Rhinoplasty FAQ’s
This article is intended for Canadian residents only. This information is intended for general educational purposes and does not substitute for personalized medical advice. Every patient's anatomy and goals are unique. Please schedule a consultation with Dr. Bonaparte to discuss your specific situation and have all your questions addressed thoroughly. Information provided is not designed or intended to constitute medical advice, or to be used for diagnosis.
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Immediately After Surgery: The Cast, Bruising & Initial Care
How long will it take for bruising to go away after my rhinoplasty surgery?
Why Does My Nose Look Big or Swollen After My Rhinoplasty Cast is Removed?
What should I do if stitches from my rhinoplasty (Nose Surgery) fall out?
Why do I have Pimples or a breakout on my nose after rhinoplasty cast is off?
Comfort & Sensations During Early Recovery
What is Normal Pain After Rhinoplasty, and When Should I worry?
Why is it so hard to breath through my nose after rhinoplasty, and when will it improve?
My nose feels numb after a rhinoplasty. How long until sensation returns?
Swelling, Healing & Changes Over the Months
Why does my Nasal tip look big or swollen after rhinoplasty?
I feel a bump on my nose a few months after Rhinoplasty - Is my old bump returning?
Daily Life & Activities Post-Rhinoplasty
Understanding Your Final Rhinoplasty Results
Specific Considerations for Revision Rhinoplasty
Considering rhinoplasty (nose surgery) in Ottawa is a significant step, and it's natural to have many questions about the procedure, what recovery involves, and the kinds of results you might expect. To help guide you, Dr. Bonaparte has compiled answers to some of the most frequently asked questions about rhinoplasty based on his extensive experience
How long will it take for bruising to go away after a rhinoplasty?
Bruising around the eyes and nose is a common and expected part of recovery after rhinoplasty (often called a "nose job"). While nearly everyone will experience some bruising, the extent can vary significantly from patient to patient.
What Influences Bruising After Rhinoplasty?
Several factors determine how much bruising you might experience:
Extent of Surgery: This is the primary factor.
Bone Work: Procedures that involve reshaping or breaking the nasal bones (osteotomies), often necessary to narrow the nose or remove a significant bump, typically result in more noticeable bruising. This is because the bone work can disrupt small blood vessels under the skin.
Septoplasty: A septoplasty alone (to correct a deviated septum for breathing) usually causes minimal to no external bruising, as it primarily involves work inside the nose.
Tip Work Only: If your rhinoplasty focuses solely on the nasal tip (cartilage work), you'll likely experience less bruising compared to procedures involving the nasal bones.
Individual Healing: Some people naturally bruise more easily than others.
Skin Thickness and Tone: Bruising might appear more prominent on lighter, thinner skin.
Typical Timeline for Rhinoplasty Bruising:
Peak Bruising: Bruising often appears most noticeable 2-3 days after surgery.
Gradual Fading: You can expect most significant bruising to fade within 7 to 14 days.
Beyond 2 Weeks: It's uncommon for noticeable bruising to persist beyond two weeks, though very faint discolouration might linger slightly longer in some individuals.
Covering Bruises: Light bruising can often be concealed with makeup once your surgeon gives you the okay, typically after the cast or splint is removed.
What About Treatments to Reduce Bruising?
Many patients ask about ways to minimize or speed up the healing of bruises, such as Arnica montana or steroids.
Steroids: While sometimes used, there isn't strong scientific evidence to support the routine use of steroids specifically to reduce rhinoplasty bruising, and they carry potential side effects. For these reasons, we generally do not recommend them for this purpose.
Arnica: Arnica is a homeopathic remedy. While there's no conclusive scientific proof that it significantly reduces bruising after rhinoplasty, it's generally considered safe for most patients if they wish to try it. However, it's best to discuss any supplements with your surgeon before your procedure.
Dr Bonaparte’s Approach in Ottawa:
At our Ottawa rhinoplasty practice, we focus on meticulous surgical technique to minimize tissue trauma, which is the most reliable way to reduce excessive bruising. We will provide you with comprehensive pre-operative and post-operative care instructions to support your healing.
Key Takeaway: Plan for about two weeks of visible bruising. While it may vary slightly for each individual, this serves as a general guideline for both social and work planning. We are here to guide you through every step of your recovery."
You can also read about some other possible treatments for Bruising in this article -
How Long Does the Cast Stay On After a Rhinoplasty?
After your rhinoplasty (nose job) with Dr. Bonaparte at our Ottawa clinic, a protective cast or splint is often placed on your nose. This serves several important functions during the initial healing period.
Why Does Dr. Bonaparte Use a Cast After Rhinoplasty?
The primary reasons for using a nasal cast include:
Protection and Support: The cast helps to protect the newly sculpted nasal bones and tissues, especially if osteotomies (surgical adjustments to the bones) were performed or if a bump was removed. It acts as an external support, helping to maintain the new shape of your nose as it begins to heal.
Minimizing Swelling: A cast can provide gentle compression to help limit initial swelling.
Stabilizing Tissues: It helps keep the nasal bones and cartilage stable and in their new, corrected position. This is particularly important if grafts were used during your surgery or if an open rhinoplasty technique was performed by Dr. Bonaparte.
A Gentle Reminder: While not its main purpose, the cast also serves as a physical reminder to avoid touching or accidentally bumping your nose.
It's important to understand that while a nasal cast offers significant protection, it cannot immobilize the nasal bones as completely as a cast on a limb.
Do All Rhinoplasty Patients Need a Cast?
Not every patient will require a cast. Dr. Bonaparte will determine if a cast is necessary based on the specifics of your procedure. Generally, if your rhinoplasty involves:
Adjustments to the nasal bones (e.g., narrowing the nose, removing a hump)
The use of structural grafts
An open rhinoplasty approach
...you will likely have a cast.
How Long Will the Cast Stay On?
The nasal cast typically remains in place for 5 to 10 days. At our clinic, Dr. Bonaparte or a member of our team will usually remove it approximately one week after your surgery.
Important Notes About Your Cast:
If the Cast Loosens or Falls Off: Should your cast become loose or fall off before your scheduled removal appointment, please contact our office for guidance. It's often not a significant issue, but we like to be informed as there are cases where it can cause problems.
Do NOT Remove or Adjust the Cast Yourself: It is crucial that you do not attempt to remove, reposition, or adjust the cast on your own. Doing so could shift the healing bones or cartilage and potentially compromise your surgical results, possibly leading to a crooked appearance.
What to Expect During Cast Removal:
The removal process is generally quick. Most patients describe the sensation as similar to removing a very sticky bandage – a bit of pulling and mild, brief discomfort.
Managing Discomfort: To make the experience more comfortable, we often recommend taking one of your prescribed pain medications about 30-60 minutes before your cast removal appointment.
Dr. Bonaparte and our team are dedicated to ensuring your comfort and optimal healing throughout your rhinoplasty journey in Ottawa."
