr. Palmer!

I had my nose done a little over a week ago and am very happy with the outcome. Its still swollen but I think I am going to be very happy with it. My question though is that my nose and upper lip still feel numb. I know this is normal but its affecting my smile. so much that my smile is completely different. My upper lip doesnt even lift above my upper teeth like it used to. Is this normal? Once the numbness goes away will this go back to normal? I love my new nose but I hate my new smile!! Help!

Thanks!

Hi Dr Palmer,
I tried to post my question but do not see it so here I go again, I wrote before regarding the swollen right side of my nose under my eye it is a pretty big bump. After my surgery on the 7th day I started to bleed a lot from the right nostril and felt a lot of pressure in the area that is still swollen. My Dr. had already said that all is well and that I just need to give it time, but it really is worrying me. Could the bleeding have caused my nose to heal abnormally, it has been 2months since surgery, and the rest on my nose (except that side) looks fine..

Hi,

I’m post rhinoplasty 5 weeks ago to correct a broken nose which was had a very slight deviation and slight hump due to the broken nose. Although I have fine features, I had what was considered a large nose for my frame and naturally had an upturned boxy tip.

The surgeon has done a fantastic job in my request to shorten my nose, eleviate the bump, and keep my box like upturn tip but make everything pretty much smaller, and overall, I have had a pretty good effect which has kept an upturned tip and drawn more towards my eyes than my nose. My main concern is that over the past week, (I’m now in the 5 week phase) my nose seems to have settled a bit more and given it the effect that it seems longer from the side and profile and not as cute in an upturned way which is starting to concern me as i feel my old nose is started to grow back!

I notice you mention manipulation, I have been taping my nose nightly and from the front it looks perfectly straight, is there anything I can do to manipulate my nose to keep my tip upturned? Please advise your suggestion?

Many thanks Nicky

ahoy there! Doc,

I got open Rhinoplasty with a dorsal cartilage graft (human rib allograft) a month ago.

After the third week all the swelling was gone and I began to notice my nose was a ski slope before and unfortunately still looks that way.

Looking at it now, I like the top half but not the bottom half. Only 2 weeks back when it was taped it was flat and straight like I wanted!

The only difference is now instead of the ‘ski slope’ being caused by a depressed upper half it is being cause by a bulbous bottom half. I WANT THE TIP FLATTER!

I consulted my surgeon about it this morning again (who is btw a world renowned member of the AAFPRS) and he continues to say that I must wait a year!

Is there anything I can do about it right now ?

hi dr,

6 yrs after my first rhino, i had formed so much scar tissue. So i went to a different dr and had a revisional rhino to remove it. He then gave me a series of kenalog 10 injections to help prevent the scarring again. I’m now 4 yrs post op from this second rhino and still get occasional kenalog 10 injections (about every 6 mos). I feel at about the 6 mos mark there is a little scar tissue that seems to get remedied by the injection STILL. Have you ever heard of this? I was hoping the scarring would have stopped by now. Will I have to get these injections for ever?? Will they continue to be effective??

Hi Nicky here again,

Thanks for your advice regarding the surture option later on to keep my tip upturned. I’ll definitely have a chat to my surgeon regarding this if it turns out how I don’t anticipate.

I’ve got another question in relation to taping as I am still taping my nose on a nightly basis coming up to 6 weeks after surgery. I tend to tape 4 strips along the top but now taping underneath to hopefully position the tip higher (you’re probably laughing your head off now!) ;ODD.

