Time needed for swollen tip after rhinoplasty
After four months, particularly if you had an open rhinoplasty, the tip swelling will not be totally resolved. Many factors determine the final outcome, especially the thickness of the skin originally.
Your profile looks pretty good at this point, but there is a background item in the picture that obscures very fine detail, and it is not a real close-up view. My advice would be to wait a MINIMUM of 6 months and perhaps up to a year.
A tip graft is often a good way to approach a tip without good definition, it that is what it turns out to be. (Paul W. Loewenstein, MD, Milwaukee Plastic Surgeon)
Swollen tip after rhinoplasty can take up to a year to resolve
I know that after 4 months you are probably feeling frustrated that your tip is not exactly the way you expect it, and looks wide or round. It takes up to a year for all this to resolve, but you can have kenalog (a steroid) shots in your nose to help the swelling go away quicker. (Andrew Jacono, MD, Great Neck Facial Plastic Surgeon)
Revision Rhinoplasty Can Make a Profound Difference
Most rhinoplasty specialists would wait for 12 months before proceeding with any revision. The reason for this is that it can take 12 months (or longer) for the majority of the post-operative swelling to subside and for scar tissue to mature. There are certain circumstances in which patients could undergo surgery sooner than 12 months – this is something that needs to be addressed on an individual basis.
It is early to be making final judgements on your surgical results, but when analyzing your nose from the side there are two things that are making the tip appear “too round”. First, the area between your nostrils (called the columella) and the area just below the most anterior portion of your tip (called the infratip lobule) are too pronounced. Some doctors refer to this as a hanging columella and an accentuated double break. Secondly, there is no differentiation between your bridgeline and your tip (called a supratip break).
By reshaping this area, the vertical height of the tip is decreased and the roundness is corrected. Only you can make the determination whether you are satisfied with your result. Sometimes, having a consultation with one or more revision rhinoplasty specialists can give you a better idea of how your nose might look with additional surgery. Recently, 3D computer imaging has become available that allows patients to see how their nose might look after surgery – even revision surgery. (C. Spencer Cochran, MD, Dallas Facial Plastic Surgeon)
Four months is too early to be considering a revision for the tip. It will continue to go down. I continue to be amazed by how much the tip goes down over time. I would give it at least 7 to 8 months if it was done closed and 1 year if done open before considering a revision.
However, some tips to help it go down include asking your physician if Kenalog (steroid) shots would be helpful. An injection of 0.1 to 0.2 cc of 10mg/cc of Kenalog can help to reduce tip edema and is espcially effective if you tape your nasal tip with paper tape at night for up to one month after the injection.
Some physicians advocate a low sodium diet but I am not sure that I have seen this make a difference. Certainly sunscreen is important. Too much sun will lead to swollen tip after rhinoplasty and this can significanlty impede the tip swelling from resolving. (Steven H. Dayan, MD, Chicago Facial Plastic Surgeon)
Healing after rhinoplasty takes a while
Your nose looks really good. There is some fullness in the supratip area (above the tip), and in the columella region (below the tip). At four months, there is usually still some swelling present, so it is best to leave it alone. You can address it with your surgeon as well. (Stella Desyatnikova, MD, Seattle Facial Plastic Surgeon)
Wait till all swelling is resolved
From the picture your nose looks good, but the best thing is to wait at least a year after surgery and then look at the before and after pictures. There is more risk of scarring with redo rhinoplasty. (Kamran Khoobehi, MD, New Orleans Plastic Surgeon)
Wait at least a year before undergoing revision rhinoplasty
It is difficult to evaluate your tip in the photograph that you have submitted. You appear to be a beautiful woman and have a very nice nasal profile. Your nose will continue to refine its shape over the next year. Wait at least until a year after your surgery before going back for revision surgery. This should all be discussed thoroughly with your rhinoplasty surgeon. (Michael A. Persky, MD, Encino Facial Plastic Surgeon)