Read More about Rhinoplatsty in Dr Bonaparte’s collection of articles
"It's very common for patients to notice that their nasal cast (or splint) doesn't look perfectly straight or smooth after their rhinoplasty. You might see subtle lumps, bumps, or what appears to be a slight twist in the cast itself. Please be reassured, this is usually normal and rarely reflects the final shape of your nose.
My Rhinoplasty Cast Looks Uneven or Lumpy – Is This Normal?
Understanding Your Nasal Cast with Dr. Bonaparte:
At our Ottawa clinic, Dr. Bonaparte uses a thermoplastic splint for your nose after surgery. Here’s a little about how it works and why its appearance can vary:
How Thermoplastic Splints are Applied: This type of splint is made from a special material that becomes soft and pliable when warmed (e.g., in hot water). Dr. Bonaparte carefully molds it to your nose during the surgery.
Natural Warping as it Hardens: As the thermoplastic material cools and hardens on your nose, it can sometimes warp slightly. This means the outer surface of the cast might not be perfectly symmetrical or straight, even if the underlying structures of your nose are perfectly positioned.
Focus is on Internal Support: The primary role of the cast is to protect and support the underlying nasal bones and cartilage. Its external appearance is secondary to this crucial function.
Key Points to Remember About Your Cast's Appearance:
Cast Shape vs. Nose Shape: In almost all situations, the external look of the cast does not indicate how your nose will look once the cast is removed. The delicate work Dr. Bonaparte performs is on your nasal structures beneath the cast.
Do NOT Adjust or Move the Cast: This is critical. Attempting to straighten, push on, or move the cast yourself can disrupt the healing tissues and bones underneath. This could negatively impact your surgical outcome.
Intentional Shaping: In some specific cases, Dr. Bonaparte may intentionally shape or position the cast in a particular way to provide optimal support or gentle pressure to a certain area.
Our Advice:
While it's natural to scrutinize your appearance during recovery, try not to worry about minor irregularities in the cast itself. The most important thing is to allow the cast to do its job undisturbed. If you have significant concerns about the cast, please don't hesitate to contact our Ottawa office.
Rest assured, Dr. Bonaparte and our team are focused on achieving the best possible surgical result for your nose, and the cast is just a temporary protective measure."
Read More about Rhinoplatsty in Dr Bonaparte’s collection of articles
What is Normal Pain After Rhinoplasty, and When Should I Worry?
Understanding what to expect regarding pain is an important part of your rhinoplasty (nose job) recovery. While some discomfort is normal, certain types of pain can be warning signs.
Typical Pain Experience After Rhinoplasty:
Initial Discomfort: It's common to experience mild to moderate pain, tenderness, or an aching sensation in your nose and surrounding facial area for the first few days after your surgery with Dr. Bonaparte. This is usually well-managed with the pain medication prescribed to you.
Expected Improvement: Your discomfort should gradually improve after the first 2-3 days. While you might still feel tender, the intensity of the pain itself should lessen over time.
Critical Warning Signs: When to Seek Immediate Medical Attention
It is not normal for your pain to significantly worsen after the first couple of days, or for your prescribed pain medication to suddenly stop being effective.
Contact Dr. Bonaparte, your surgeon, or go to the nearest Emergency Department immediately if you experience:
Worsening Pain: Especially if pain sharply increases after day 2 or 3 of your recovery that you can not manage.
Pain Uncontrolled by Medication: If your prescribed pain relief is no longer managing your discomfort.
Other Concerning Symptoms Along with Pain: Such as a high fever, excessive or foul-smelling discharge from the nose, or significant changes in skin colour on your nose(e.g., dark purple, black, or very pale patches) that are spreading , vision change, loss of eye motion, severe worsening headache .
Why Worsening Pain after a Rhinoplasty is a Concern:
While rare, an increase in pain after the initial period can be a sign of complications that require prompt medical attention. These may include:
Infection: An infection in the surgical site can cause increased pain, swelling, redness, warmth, and possibly fever.
Necrosis (Tissue Damage): This is a very uncommon complication where the skin or underlying tissues of the nose are not receiving enough blood supply. It can lead to severe scarring if not treated urgently. Early signs can include severe, localized pain and changes in skin colour. Necrosis is often reversible if identified and treated promptly.
Other rare complications such as bleeding around the eye
Your Health is Our Priority in Ottawa:
Dr. Bonaparte and our team are committed to your safety and well-being. Never hesitate to reach out if you are concerned about your pain levels or any other aspect of your recovery.
To reiterate: If your pain significantly worsens after the initial 48-72 hours post-rhinoplasty, or is not controlled by your medication, this requires urgent assessment. Please contact us or seek care at an emergency facility without delay
Read More about Rhinoplatsty in Dr Bonaparte’s collection of articles
Why Does My Nose Look Big or Swollen After My Rhinoplasty Cast is Removed?
It's a very common experience: the cast comes off after your rhinoplasty (nose job), and your nose appears larger or wider than you expected, perhaps even bigger than before surgery. This is almost always due to swelling, which is a completely normal and temporary part of the healing process.
Understanding Post-Rhinoplasty Swelling:
To perform a rhinoplasty, whether using an open or closed technique, Dr. Bonaparte needs to gently lift the skin and soft tissues from the underlying bone and cartilage framework of your nose. This process, while essential for reshaping the nose, temporarily affects the skin in a few ways:
Disruption of Fluid Channels: The surgery temporarily disrupts the tiny blood vessels and lymphatic channels within the nasal skin. These channels are responsible for the normal flow of fluids.
Inflammatory Response: Like any surgery, rhinoplasty triggers your body's natural healing response. This involves inflammation, which brings more fluid and healing cells to the area.
Combined Effect: The combination of disrupted drainage and active inflammation leads to an accumulation of fluid in the nasal tissues, causing them to swell. Even a small amount of fluid can make the relatively delicate skin of the nose look significantly larger or less defined.
Patience is Key: This is an Early Stage of Healing
The appearance of your nose immediately after the cast is removed is not your final result. It's crucial to remember that you are in the very early stages of healing. Your body is working hard to create new pathways for fluid drainage and reduce inflammation.
Typical Timeline for Swelling Resolution After Rhinoplasty:
While individual healing varies, here’s a general guide to what you can expect regarding swelling after your procedure. Of course, this varies between people and is just meant as a guide:
First 2 Weeks (Including Cast Removal): Expect your nose to be quite swollen. This is when swelling is often at its peak or most noticeable to you.
2 Weeks to 1 Month: You'll likely see the swelling start to decrease more rapidly. Your nose will still be visibly swollen, but improvements should become apparent.
1 to 3 Months: Your nose will begin to look significantly better and more defined, though not yet perfect. Patients often notice that the bridge and upper part of the nose settle faster, while the nasal tip may remain round, firm, and appear more swollen for longer. This is normal.
Around 6 Months: Approximately 70-80% of the swelling should be resolved. The tip will start to feel softer and look more refined, though it may still feel a bit full or thick compared to its final state.
6 Months to 1 Year (and beyond): The remaining 90%+ of the swelling will gradually subside. Subtle refinements will continue as the last vestiges of swelling disappear. For some patients, especially those with thicker skin or undergoing revision surgery, it can take 18 months or even longer to see the absolute final, refined result.