But seriously, what are your thoughts on (a) the actual benefits of taping the nose after surgery and (b) the length of time people should do this.. (c) does it make any difference as to where you should tape?… cheers Nicky

Dear Dr Palmer
Thankyou for your wonderful website, since my Nose Job 3 weeks ago, I cannot eat or sleep, because I am devastated by the outcome. I came to my PS stating that I would like a more defined tip and a slight narrowing of the nostrils. My nose to start off with is not huge but just lacks definition, and my base was wider than my eyes which was why I wanted the narrowing. The day of surgery my PS tells me he would widen my bridge and elevate it by 2mm because that was the only way to get a tip because he said my bridge was not high enough (which it is because I have never had an issue with my bridge especially since I know I am very self critical of my features and I would be the first one to find fault) at which point I told him I wanted only what we had dicussed. He told me I would look great and not to worry.
Needless to say I was horrifed after. Through closed rhino, he used a gortex implant to build a bridge that I was happy with beforehand and define my tip, which only made my tip look more bolbous and look bigger. My profile is so unnatural, with it starting from as high as between my eyes,it just juts out and there is no sloping, it just goes straight down.
When I went in for my post op, I was told that RASPING could be done to file dowm my bridge and refine the tip. I am aware that RASPING is done to humps but can it be done when it is as high as where my eyebrows begin??? That how far up my implant goes. Is rasping effective for the tip also? Also because the implant is placed so high it has pulled my skin higher , making my eyes appear smaller, will rasping help this? Thankyou for taking the time to read this……I wish I lived in your city….or that you would move to Toronto…
Much Love and Respect Annisa

Dear Dr. Palmer,

I had nose surgery performed two weeks ago for the removal of a dorsal hump that developed as the result of a break years ago.

Unfortunately, there’s still an albeit smaller hump on my nose. My Dr. explained this away as “tenting” but it seems to be more than just skin. Is this a common occurance, and do you think it will reduce in size with time?

Thanks!

-C

Dear Dr Palmer,
Thank you for your kind words of hope and speedy reply to my dilemma. I am grateful that I stumbled across this website because after reading everyone’s questions and your answers, I find you to be truely knowledgable and quite caring to take the time out to do this especially since you are such a high profile plastic surgeon in the cosmetic surgery world. I will go to my PS. and ask for the removal of the gortex, but will there be any detrimental effects, would I look exactly the same as before?
And what do you suggest I can do if I did look the same? Can I still have the narrowing of the nostrils and defintion of the tip that I was trying to achieve?
Would I be able to do this at the the same time as the removal? After 10 years of waiting (now 29) I feel kinda cheated that this is happening….
With continuing admiration,
Sincerely, Annisa

Hi Dr. Palmer, I had a rhinoplasty done about 5 months ago to reduce the size of the nose. The shape of the nose looks good but i still have a lot of swelling. Is there anything I can do to reduce it, Im getting married next month and I don’t want to have a swallon nose in my wedding pictures =( please suggest something, I have been sleeping with my head elevated but that didn’t help much, still a lot of swelling around the nose right under the eyes and some at the tip of the nose. Please suggest something, Thank you!

My surgeon hasn’t really suggested anything, and he just expects me to wait. Im devastated, i don’t want to be a bride with a swallon nose =( is there anything i can do at home, any kind of treatment, therapy nething, that would help a bit. Kindly help, it means a lot.

Hi,

I had open Rhinoplasty done a week and a half ago. I did not have my nose broken just the tip worked on. I had a bullish tip and it faced down. Last night in my sleep I hit my nose. It did throb a little but only lasted a short time. Should I be worried? I didn’t have any bleeding and from day one I had no brusing only swelling. (which I still have) I keep hearing nothing can be done for one year anyway so do you think I need to contact my doctor?

Thank you,

Susan

Dear Dr, I have until june 24th..do u think putting icy packs or ice would help reduce the swelling? I got my surgery done beginning of Febuary, it has been about 5 months now. Kindly suggest the name of some treatment or therapy that I could ask my surgeon about. May be if I show some awareness, He’ll consider helping out. Thank you once again.

Thank you for taking the time to respond. I did call today and he said it should be fine.

