Gregory Dibelius (0:00) 

Hey everyone, today I want to talk about one of the most important topics in rhinoplasty, which is swelling reduction after the surgery.

Gregory Dibelius (0:08) 

I think this is one of the biggest issues that patients contemplating the surgery are asking about, probably one of the biggest topics on the forums for patients who’ve had the surgery.

Gregory Dibelius (0:18)

So I wanted to talk about some of the myths and hopefully dispel some of them and we’ll go over a case to illustrate some of the issues.

Gregory Dibelius (0:25)

So a good rule of thumb is that it takes 12 months for the final result, quote unquote. I think this is mostly true. The reality is there’s a huge amount of change in that time period.

Gregory Dibelius (0:35)

But the other thing that people don’t consider are two things. One, the process actually lasts much longer. It lasts probably the entire lifetime of the patient.

Gregory Dibelius (0:44)

And secondly, that there’s always going to be swelling fluctuations throughout the lifetime of the patient.

Gregory Dibelius (0:51)

So you’ll notice it early on, but then even at two, three, five years, you’ll notice there are days that there’s fluctuation, there’s increased swelling, and then days when everything looks great and there’s tons of definition. And this will happen for years.

Gregory Dibelius (1:04)

So I think in terms of when you’re thinking about what the final outcome really is, 12 months is a good time point.

Gregory Dibelius (1:10)

So I’d like to go over some of the issues during that first 12 months. 

Gregory Dibelius (1:15) 

So the day you get your cast off, it’s definitely a high swelling day. A few days after that, probably even more so as the compression from the dressings is released.

Gregory Dibelius (1:25) 

What we aim to do in our practice is essentially from the moment the cast comes off, we want patients to be feeling okay with going outside, even with a high amount of swelling, going to a movie or a restaurant or any event. Probably not key events like weddings or something where a lot of photography will be done, but we want people feeling comfortable in their own skin very quickly after surgery.

Gregory Dibelius (1:47) 

Usually after the first month, this is at a very acceptable level of swelling, but it’s always kind of fun to think that it’s just the beginning of the healing process and the results will evolve and mature over time.

Gregory Dibelius (2:00)

So here’s a case where we have a patient who had a surgery and we see the patient at one week post-op, we’re taking off the cast, obviously there’s a high degree of swelling.

Gregory Dibelius (2:11)

Our second time point here is eight weeks post-op, so two months.

We can see a really nice result that the patient and myself are very happy with, however it’s still early days. This is only two months out, but there are no issues with socializing, going out, going to a restaurant, etc. 

Gregory Dibelius (2:28)

However, when we look forward to one year, that magical one year mark, we see a huge change in definition. The tip in particular has gotten a lot of definition. This is the thing that many patients are waiting for.

Gregory Dibelius (2:39)

I have a second image of this case that shows the difference between sort of a relatively late time point, which is five months, and that same 12-month time point.

Gregory Dibelius (2:48)

What you can see is that even in that second half of the recovery period in the first year, there’s still a ton of change. So a patient who’s six months out who is still anticipating some changes, you know, they’re absolutely correct. It will continue to mature over the next six months, even though that seems like a long time after surgery.

Gregory Dibelius (3:06)

So I think the lesson here is that, yes, I think 12 months is a fairly good representation of what happens during a surgery and we get the final result, but it’s important to realize that we try to build noses to last through the entire lifetime of the patient.

Gregory Dibelius (3:22)

So if you want to talk more about revision rhinoplasty, rhinoplasty, you want to come in for a consultation, just give us a call, shoot us an email. We’d love to meet with you.