An Important Note from Dr. Bonaparte:
While the full healing timeline can seem long, please be reassured. Most patients are very happy with the appearance of their nose and can confidently go about their lives well before all the swelling has completely resolved. We are here to guide you through each stage of your recovery."
Remember, patience is essential during your rhinoplasty recovery. Dr. Bonaparte and our team will monitor your progress and are always available to answer your questions.
How Long Will Swelling Last After My Rhinoplasty?
The duration of swelling after a rhinoplasty (nose job) is a key concern for patients, and it varies based on several factors, including the surgical technique used by Dr. Bonaparte and your individual healing process. While it takes time for all swelling to resolve, your nose will go through predictable stages of improvement.
General Swelling Timeline: What to Expect
It's important to understand that the most dramatic swelling typically subsides relatively quickly, but residual swelling, especially in the nasal tip, can persist for much longer.
Initial Phase (First 2 Weeks): This is when swelling is most significant and noticeable. Your nose will likely feel puffy and look quite swollen when the cast is removed.
Early Resolution (2 Weeks to 1-2 Months): You should see a rapid decrease in the obvious swelling. Your nose will start to look more natural, though it will still be swollen, particularly if you've had an open procedure or extensive work done.
Mid-Phase (3 to 6 Months): Significant improvement continues. The definition of your nose will become much clearer. For many, around 70-80% of the swelling resolves by the 6-month mark. The nasal tip, however, is often the last area to settle and may still feel firm and look a bit rounded.
Late Phase (6 Months to 1 Year+): The remaining subtle swelling, primarily in the tip, will gradually dissipate. By one year, over 90-95% of the swelling is typically gone, and the tip should be softer and more refined. For some individuals, especially those with thicker skin or undergoing revision rhinoplasty, it can take 18 months or even up to two years for the absolute final traces of swelling to disappear and for the ultimate refined result to be apparent.
How Surgical Technique Influences Swelling:
Dr. Bonaparte will discuss the best surgical approach for your specific goals during your consultation at our Ottawa clinic. The technique used can influence the swelling pattern:
Open Rhinoplasty: This technique involves an external incision on the columella (the strip of skin between the nostrils). It generally allows for more extensive reshaping but also tends to result in more initial swelling and a longer period for the very last of the swelling (especially in the tip) to resolve completely. The timeline described above often aligns closely with open rhinoplasty recovery.
Closed Rhinoplasty: With this approach, all incisions are made inside the nostrils. Typically, patients who undergo a closed rhinoplasty may experience somewhat less initial swelling, and the more obvious swelling might resolve a bit quicker. However, deeper tissue healing and the resolution of subtle swelling, particularly if bone work or significant tip changes were made, still take many months. Even with a closed approach, expect the nasal tip to be the last area to fully refine, which can take a year or more.
Important Considerations:
Your Nose Will Look Good Before It's "Perfect": It's crucial to remember that your nose will look socially acceptable and much improved long before the final 5-10% of swelling has vanished. Most patients are comfortable with their appearance within a few weeks to a couple of months.
Patience is Essential: The healing process after rhinoplasty is a journey, not a sprint. Allow your body the time it needs to heal and for the final, beautiful results of Dr. Bonaparte's work to emerge.
We will monitor your healing closely during your follow-up appointments at our Ottawa practice and are here to answer any questions you have throughout your recovery."
Why Does My Nasal Tip Look So Big or Swollen After Rhinoplasty?
It's very common for patients to feel that their nasal tip looks particularly large, rounded, or undefined after a rhinoplasty, even when swelling on the bridge of the nose has started to improve. This is a normal part of the healing process, and there are specific reasons why the tip is often the last area to show its final refined shape.
Why the Nasal Tip Holds Swelling Longer:
The general reasons for swelling (as explained in our FAQ "Why Does My Nose Look Big or Swollen After My Rhinoplasty Cast is Removed?") – the temporary disruption of blood and lymphatic fluid channels and the body's natural inflammatory healing response – certainly apply to the tip. However, the nasal tip has a few unique characteristics that make it prone to more prolonged swelling:
Gravity: The tip is the most dependent part of the nose, meaning gravity can cause fluid to settle there.
Thicker Skin: For many individuals, the skin over the nasal tip is thicker than the skin over the bridge, and thicker skin tends to retain swelling longer.
Intricate Surgical Work: The tip is often where the most detailed and complex cartilage reshaping occurs during rhinoplasty to achieve the desired definition and rotation. This intricate work can lead to more localized swelling.
Slower Re-establishment of Drainage: The delicate lymphatic and blood vessel networks can take the longest to fully re-establish their normal function in the very distal part of the nose – the tip.
What to Expect with Tip Swelling:
While the overall swelling in your nose will follow the general timeline (with significant improvement in the first 1-3 months and about 70-80% resolved by 6 months), the tip often lags behind.
Early Stages (First 1-3 Months): While the bridge may be looking more defined, your nasal tip will likely still appear quite swollen, firm, and possibly rounded or "bulbous." It may lack the definition you're anticipating. This is normal.
Mid Stages (3-6 Months): You'll start to see more refinement in the tip. It will begin to soften, and the apparent size will decrease, but it will still not be the final result.
Later Stages (6 Months to 1 Year+): This is when the majority of tip swelling resolves for most patients. The tip will become softer, more defined, and its final shape will emerge. For some patients, especially those with thicker skin or undergoing revision surgery, subtle tip swelling can persist for 18 months or even longer.
Patience is Crucial for Tip Refinement:
Dr. Bonaparte understands that it can be challenging to wait for the final results, especially concerning the nasal tip. However, patience is truly key. The changes in the tip can be gradual but are continuous.
It's important not to judge the final appearance of your nasal tip too early in the recovery process. Rest assured that the apparent largeness is typically due to this stubborn, but temporary, swelling. We will monitor your healing progress closely during your follow-up appointments at our Ottawa clinic.
My Nasal Tip Still Looks Big a Few Months After Rhinoplasty – Is This Normal and When Will It Improve?
Yes, it is completely normal for your nasal tip to still appear somewhat swollen or larger than you expect a few months after your rhinoplasty. In fact, the tip is renowned for being the very last area to settle and show its final, refined shape. Patience during this stage is key, though we understand you're eager to see the complete result.
Understanding Tip Healing at the "Few Months" Mark:
As we've discussed in our other FAQs on swelling (like "Why Does My Nasal Tip Look So Big After Rhinoplasty?"), the nasal tip has unique characteristics (thicker skin for some, intricate cartilage work, gravity) that make it hold onto swelling longer than other parts of your nose.
What's Happening at 2-4 Months Post-Op: By this stage, a significant amount of the initial, more generalized swelling has usually subsided from the bridge and upper portions of your nose. However, the tip is still actively healing and remodeling. It will likely feel quite firm and may lack the fine definition you're anticipating. While the overall shape of your nose is becoming more apparent, the tip is still a work in progress.