Take care and thanks again,

Susan

Hi,
I had rhinoplasty surgery (narrowing of tip/nostrils and bridge), and a correction of a deviated septum, one week ago. I just got the cast taken off today, and was told to firmly pinch the bridge of the nose daily, so that the bone falls into place. I was told to do this once a day, for a few weeks..is this okay? And are there other things I should do to make sure my nasal bone takes shape correctly? Thanks!

Hello Dr Palmer,

My closed rhinoplasty was 7weeks ago. Most of the swelling around my bridge seems to have gone but there is still quite alot of swelling along the rest of the nose. At times it feels like my nose is throbbing (not intense, just a nagging feeling of pressure) and it is very stiff towards the bottom of my nose. If this is normal, how often should these feelings last and is it part of healing process?

hi, i had rhinoplasty a little over 2 months ago and it went great. It healed quickly and my surgeon said it’s one of the best he’s seen. But, I wanted to know, can blowing or picking at the inside of the nose gently after about a month still have an impact? Recently, I’ve noticed a very slight bump on the bridge of my nose, where the septum is. I used to have a bump there before the surgery, and it was smooth up until now. Is this just temporary swelling or is it something to be worried about? I am seeing my doctor in about a week, but I just wanted to know if there is any information you could give me until then.

Dear Dr, I have made an appointment with my Dr. and will be seeing him today. Hopefully the suggested treatments will help. Thank you sooo much again =)

Hello Doctor, I’m thinking of undergoing rhinoplasty surgery (narrowing of tip/nostrils & bridge) and a correction of a deviated septum…do you think it’s a good idea to do BOTH of them at the same time?

Hi doctor,

I was wondering when it is ok to start running after rhinoplasty. It has been almost 4 weeks since my open Rhinoplasty and I have been doing light squats for about a week now. I was very active before my surgery and I am very excited to start working out again. I’ve looked on many websites and some say 3 weeks others say 6. It seems that there are alot of different opinions out there. What do you recommend. I didn’t have any bones broken only the tip worked on. I am going crazy not being able to do my normal workouts.

Thanks again,

Susan

Hi doc,
Susan again. I had one more question…..I was going to do a blue peel next week and I was wondering if that was ok. By then it will have been 4 weeks since my Rhinoplasty.

Thank you,

Susan

Thanks Dr. Palmer, I have already spoken with my plastic surgeon, and so far things are going well… I just have to squeeze the nasal bone once a day to make sure that it’s in place. He had narrowed it down quite a bit.
I also had a septoplasty done, but feel that my nose feels stuffy off and on.. how long after surgery will I be able to breathe completely normally? Thanks!
-Roya

Hello Doctor, I recently had rhinoplasty done to fix a deviated septum, it has been 2 weeks after my surgery so far and and still i am unable to squint my eyes and smile properly. The top row of my teeth are now covered and I have a horrible fake smile. I was wondering will I ever get my old smile back, if not is there anything I can do to get it back.

Dr. Palmar, I have had quite an ordeal stemming from a sports injury I suffered about 19 years ago. This sports injury created a bad saddle nose deformity that had to be fixed with nasal grafts. My story is complex as I have had 3 grafts to date. The first graft was cranial bone (very good graft) and it lasted for 15 years before it reabsorbed significantly and broke. The last two grafts were rib grafts. The first rib graft warped & absorbed and my surgeon tried unsuccessfully to fix it. So, I sought help from a revision specialist in rib grafts. The specialist recommended replacing the rib graft and did a successful, second rib graft surgery. Unfortunately, I caught a staph infection during the 2nd rib graft surgery and the entire graft had to be removed. Needless to say, I was devastated. Now, I am hesitant about doing any future surgeries but I still have to correct the saddle nose.

Rather than opting for another rib graft surgery, because of all that I have been through, I am hoping to find something else that I can use besides rib. I was reading information on your site regarding silicone for dorsal grafts but I have been told in the past that due to my nasal perforation that I should not pick any man made materials; as infection rates are higher in people with nasal perforations.

