Feb 25

Is fluctuating swelling, redness, or bluish discoloration normal a year after Revision Rhinoplasty? Will it go away?

We were recently asked this question by someone who was understandably worried about these persistent symptoms about one year after a revision rhinoplasty. She wondered whether steroid injection would still work at this stage.

While discoloration is admittedly unusual at this stage, the key to this question is fluctuation. If swelling and redness were persistent and not getting better, we would be concerned about a possible low grade infection or chronic inflammatory condition, especially if there were a graft of foreign material placed in the nose. When swelling or discoloration fluctuates between being present and then going away, we are not nearly as concerned.

Whenever rhinoplasty is performed, the surgeon is lifting the skin and soft tissues of your nose to alter the cartilage and bony framework. By definition, this process involves disrupting the little nerves that provide sensation to some areas of skin and the little vessels that allow normal drainage of fluid from your skin. Thankfully, this ‘injury’ heals and all goes back to normal. With each successive surgery though, this healing can take longer and it is uncommon,┬ábut not abnormal, to have some of the symptoms being talked about even at one year after a revision.

These symptoms are definitely annoying, but the fluctuating nature of these symptoms is really a good sign. That means that there is still some healing to go and things will continue to improve. Some people pass this stage at 9 months. For others, it may sometimes take another six months or, rarely, longer until you see this go away completely. Steroid injections are meant to help you get there faster and can still help at your stage of healing.

Until then, it is normal to have flushing of the skin in hot environments, bluish discoloration in colder temperatures, and fluctuating swelling and congestion, especially when laying down for long periods or when exercising or doing any activity where fluid collects in the area.

The marker of healing is fluctuation. As time goes by, the swings from ‘swollen’ to ‘happy’ days will start to narrow and the fluctuation will eventually stop. That’s when you know you’ve reached a near-final result.

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