The "Looking Good, Not Perfect" Stage: While your overall nose might look quite good and socially presentable much earlier, the statement "great but not perfect" particularly applies to the tip for many months. The timeline for tip refinement is more extended.
How Long Does Tip Swelling Really Last?
The journey to your final nasal tip appearance continues well beyond the first few months:
Significant Improvement (3 to 6 Months): You should continue to see noticeable improvements in the definition and size of your tip during this period. It will gradually soften, and the apparent fullness will decrease.
Majority of Swelling Resolution (6 Months to 1 Year): For most patients, the vast majority (around 90-95%) of tip swelling resolves within this timeframe. The tip becomes significantly more refined, softer, and closer to its final appearance.
Final Refinements (1 Year to 18+ Months): The last subtle amounts of swelling can take even longer to fully disappear, especially for individuals with thicker nasal skin or those who have undergone revision rhinoplasty. These final changes are often very subtle but contribute to the ultimate delicacy and definition of the tip.
What Dr. Bonaparte Advises:
"During your follow-up appointments at our clinic, we carefully monitor the healing of your nasal tip. It's important to remember that this gradual refinement is a normal and expected part of the rhinoplasty process. Comparing your nose at 3 months to how it will look at 12 or 18 months will show significant evolution, especially in the tip. Trust the process, and keep us informed of any concerns."
While it requires patience, the continued reduction in tip swelling will lead to the more refined and defined nose you and Dr. Bonaparte planned for
I Feel a Bump on My Nose a Few Months After Rhinoplasty – Is My Old Bump Returning?
It's understandable to be concerned if you feel or see a new bump on your nose a few months after your rhinoplasty, especially if you had a dorsal hump removed. The good news is that in most cases, this does not mean your original bump is returning. What you're likely experiencing is a normal part of the bone healing process.
Understanding Bony Callus Formation:
When the nasal bones are surgically altered (for example, when a bump is removed or the bones are narrowed), they need to heal. During this healing, your body naturally forms what's called a bony callus.
What is a Callus? Think of it like a small, internal "scaffold" of new bone that bridges the altered area. It’s similar in concept to how a scab forms over a skin wound to protect it while new skin grows underneath. This callus is part of the bone's mending process.
Why You Might Feel or See It: In the months following surgery, particularly between 1 to 6 months, this healing callus can sometimes be felt as a small, firm bump. Occasionally, if the overlying skin is thin or there's still some residual swelling around it, it might even be slightly visible.
Why You Might Feel or See It: In the months following surgery, particularly between 1 to 6 months, this healing callus can sometimes be felt as a small, firm bump. Occasionally, if the overlying skin is thin or there's still some residual swelling around it, it might even be slightly visible.
Timeline for Resolution: The important thing to know is that bony calluses typically remodel and smooth out over time. As the underlying bone solidifies and strengthens, your body naturally reabsorbs much of this excess callus. This smoothing process can take several months, often continuing for 6 to 12 months, or even longer, after surgery. Swelling in the area will also continue to decrease, making the bump less apparent.
Other Less Common Possibilities:
While a healing callus is the most common reason for a new bump a few months post-rhinoplasty, there are rare situations where a bump might persist or develop due to other factors:
Residual Swelling or Thickened Scar Tissue: Sometimes, localized swelling or a small amount of thickened scar tissue under the skin can feel like a bump. This also tends to improve with time and sometimes with specific treatments Dr. Bonaparte might recommend, like gentle massage or taping if appropriate.
True Bony Irregularity: In rare instances, a small irregularity in the bone or cartilage might remain or become apparent as the majority of swelling subsides. This could be due to how an individual's body heals, forming a thicker area of bone.
What Should You Do?
If you notice a bump on your nose a few months after your rhinoplasty with Dr. Bonaparte:
Don't Panic: Remember that a healing callus is common and usually temporary.
Attend Your Follow-Up Appointments: These appointments at our Ottawa clinic are crucial. Dr. Bonaparte will assess your healing, including any areas of concern like a bump. He can usually determine the cause and explain what to expect.
Discuss Your Concerns: Voice your concerns to Dr. Bonaparte. He can provide reassurance and guidance based on your specific situation.
In the vast majority of cases, what feels like a bump will resolve or become unnoticeable with time. If, in a rare situation, a true bony irregularity or significant scar tissue persists after the full healing period (typically beyond a year), Dr. Bonaparte will discuss the best options with you. Sometimes, a very minor procedure might be considered to refine the area, but this is typically a straightforward solution if needed at all.
The key is ongoing communication with your surgeon and patience with the healing process.
My Rhinoplasty Scar (Columellar Scar) Looks Uneven a Month After Surgery – Why, and How Can It Be Improved?
It's very common and normal to notice that your columellar scar – the small incision under your nose used in an open rhinoplasty – looks a bit uneven, perhaps even a little 'puffy' or like there's a slight step-off, around one month after your surgery with Dr. Bonaparte. This appearance is almost always temporary and related to localized swelling.
Why Your Columellar Scar Might Look Uneven at One Month:
As explained earlier in our FAQs about swelling (Questions 5 and 7), rhinoplasty surgery temporarily disrupts the normal circulation and lymphatic (fluid) drainage pathways in the nasal tissues.
The "Water Dam" Effect: Your columellar incision line can act like a temporary 'dam' for this fluid. Swelling (lymphatic fluid) can accumulate in the skin of the nasal tip above the scar line. The skin below the scar (on your upper lip) is not affected in the same way.
Illusion of Unevenness: This difference in swelling – puffy tissue above the scar and less swollen tissue below – can create the visual impression that the scar itself is uneven, indented, or not perfectly aligned. At this early stage (one month post-op), it's usually the swelling, not the scar itself, creating this look.
How Can This Be Improved and What's the Timeline?
The good news is that this appearance typically resolves on its own as the swelling subsides and your scar matures.
Patience is Key (Swelling Reduction):
The most important factor for improvement is time. As the lymphatic drainage in your nasal tip gradually improves over 6 to 12 months, the puffiness above the scar will decrease. This will make the scar appear flatter and more even with the surrounding skin.
For most patients, this perceived unevenness significantly diminishes as the tip swelling resolves.
Scar Maturation:
Beyond the swelling, the scar itself will go through a maturation process. Initially, it might be pink or reddish and slightly raised. Over many months (often 6-18 months), it will typically fade, soften, and become much less noticeable. Most columellar scars heal exceptionally well and are barely perceptible once fully mature.
What You Can Do (and What to Avoid at 1 Month):
Follow Post-Operative Instructions: The most crucial thing is to adhere to the specific care instructions Dr. Bonaparte provided for your incision line. This usually involves gentle cleaning and possibly applying a prescribed ointment in the very early stages.
Sun Protection: Protecting your healing scar from direct sun exposure is vital to prevent it from darkening. Use a high-SPF sunscreen (once cleared by Dr. Bonaparte to apply it directly) and consider wearing a hat when outdoors for prolonged periods.
Avoid Premature Interventions: At one month post-op, it's generally too early for specific scar treatments like aggressive massage, silicone sheets, or steroid injections unless specifically directed by Dr. Bonaparte for a particular reason. Your body is still in the active healing phase.