Is there a type of dorsal graft that you would recommend, besides rib, for patients with nasal perforations? Or would silicone and/or gore-tex still be viable options? Thanks a lot for your help.

Kevin

Hi Dr Palmer,
I have undergone three rhinoplasties at an interval of 6 months each and I had my last rhinoplasty some three years back. My last rhinoplasty involved a cartilage graft at tip of my nose(graft taken from ear). Since then I have been experiencing that my nose gets stiff when exposed to pressure (e.g. exposure to heat, exertion, lack of sleep, eating something hot or spicy). I feel the nerves around my nose get compressed during this stiffening phase. Finally the nose swells and returns back to normal state. I have consulted many skin specialists, ENT and plastic surgeons, each offfering different explainations, however the most appealing explaination I could get was that excessive scarring stimulates my nerves causing the nose to stiffen.
I want to ask, have you ever experienced similar problem with somebody who has undergone multiple rhinoplasties. Could the above explaination be valid enough. If so can I do something to soften the scarry tissue.
Thanks

Thanks Dr Palmer for diagnosing it so beautifully. I think now that I’m clear about the cause, my progress towards managing it would be more focussed.

Dr Palmer after reading your reassuring words to your other bloggers, I was hoping you could provide me with a response to my concerns about excessive post-op anxiety.

I have found the slow recovery process of my rhinoplasty 2 and a half months ago quite distressing, as it has also coincided with some significant tragedy in my family and my anxiety and grief has been high.

I have been feeling many of the sensations described by Shreya above – in the same conditions – but also after I have been very tense and stressed. Thus my swelling seems to be going up and down – sometimes seeming to regress quite significantly. I have also had alot of the pulling feeling around my bridge – most days.

My questions are: Will significant tension in the body & crying etc affect the long-term outcome of my nose??

I am concerned I am doing something to prevent the swelling from draining and thus leading to scar tissue development
Or will the lymphatic drainage system you describe above eventuall sort this out naturally, as it is my 1st rhinoplasty?

I am trying not to worry too much, but my surgeon is away at the moment and your honest & constructive response would really help at this point, as it will help set my expectations.

Kind regards,
Elisa

Dr. Palmer
My main objective was to get a smaller,more delicate less bulky tip and still avoid the “pinched nose” look. My first rhinoplasty was a year ago and although the tip was my #1 concern my doctor suggested to also make the bones in the upper part more narrow. A few months after the surgery my nose didn’t look straight, a slight indentation could be seen right in the middle.According to my doctor those bones ended up “shifting” in the wrong direction during the healing process,also the tip looked pretty much the same as before so a revision rhinoplasty was needed. I had the second one 3 months ago and although this time the bones look nice and smooth I still don’t see significant difference in the tip area. More cartilage was taken out of the tip but the doctor said my “thick” skin wasn’t helping much to see the new adjustments. Although It still feels firm and sometimes, while massaging my nose i feel like a needle pinch on both sides of the tip my doctor says the swelling is almost gone. How can this be possible??
At the exact moment all bandages,tapes were removed(two weeks after the surgery) my nose looked slimmer than the folling days or even now. I really don’t understand this healing process.

Dear Dr Palmer,

I had a closed rhinoplast procedure 11 days ago, to remove the hump and reduce a bulbous tip. I had the cast off 4 days ago but I am feeling very self conscious. The nose is now straight but I still feel like the tip is still large and feels quite firm and the more I worry about it the more I cant face leaving the house. Is there still swelling and is it likely to reduce more. My plastic surgeon says he is very pleased and I have another appointment in 6 weeks.

i don’t see my original message. does it take a few days to be posted?

ok now i see it, thanks

Dr. Palmer is the scar tissue you are talking about permanent? would i get the same results in the long way if i get kenalog injections or if i just wait to heal naturally? What about cortisone creams? are they also an option to reduce swelling? I would like to know anything possible to try help the swelling subside and also would like to know why if my PS says the swelling is almost gone my nose is still sore and firm. Thank you for the advice.
(i had the open technique for the original surgery a year ago, and a close technique for the revision three months ago).

