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Rhinoplasty can produce some of the most dramatic changes on the appearance of one’s face. Sitting dead center in the face, it is hard to escape what it looks like…and even harder to hide it should it have surgery. Besides the splint and tapes that envelope the nose during the first week after surgery, there are a minimum of several weeks afterwards in which the swelling and bruising are still inescapable from detection.

 

For this reason, a story out of Egypt today highlights the recovery process from rhinoplasty surgery. An Egyptian government official was forced to quit the parliament after being caught lying about cosmetic surgery. To coverup that he had had nose surgery, the official claimed that he was assaulted and robbed in a car jacking assault. He appeared on TV with a bandage on his face alleging that the attack occurred on a highway outside of Cairo. Given the prevalence of such assaults since the overthrow of President Mubarak, this would normally be a believable story. But he apparently was ratted out by the doctor and hospital where he had surgery. Given that the official’s Islamic party follows a line that forbids cosmetic surgery, he was expelled from his position.

 

Fortunately, the vast majority of people will not be subject to loss of their job or political party should they have a rhinoplasty. But this extreme example highlights a common problem with this structural facial surgery…the recovery process is often underestimated. While many plastic surgery websites state that rhinoplasty recovery is two or three weeks, this refers to the ‘surgical recovery’ process, the shortest end of rhinoplasty recovery. While the obvious signs of bruising (usually under the eyes), most pronounced swelling and severe congestion (if a septorhinoplasty is done) may largely be gone in the first month after surgery, the final result is far from becoming apparent.

 

The aesthetic recovery from rhinoplasty takes a long time, much longer than that of the surgical recovery. This doesn’t mean that one can’t walk around and their nose looks like it has obviously had surgery. But refinement and achieving one’s desired nose shape and form is achieved in the time frame of months not weeks. The skin that overlies the nose is remarkably well vascularized but gets rid of swelling slowly and relies on scar contracture to reveal its new architecture.

 

For some patients they can look remarkably good even by six weeks after rhinoplasty surgery. But for patients with thicker skin and a more broad and wide tip of the nose, getting to the point of visible improvement can be excrutiatingly slow. This means that don’t plan on a critical social engagement for at least three months after surgery. Plan your nose surgery accordingly…and your explanations carefully.

 

Dr. Barry Eppley

Indianapolis, Indiana

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