Discuss with Dr. Bonaparte: During your follow-up appointments at our Ottawa clinic, Dr. Bonaparte will monitor your scar healing. If, much later in the healing process (e.g., after 6-12 months), there are any true concerns about the scar's appearance beyond normal maturation, he will discuss appropriate options with you. However, intervention is rarely needed for this specific issue of early perceived unevenness due to swelling.
Long-Term Outlook:
Rest assured, the columellar scar in open rhinoplasty is designed to heal very inconspicuously. The temporary unevenness you're noticing at one month is a common phase related to swelling. With time and proper care as guided by Dr. Bonaparte, the vast majority of these scars heal beautifully
How long do I have to wait to get the final result of my rhinoplasty?
Understanding the timeline for seeing your final rhinoplasty results is important for managing expectations throughout the healing journey. While you'll see significant changes relatively early, the complete, refined outcome takes time to emerge.
The "12-Month" Guideline and Beyond:
You may have heard or read that it takes about 12 months to see the final results of a rhinoplasty. This is a good general benchmark, as the majority of swelling and tissue settling occurs within this timeframe. However, as Dr. Bonaparte explains to his patients at our Ottawa clinic, healing is a gradual and individual process:
Early Changes (1-3 Months): During the first few months, you'll see the most dramatic reduction in swelling. By the second or third month, your nose will likely look very good, and much of the initial puffiness, especially on the bridge, will have subsided. You'll have a clear sense of the new shape, though the tip will still be quite swollen and lack its final definition.
Significant Refinement (3-6 Months): Your nose will continue to refine. By the six-month mark, a large percentage (often 70-80% or more) of the swelling is typically gone. 1 The overall structure will look fantastic, and you'll be enjoying your new profile. However, the nasal tip, in particular, will still be evolving.
Nearing the Final Result (6-12 Months): This is when the majority of patients will see something very close to their final outcome. Over 90-95% of the swelling, including much of the stubborn tip swelling, should be resolved. The definition, especially in the tip, becomes much more apparent, and the tissues will have softened considerably.
Full Maturation (1 to 2 Years, Sometimes Longer): For the absolute final, subtle refinements to become visible, and for all residual swelling to completely disappear, it can take 1 to 2 years. This is particularly true for:
Patients with thicker nasal skin.
Those who underwent an open rhinoplasty.
Revision rhinoplasty cases.
The final settling and softening of the nasal tip.
What Does "Final Result" Mean?
It's helpful to distinguish between when your nose looks "great" and is socially presentable (which happens relatively early) and when every last bit of swelling has vanished and the tissues are fully settled and soft. Most patients are very happy with their appearance long before the 18-24 month mark, as the changes during the second year are often very subtle and might only be noticeable to you and Dr. Bonaparte.
Dr. Bonaparte's Perspective:
"While we often use 12 months as a key milestone for assessing rhinoplasty results, I encourage patients to view healing as a continuum. Your nose will typically look wonderful much sooner than that, but the journey to the ultimate, stable, and refined outcome can take up to two years, especially for the nasal tip. We will follow your progress closely through this entire period."
The key is patience. The structural changes made during your rhinoplasty are permanent, but the overlying soft tissues need ample time to conform and for all swelling to fully dissipate to reveal that final, beautiful result
When is it Safe to Blow My Nose After Rhinoplasty (Nose Job)?
After your rhinoplasty (nose job) with Dr. Bonaparte, it's crucial to be gentle with your nose to allow the delicate structures to heal properly. Blowing your nose too soon or too forcefully can potentially disrupt healing.
Why You Need to Be Cautious About Blowing Your Nose:
Several sensitive areas are healing after surgery, and forceful nose blowing can lead to:
Shifting of Healing Nasal Bones: If your nasal bones were repositioned, forceful blowing could theoretically move these healing segments.
Dislodging Internal Stitches: Stitches inside your nose are delicate and could be dislodged by strong pressure.
Damage to Septal Work or Grafts: If you had a septoplasty or if cartilage grafts were used to shape your nose, the healing septum and these delicate grafts need to be protected from undue force to ensure they heal in their intended position.
Nosebleeds (Epistaxis): The lining of your nose is very delicate after surgery. Forceful blowing can irritate healing blood vessels and trigger a nosebleed.
Increased Swelling or Bruising: The internal pressure can stress healing tissues, potentially worsening or prolonging swelling and bruising.
Pain and Discomfort: Blowing your nose when tissues are tender can simply be painful.
Potential for Infection: While a lower risk, forcefully blowing your nose, especially if not done gently or if nasal passages are significantly blocked, could potentially propel bacteria from the nasal cavity into healing tissues or sinuses, potentially increasing the risk of an infection.
Subcutaneous Emphysema (Rare): In rare instances, if there is a small tear in the nasal lining, forceful blowing against a blocked passage could cause air to be trapped under the skin of the nose or surrounding facial areas. This can create a crackling sensation under the skin and cause temporary swelling. While usually not serious and self-resolving, it can be alarming and can progress to an infection.
Dr. Bonaparte's Recommended Timeline for Blowing Your Nose:
To ensure the best healing, please follow this staged approach:
First 2 Weeks (Days 1-14): Absolutely NO Nose Blowing.
During this initial period, it's very important to avoid blowing your nose altogether.
What to do instead: Dr. Bonaparte will provide instructions on using saline nasal sprays to keep your nasal passages moist and help clear any light mucus or dried blood. You can gently dab your nostrils with a tissue if needed. Avoid sniffing hard.
After 2 Weeks (Starting Week 3, around Day 15): Very Gentle Blowing Permitted (with saline).
Once you are past the two-week mark, you may begin to blow your nose very gently, one nostril at a time.
Always use a saline nasal spray first to moisturize the nasal passages and loosen any mucus. This will reduce the force needed.
After 3 Weeks (Starting Week 4, around Day 22): Moderately Gentle Blowing (with saline).
You can gradually increase the force slightly, but continue to be gentle and blow one nostril at a time.
Continue to use saline spray beforehand to make it easier.
After 1 Month (Approximately Day 30+): Gradual Return to Normal.
You can typically start returning to your normal nose-blowing habits. However, continue to be mindful and avoid overly aggressive blowing for another few weeks as healing is still ongoing.
Important Note from Dr. Bonaparte:
"These are general guidelines. Your specific instructions might vary slightly based on the exact procedures you had performed. If you feel an urgent need to blow your nose before the recommended time, or if you have excessive stuffiness, please contact our Ottawa clinic for advice. Always err on the side of caution to protect your healing results."
Following these instructions carefully will help ensure a smooth recovery and protect the outcome of your rhinoplasty.
When Can I Safely Resume Exercise and Gym Workouts After Rhinoplasty?
Returning to exercise after your rhinoplasty (nose job) is an important part of getting back to your normal routine, but it's crucial to do so gradually and safely to protect your healing nose and ensure the best possible results. Dr. Bonaparte advises a cautious approach to avoid complications like bleeding, increased swelling, or injury.