Hi
I had a primary op first time around in London and the surgeon took way too much off my nose leaving it flattened, scooped out and turned up. My original nose was actually already quite straight but I wanted two bumps on either side of the bridge refined as they made the nose look crooked. The doctor knew what I wanted was a subtle change but when the cast came off I was devasted that it was so much shorter. He broke the bones and repositioned them lower on my cheeks in order to reduce the height of the bridge (we did not agree this but he said he thought it would make it look more refined). Since then I have had a tip revision which has brought the tip down but the whole nose still looks weird as the bridge is much lower than it should be. Most surgeons that I’ve spoken to don’t want to seem to re-break the bones and reposition them as they were (though they are quite long nasal bones already – about one third of the entire length of the nose). Before I get a further revision done I would like to ask if you think it is possible to rebreak and rest the bones to give more height and projection? I don’t really want an implant as the bones look strange on the cheeks as they are.
Any advice very gratefully received – this whole thing has been such a terrible nightmare – thanks

Hi
I had a primary op first time around in London and the surgeon took way too much off my nose leaving it flattened, scooped out and turned up. My original nose was actually already quite straight but I wanted two bumps on either side of the bridge refined as they made the nose look crooked. The doctor knew what I wanted was a subtle change but when the cast came off I was devasted that it was so much shorter. He broke the bones and repositioned them lower on my cheeks in order to reduce the height of the bridge (we did not agree this but he said he thought it would make it look more refined). Since then I have had a tip revision which has brought the tip down but the whole nose still looks weird as the bridge is much lower than it should be. Most surgeons that I’ve spoken to don’t want to seem to re-break the bones and reposition them as they were (though they are quite long nasal bones already – about one third of the entire length of the nose). Before I get a further revision done I would like to ask if you think it is possible to rebreak and reset the bones to give more height and projection? I don’t really want an implant as the bones look strange on the cheeks as they are.
Any advice very gratefully received – this whole thing has been such a terrible nightmare – thanks

Hello,

I had an open rhinoplasty w/ tip work (among other things) 2 and a half weeks ago. The recovery had been great until two days ago. My niece accidentally headbutted me with a moderate amount of force. The strike was toward my face and upward, hitting the tip and pushing it toward me, from right to left, and slightly up. No bleeding, but there was some pain, and my nose swelled slightly. Now it looks like the middle/lower thirds of my nose is drooping compared to where it was before the impact. I am wondering if the only risk relating to post-surgery trauma is bone shifting/fracture, or are there any support grafts, etc, that may have been broken or dislodged with the strike? If so, is it necessary to wait for the typical 6 months to attempt to repair them? Sorry for the long post, I have searched for hours upon hours for any info on post surgery trauma, but the only things I have found are journals to which I cannot get access. Thanks

I just did my rhinoplasty two weeks ago…now i feel my nose very sensitive and skin ard my nose very itchy…any comments pls email to me angeline_ooi@hotmail.com

I just want to say a HUGE Thankyou to Dr Palmer. What a generous person to continue to provide reassurance and advice on his holidays.

I have been reading this blog since my surgery in April and have found it has provided so much sound and rational explanation and facts, but also kind words of support and reassurance which is as vital after surgery to your face!!!

Thanks Dr Palmer. Enjoy the rest of your well deserved holiday

Thankyou for your response Dr Palmer.

In the last few weeks following the deaths, my stress levels which were already higher after my surgery have increased significantly and I feel I am now suffering from anxiety – as I think I’ve got myself into a negative process of ‘worrying that my worrying’ is affected my nose.

As a result I have had a few incidence where I have been having heart palpitations; flushing to my face and feeling significant pressure around my nose as a result. I am working to get this under control and am aware all those hormones and blood pressure are not likely to help my healing, but if I get control of it, can I prevent any long term damage? Do you think any would have occurred?

