Question:
My nose job was about five or six weeks ago. My swelling seems extreme in the morning but then it sort of fades by evening. I know swelling is normal, but is it normal for it to come and go like this? Someone told me this morning swelling can be permanent, is this true?

Answer:
It is normal for your swelling after rhinoplasty to come and go at 6 weeks and even longer.  As you lay flat in the evenings the venous pressure builds up in your facial area causing fluid to come out of the vascular space and into the tissues.  This is the same reason that your eyes are more puffy in the morning.  As you keep your head above your heart during the day this process reverses and the fluid returns to the vascular space.  This is a normal daily cycle.  Because you had your nose operated on recently there is still some inflammation in the tissues that increases the leakiness of the vessels.  As your surgery becomes more remote this process will abate.  The swelling in your nose will continue to decrease until it is finally resolved.  The reason that some people will say that swelling can be permanent is that in some cases the nose will continue to change for years after rhinoplasty.  This is not really swelling, but is the skin contracting over the cartilage.  If the surgery was performed well this will not be an issue.  In some cases however, this can lead to changes that will be unfavorable.

Posted by Dr. Buckingham