Why You Need to Be Cautious with Exercise Post-Rhinoplasty:
Risk of Bleeding: Activities that significantly raise your heart rate and blood pressure can increase the risk of nosebleeds in the early healing period. Your nasal tissues have many healing blood vessels that are vulnerable.
Increased Swelling: Higher blood flow to the head during exertion can also lead to more pronounced or prolonged swelling of your nose. Some patients notice temporary puffiness after exercise even a month or two post-surgery.
Risk of Impact/Injury: Your nose is very delicate as it heals. Accidental bumps or impacts during exercise could compromise the surgical outcome.
Pressure from Straining: Activities involving straining (like heavy lifting) can increase pressure in your head and nose, which is not ideal for healing.
Dr. Bonaparte's General Guidelines for Returning to Exercise in Ottawa:
Please remember these are general guidelines. Dr. Bonaparte will provide you with personalized advice based on your specific surgery and healing progress. Always listen to your body and stop if you feel pain, throbbing, dizziness, or a significant increase in swelling.
Week 1 (Days 1-7): Focus on Rest and Light Activity.
Activity: Primarily rest. Gentle walking around your house for short periods (e.g., 5-10 minutes a few times a day) is encouraged starting a day after surgery to promote circulation and prevent blood clots and this can progress to longer walks outside. Light housework is also ok after day 3.
Avoid: All other forms of exercise, including anything that makes you break a sweat or breathe heavily. No lifting anything heavier than a few pounds. No Bending over (Yoga).
Week 2 (Days 8-14): Continued Light Activity.
Activity: Brisk walking and you can continue and gradually increase the duration of your walks, some light activity (stretching).
Avoid: Strenuous activities, jogging, bending with your head below your heart, and lifting.
Weeks 3-4 (Days 15-28): Gradual Introduction of Low-Impact Cardio.
Activity: With Dr. Bonaparte's clearance, you can typically start reintroducing low-impact cardiovascular exercise. This includes:
Stationary cycling (at a moderate pace).
Elliptical trainer (at a low intensity).
Light Yoga
Intensity: Keep your heart rate at a moderate level. Aim for about 25-50% of your usual effort.
Avoid: Running, jogging, swimming, weightlifting, high-intensity interval training (HIIT), yoga inversions (like downward dog), and any activities with a risk of impact.
Weeks 5-6 (Days 29-42): Increasing Moderate Exercise.
Activity: You may be able to gradually increase the intensity and duration of your cardio workouts (e.g., light jogging for some, but listen to your body). You might also begin to reintroduce:
Light weight training: Start with much lighter weights than usual (e.g., 50% of your normal) and avoid straining or holding your breath (Valsalva maneuver).
Swimming: If all incisions are fully healed and Dr. Bonaparte approves (be mindful of pressure from goggles).
Yoga/Pilates: Continue to avoid inversions or positions that put pressure on your face.
Intensity: You might progress to 50-75% of your usual effort if you feel comfortable and have no adverse effects.
Avoid: Heavy lifting, strenuous activities that cause significant straining, contact sports, and activities with a high risk of facial injury.
After 6-8 Weeks: Gradual Return to Most Regular Exercise.
Activity: Most patients can begin to return to their more regular exercise routines, including more vigorous cardio and heavier weightlifting, with Dr. Bonaparte's approval.
Important: Continue to increase intensity and duration gradually. Pay attention to any increased swelling or discomfort.
Contact Sports and High-Risk Activities:
Timeline: Activities with a high risk of your nose being hit (e.g., basketball, soccer, hockey, martial arts, boxing) should be avoided for a much longer period, typically 3 to 6 months, or even longer, as advised by Dr. Bonaparte. Your nasal bones need to be fully healed and stable.
Protection: When you do return to such sports, protective facial gear may be recommended.
Key Considerations:
Listen to Your Body: This is paramount. If an activity causes pain, throbbing, or a noticeable increase in swelling in your nose, stop immediately and scale back.
Swelling Fluctuations: Don't be surprised if you notice some temporary increase in nasal swelling after workouts, even several weeks or a few months after surgery. This usually subsides.
Individual Healing: Everyone heals at a different pace. Your timeline might vary.
Dr. Bonaparte and our team will guide you on when it's safe to resume specific activities during your follow-up appointments at our Ottawa clinic. Our priority is your safe recovery and the protection of your surgical results.
Why Do I Have Pimples or a Breakout on My Nose After My Rhinoplasty Cast is Off?
It's quite common to notice some red spots, pimples, or a general acne-like breakout on your nose and surrounding skin immediately after your rhinoplasty cast and tapes are removed by Dr. Bonaparte's team at our Ottawa clinic. This is usually a temporary reaction and here's why it happens:
Why Breakouts Occur After Cast Removal:
During your rhinoplasty, surgical tapes and a cast are applied to your nose. These are essential for:
Minimizing swelling.
Protecting the healing tissues.
Helping the skin conform to the new underlying nasal structure.
However, these coverings mean your skin isn't exposed to air and can't 'breathe' as it normally does. The tapes and adhesives can trap oil, sweat, and dead skin cells, leading to:
Blocked Pores (Congestion): This is the primary cause, leading to blackheads, whiteheads, and inflammatory pimples, similar to a typical acne breakout.
Skin Irritation: Some individuals may also experience mild irritation from the adhesives themselves.
Patients who are naturally prone to acne may be more likely to experience these temporary breakouts.
What You Can Do About Pimples After Your Cast is Removed:
The good news is that these breakouts are usually temporary and resolve as your skin readjusts. Here are some gentle steps Dr. Bonaparte recommends to help manage them:
Gentle Cleansing: Once Dr. Bonaparte gives you the okay to wash your face normally, use a mild, non-comedogenic (won't clog pores) cleanser twice a day. Avoid harsh scrubbing, as your skin will still be sensitive. Pat your skin dry gently.
Light, Non-Comedogenic Moisturizer: Keeping your skin hydrated is important, even if you have breakouts. Choose a light, oil-free, and non-comedogenic moisturizer.
Over-the-Counter Acne Treatments (Use with Caution):
Salicylic Acid: Products containing a low percentage of salicylic acid (e.g., 0.5% to 2%) can help exfoliate the skin and clear pores. Start by using it a few times a week to see how your skin tolerates it, as your nose will be more sensitive than usual.
Benzoyl Peroxide: This can be effective for inflammatory pimples, but it can also be quite drying and potentially irritating on freshly operated skin. If you choose to use it, opt for a very low concentration (2.5%) and use it sparingly as a spot treatment.
Important Note: Introduce any new active skincare ingredient one at a time and very gently. If you experience significant redness, burning, or irritation, discontinue use and consult our clinic.
Avoid Picking or Squeezing: This can worsen inflammation, lead to scarring, or even cause an infection, especially on healing skin.
Patience: For most people, these breakouts will clear up within a few days to a couple of weeks once the skin is exposed to air again and a gentle skincare routine is resumed.