Sorry, to keep coming to you, but my surgeon is also on leave and I have an appointment with him next week.

Thankyou so much…..

Dear Dr Palmer,

I am now 16 days post op, and i seem to have contracted a really bad cold. I am constantly sneezing, blowing my nose and sniffing. Can this cause damage to my nose as im a bit worried as my nose seems to feel slighty burning and stinging sensation. This has to be the worst time to catch a cold, but thats what you get for living in England where the weather is rubbish. Also i still feel like my nose is still extremely huge and bulbous, can having a cold affect the swelling.

Thank you.

Hello Dr. Palmer …is the scar tissue you are talking about permanent? would i get the same results in the long way if i get kenalog injections or if i just wait to heal naturally? What about cortisone creams? are they also an option to reduce swelling? I would like to know anything possible to try help the swelling subside and also would like to know why if my PS says the swelling is almost gone my nose is still sore and firm. Thank you for the advice.
(i had the open technique for the original surgery a year ago, and a close technique for the revision three months ago).

I had a revision rhinoplasty 1 week ago. Though I realize it takes at least 6 months to see significant results, and in my case potentially longer, I am concerned about the bridge of my nose. During my first rhinoplasty the area near my eyes was filed down – and results were immediately achieved. However during my second one, my surgeon used a rasp to shave down the bone around the midway point of the nose, and I still have a hump in that area. It feels extremely firm, and I am worried that this is still the bone and not just swelling. Did he not file it down enough or is this just swelling? When I apply pressure to the area it appears to go down and my profile appears to improve for a moment.

Hi Dr. Palmer,

What a great service you are offering.

I just had a rhinoplasty about a month ago to reduce the size of the tip and width. I still have some swelling, with one side more than the other. My problem is though when I smile I don’t smile like I did. My upper lips curl under instead of curling up/out–I don’t show any teeth. Is this normal? Will it go away? It feels as if my skin is really tight (is that the swelling). I really feel the pressure on my nostrils when I try, so now I don’t smile very ofter. But, outside of the functionality of the nose in coordination with the rest of my movements in smiling, I do like my new nose. He did do well, if I could just smile to show it…

Lastly, wearing this splint for a week really reeked havoc on my skin–I need a deep cleaning. It is safe a month post-surgery to get a facial.

Thanks, jamie

Dear Dr Palmer,

i am now nearly for weeks post-op after a closed rhinoplasty. I had a hump in the bridge removed and a bulbous tip reduced. I have now noticed that the nose seems to dip underneath just below where the hump was removed. I cant tell if its a dent or if it looks like this because the bulbous still looks extrememly huge. But from a side profile my nose is no longer straight like after my surgery but dips below the bridge and and is then raised to an even bigger bulbous tip than before. Is this normal?

I had my nose done both side fractured and the bridge filed down. I had it done almost 5 weeks ago and the bridge still looks as if there is a bump and one side there is a bump and the other side it is PERFECT! How long should I wait before calling my doctor who did it and getting it redone?
Thanks!

Dear Dr. Palmer:

I too am 4 weeks post-op and I too had a bump removed and a bulbous tip reduced. My nose also looked straight until this stage, where the tip seems quite large and bulbous. It no longer looks straight, but rather scooped. I realize that the reduction in swelling takes time; however, I am also worried that what I am seeing is a swollen version of the final shape. How much more will the tip reduce after 4 weeks?

Thanks for this site. Reading it has helped me immensely.