Pre-Surgery Skin Preparation:
If you have a history of significant acne, please discuss this with Dr. Bonaparte during your consultation. While not the focus here, there may be skincare strategies we can recommend before your surgery to help prepare your skin and potentially minimize post-operative breakouts.
When to Contact Us:
While most post-cast breakouts are mild and resolve on their own, please contact our Ottawa clinic if:
The breakout is severe or widespread.
It seems to be getting worse instead of better after a week or two of gentle care.
You notice signs of infection (e.g., significant pain, pus, spreading redness, warmth).
Dr. Bonaparte and our team are here to support you through every aspect of your recovery, including managing these temporary skin concerns."
What Should I Do If Stitches From My Rhinoplasty (Nose Surgery) Fall Out?
It's not uncommon to notice a stitch or two falling out after your rhinoplasty (nose surgery), and this understandably can cause some concern. However, in most instances, it's not a problem. Here’s what you should know:
Types of Stitches Used in Rhinoplasty by Dr. Bonaparte:
Dr. Bonaparte uses different kinds of sutures (stitches) depending on their location and purpose:
Dissolvable Stitches: These are often used inside your nose (for example, after a septoplasty or to close internal incisions). As their name suggests, they are designed to dissolve and fall out on their own as your tissues heal. You might notice them as small threads when you gently clean your nostrils, typically anywhere from a few days to a few weeks after surgery. This is perfectly normal and expected.
Non-Dissolvable Stitches: These are sometimes used for external incisions, most commonly the small incision on the columella (the strip of skin between your nostrils) if you've had an open rhinoplasty. These stitches do not dissolve and are typically removed by Dr. Bonaparte or a member of our team at our Ottawa clinic, usually about one week after your surgery.
Why Stitches Might Fall Out:
Nasal tissues, especially the internal lining, tend to heal quite quickly. Once the tissue has healed sufficiently, a stitch (even a dissolvable one that hasn't fully dissolved) may simply work its way loose and fall out. This can happen a few days after surgery or sometimes a bit later.
Is a Stitch Falling Out Early a Problem?
Usually Not a Concern: In the vast majority of cases, especially if it's an internal dissolvable stitch, one or two stitches falling out, even if it seems a bit early, is not a problem and is unlikely to affect the final outcome of your surgery. By the time a stitch falls out, the initial and most critical phase of wound healing in that specific spot has often already occurred.
What to Do:
Don't Panic: Stay calm.
Do Not Pull at Loose Stitches: If you see a loose stitch, resist the urge to pull it out. Let it fall out naturally or Trim it carefully with clean, small scissors if it's dangling and bothersome, but only if you feel comfortable doing so and it's clearly detached at one end.
Keep the Area Clean: Continue to follow Dr. Bonaparte's instructions for cleaning your nostrils and any external incision lines.
When to Contact Dr. Bonaparte's Clinic:
While it's usually not an issue, we always encourage you to reach out to our Ottawa office if you have any concerns. You should definitely contact us if:
An External Incision Appears to be Opening: If stitches from an external incision (like the columellar scar) fall out and the edges of the skin seem to be gaping or separating.
There is Active Bleeding: More than a tiny speck of blood from where the stitch was.
You Notice Signs of Infection: Such as increasing redness, warmth, significant pain, pus, or a foul odor from the area.
Multiple Stitches Fall Out Very Early: Especially from an external incision.
You are Simply Worried: We would rather you call us for reassurance. Dr. Bonaparte can assess the situation, even if it's based on a description or a photo you might send (if requested by our team).
Rest assured, the healing process is robust. Most of the time, a lost stitch is just a sign that your body is healing as it should. However, Dr. Bonaparte and our team are always here to address any worries you may have during your recovery.
Why is it Hard to Breathe Through My Nose After Rhinoplasty, and When Will it Improve?
It's completely normal and expected to have difficulty breathing through your nose in the days and initial weeks following your rhinoplasty (nose surgery) with Dr. Bonaparte. This is a temporary phase for almost all patients.
Common Reasons for Temporary Breathing Difficulty After Surgery:
Several factors contribute to the sensation of a blocked or stuffy nose right after your procedure:
Internal Swelling: Just like the outside of your nose swells, the delicate internal linings of your nasal passages also swell. This internal swelling is often the primary cause of blockage and can significantly narrow the airways.
Splints or Packing (If Used): Depending on the specifics of your surgery, Dr. Bonaparte may sometimes place internal splints or, very rarely, soft packing inside your nose to provide support or minimize bleeding. These will naturally obstruct airflow until they are removed, usually within the first week.
Internal Stitches: Dissolvable stitches inside the nose can cause a sensation of fullness or partial obstruction until they fully dissolve.
Mucus and Crusting: After surgery, the normal mucus flow and clearing mechanisms in your nose are temporarily disrupted. This can lead to a buildup of dried blood, mucus, and crusts inside the nasal passages, further contributing to blockage.
The Healing Process Itself: Your body's natural inflammatory response to surgery contributes to the swelling and changes in sensation within the nose.
When Will My Nasal Breathing Improve?
Initial Week: Breathing will likely be most difficult during the first week, especially if internal splints are in place. You may find yourself breathing mostly through your mouth.
Weeks 2 to 4: You should notice a significant improvement in your nasal airflow during this period. As the initial swelling subsides, internal crusting is managed (with saline rinses as advised by Dr. Bonaparte), and any splints are removed, your breathing will become progressively easier. Most patients find their breathing returns to a near-normal state, or even better than before if they had pre-existing blockages, within this timeframe.
Beyond 1 Month: Minor fluctuations in stuffiness can still occur for several weeks or even a few months as the last of the internal swelling resolves.
Managing Temporary Nasal Blockage:
Dr. Bonaparte will provide specific post-operative instructions, which typically include:
Using saline nasal sprays or rinses regularly to keep the nasal passages moist, clean, and to help clear crusting.
Sleeping with your head elevated to help reduce swelling.
Avoiding blowing your nose forcefully (as discussed in a separate FAQ).
Addressing Concerns About Permanent Breathing Problems:
Dr. Bonaparte understands that the possibility of permanent breathing changes is a significant consideration for patients.
Surgical Goal: A primary goal in any rhinoplasty, even cosmetic ones, is to maintain or, where possible, improve nasal airflow. Techniques are specifically employed to support the nasal structure and prevent new obstructions. If you have a deviated septum or other pre-existing breathing issues, these are often addressed during the same surgery (septorhinoplasty).
Risk Factors: Any surgery carries risks, and any alteration to the nasal structure theoretically has the potential to affect airflow. Making a nose significantly smaller, for instance, inherently reduces the size of the internal passages to some degree, which is why careful assessment and planning are crucial.
Communication is Key: If, after the initial healing period (beyond 3-6 months), you continue to experience significant breathing difficulties that you didn't have before, or if pre-existing issues haven't improved as expected, it's very important to discuss this with Dr. Bonaparte at our Ottawa clinic.
Potential Solutions: In many cases, if persistent breathing issues do arise, they can often be improved with conservative measures or, if necessary, further minor procedures.