Stacey

hai Dr Palmer i would like to know something..
i just had my implant in the begining of january..then after 6 month i notice my tip is not very sharp and it does not look like i did the implant..so last month i just did my rhinoplasty..the doctor just took the cartilage at the side of the nose…but the doctor told me that he cant trim the silicon which was put in my nose because it might cause complicating…
but then after few weeks the rhinoplasty..i still notice there is still bulbous n big hump at the tip of my nose..i feel uneasy with that..but the doctor told me to picnh my tip of nose for few min so that it will get higher but i notice it never works anything…
im planing to do the again the surgery…so could u pls tell me wat surgery suits fo me so that the tip will look very sharp,straight n small…i dont want the bump that look like the clown nose at the tip…please help me???
is there any side affects if i do ot again??when can i do again the surgery…coz the last rhinoplasty i did is 2 weeks ago…
i hope u will answer all my question…thank you..

Dr. Palmer
As i said before I had my second rhinoplasty 4 1/2 months ago and still don’t see a significant change in the tip area which was my #1 concern. My doctor says the swelling is almost gone but to me the tip looks more or less the same as before and is still firm. How much swelling can i loose in the following months? Is my nose definitely going to change more or will it look pretty much the same as now?
Is there anything i can do to help the remaining swelling subside?

hi Dr. Palmer .. i just had a close rhinoplasty 8 days ago .. it doesnt hurt much now but the bridge on my nose between my nose has like a gap on it has created a bump and when i push it down it becomes normal but when i let go the bump shows again. my surgeon said that i should push it down at least once a day so it will flatten out and she said it might be also that its still swelling the reason why it has that bump. is this true? will it flatten out after several days or months or will this be permanent?

hi dr. palmer thank you for the fast response. what was done to my nose was a nose lift im a japanese so i got a noselift to make my nose look defined and to have a slightly higher bridge. the incision was made inside on the right side of my nostrils. its been 10 days now when i got this nose job. everything looks nice however , the bridge in between my eyes the top part, is not firmly attached. it pops up. so its gives a very obvious bump and it looks like it has a triangular shape poping out in the bridge between my eyes. if only that part was firmly attached, my nose would look perfect and not have that obvious bump which disturbs me.

my ps said i should push it down at times but im just concerned what if the bump just stays up and never go down? will this be permanent or will it still change??

Hi Dr Palmer,

I had an open rhinoplasty procedure 3 weeks ago to “make my nose smaller”. The surgeon lifted the droopy tip, removed the hump on the dorsum, and performed an osteotomy to reduce the width of the dorsum.

Now, 3 weeks later and there is a marked discoloration on the area where the hump was removed. It doesn’t look like bruising, just some discoloration. I had bruising elsewhere around the eyes, etc. and that was gone after about 10 days. Also, one side of the nose appears thicker and the hump is not completely gone.

Should the nose start to resemble its final contour at this poit (ie hump gone) and what is this discoloration business. I should mention that I am of mexican descent and have thicker darker skin.

THanks

Hello Dr Palmer,

What treatment do you recommend to remedy dilated/broken blood vessels that have formed around my nose/cheeks following my rhinoplasty?

I was aware this may occur with my skin type, but would like your expert recommendation about the safest/most successful option for this condition.

Thanking you,
Tonia

I had a rhinoplasty 2 yrs ago to fix a bulbous tip that was the result of a hemangioma I had as a baby. I was very happy after the surgery as the tip was small and no longer stuck out. As time went on the nose began to get bigger and the dr said it was swelling. I did not return to him till recently and he said it is scar tissue that is making the nose appear this way. He then gave me some cortisone shots and said to come back in 2 months. Do you think these shots will be effective or that ultimetly another surgery will need to be done to have the nose look as it did after surgery and remove the scar tissue? Thanks so much!

hello again dr. palmer, thank you for the fast response you gave me here and i wish you will continue answering questions here cuz it helps us a lot.

ive went to my ps a few days ago and i talked to her about the rhino and why was the top is not firmly attached to the bridge. it turned out before i got the rhino, she examined my nose and she told me the tip of the bridge of my nose is a bit bent to the left side is not straight. that was the reason why it pops up.

so i had my 2nd rhino done by her and she said shes going to use like a wider implant. i will see the result after a week. i hope it will go well this time.