Rest assured that Dr. Bonaparte prioritizes both the aesthetic appearance of your nose and its crucial function of breathing. The initial period of difficult breathing is temporary for the vast majority of patients.
My Nose Feels Numb After Rhinoplasty. How Long Until Sensation Returns?
It's very common to experience numbness, particularly in the tip of your nose and sometimes the area under your nose (the columella) or even the front teeth, after a rhinoplasty, especially if you've had an open rhinoplasty procedure with Dr. Bonaparte. This is an expected part of the healing process.
Why Numbness Occurs: Understanding Nerve Interruption
Nerve Pathways: Your skin contains many tiny sensory nerves that provide feelings of touch, temperature, and pressure. During an open rhinoplasty, a small incision is typically made across the columella (the strip of skin between your nostrils) and the skin is gently lifted to allow Dr. Bonaparte to reshape the underlying bone and cartilage.
Nerve Disruption: This process, while essential for achieving your desired surgical outcome, inevitably interrupts some of these very fine superficial sensory nerves. These nerves are like tiny electrical wires, and when they are cut or stretched, the signals they normally carry are temporarily disrupted, leading to a feeling of numbness in the skin they supply.
Swelling's Role: General post-operative swelling can also put pressure on nerve endings, contributing to altered sensation or numbness, both externally and sometimes internally.
The Nerve Healing and Sensation Return Process:
Nerves have a remarkable ability to heal and regenerate, but it's a slow and gradual process:
Regeneration: The disrupted nerve endings will slowly begin to grow back and reconnect, or nearby nerves may extend their reach.
Stages of Sensation Return: As the nerves heal, you might experience different sensations before full normal feeling returns. It's not uncommon to go through phases where the area feels:
Completely numb
Tingly (like pins and needles)
Itchy
Occasionally, brief moments of hypersensitivity or unusual sensations as the nerves "wake up." These are all generally positive signs that nerve recovery is underway.
Timeline for Return of Sensation:
Initial Months: The most noticeable numbness is typically present in the first few weeks to months after surgery.
Gradual Improvement (3-6 Months): Many patients start to notice a significant return of sensation between three to six months post-operatively. You might notice the area feeling less "dead" and more like your own skin again, possibly with some tingling.
Continued Improvement (6-12 Months): For most patients, the majority of normal sensation in the nasal tip and columella will return within six to twelve months after their rhinoplasty.
Full Resolution (Up to 1-2 Years): In some cases, especially if there was more extensive work or individual healing variations, it can take up to a year, or occasionally even longer (up to 18-24 months), for the sensation to feel completely normal and for the last subtle changes to resolve. Permanent numbness in these areas from this cause is very rare.
Important Notes:
Patience is Key: Nerve regeneration is one of the slower aspects of healing, so patience is essential.
Internal Sensation: You might also notice that the inside of your nose feels a bit "off" or less sensitive initially due to internal swelling and healing. This also improves with time.
Dr. Bonaparte understands that numbness can be an odd sensation. Please be assured that this is a normal part of the rhinoplasty recovery for many patients. We will monitor your progress during your follow-up appointments at our Ottawa clinic. If you have specific concerns about the sensation in your nose at any stage, please don't hesitate to discuss them with us.
I'm Having a Revision (Second) Rhinoplasty: What Should I Expect After Surgery?
Undergoing a revision rhinoplasty with Dr. Bonaparte means you are addressing concerns from a previous nose surgery. It's important to understand that revision procedures are generally more complex than primary (first-time) rhinoplasties, and this often influences the recovery and outcome.
Why Revision Rhinoplasty is Different:
The main reasons for the increased complexity include:
Scar Tissue: The most significant factor is the presence of internal scar tissue from your previous surgery. Scar tissue can make the dissection more challenging, alter the normal tissue planes, and sometimes make the healing process less predictable.
Altered Anatomy: The original structure of your nose has already been changed. Dr. Bonaparte will be working with this altered anatomy, which can require very precise and often intricate techniques.
Cartilage Availability: Often, septal cartilage (the cartilage from the inside of your nose) may have been used or altered during your first surgery. If more cartilage is needed for structural support or reshaping in the revision (which is common), Dr. Bonaparte may need to obtain it from your ear or, in some cases, from a rib graft. This can have implications for your recovery (e.g., discomfort at the donor site).
Skin and Soft Tissue Changes: The skin and soft tissues over your nose may be thicker, thinner, or less pliable due to the previous surgery, which can affect how they redrape over the new underlying framework.
What to Expect After Your Revision Rhinoplasty:
While every patient's experience is unique, here are some general expectations for recovery after a revision rhinoplasty with Dr. Bonaparte at our Ottawa clinic:
Swelling Will Likely Be More Significant and Prolonged:
This is one of the most notable differences. Expect the swelling to be more pronounced and to last longer than it did after your primary rhinoplasty. The nasal tip, in particular, can remain swollen for an extended period.
The overall timeline for swelling resolution is often longer, with the majority taking 12-18 months, and very subtle swelling potentially persisting for up to two years or even more before the absolute final, refined result is seen.
Healing Time is Generally Longer:
Because of the existing scar tissue and the complexity of the surgery, the overall healing process and the time it takes to see the final outcome are typically extended compared to a primary procedure. Patience will be even more crucial.
Bruising:
Bruising can be similar to, or sometimes more or less than, your primary surgery. This is variable.
Numbness and Sensation Changes:
Numbness, especially in the tip (if an open approach is used, which is common in revisions), will likely occur. The return of sensation might take longer compared to a primary surgery due to the re-traumatization of nerves in a previously operated area.
Discomfort:
Post-operative discomfort is usually well-managed with prescribed pain medication, similar to a primary rhinoplasty. If ear or rib cartilage is harvested, you will have some additional discomfort at the donor site, which Dr. Bonaparte will discuss with you.
Breathing:
If breathing issues were a reason for your revision, improvement will be a key goal. However, initial post-operative stuffiness due to swelling will be present, similar to a primary surgery, and may take time to resolve.
Realistic Expectations for the Outcome:
Dr. Bonaparte is experienced in revision rhinoplasty and will aim for the best possible aesthetic and functional improvement. However, it's important to have realistic expectations. The goal of revision surgery is significant improvement, but the presence of scar tissue and altered anatomy means that achieving the "perfect" nose or the exact result that might have been possible in a primary surgery can sometimes be more challenging. Open discussion about achievable outcomes with Dr. Bonaparte before surgery is vital.
Emotional Aspect:
Deciding to have a revision rhinoplasty can be an emotional journey. It's important to be mentally prepared for another recovery period and to maintain open communication with Dr. Bonaparte and our team throughout the process.
The Importance of Surgeon Expertise:
Revision rhinoplasty is considered one of the most challenging cosmetic procedures. Choosing a surgeon like Dr. Bonaparte, who has specific expertise and experience in revision cases, is critical.
The most important things to remember are that healing will likely take longer, swelling will be more persistent, and patience is absolutely essential. Dr. Bonaparte and our Ottawa team are committed to guiding you through this more complex journey to achieve the best possible improvement.