Admin's blog

Many patients wonder how long it takes for all of the swelling to dissipate after a rhinoplasty. Rhinoplasty is unlike other procedures where patients can often see a "final" result within a three month span. In fact, most patients take up to a year or longer for the swelling to reach a final status. This does not mean the nose will not look presentable, but the nose still may be healing as the swelling decreases.

So what is the typical course of swelling for a patient after rhinoplasty? The above chart demonstrates the typical amount of swelling after a primary rhinoplasty. In the beginning, the nose may actually swell up to more than the size of the original nose. This is temporary swelling and will dissipate quickly.

After the first week, patients take off their casts most patients will have moderate swelling. The vast majority of patients feel comfortable returning to work at this point and returning to public. However, patients typically like only a small percentage of the nose at this point.

Usually, by the end of the second week, much of the swelling has lessened to the point that patients start to like more things the nose. It typically takes about a month to get swelling down to the point where patients like their noses. However, at this point, the nose is still not photographing well. At the three month mark, most patients nose becomes more photogenic. It is for this reason that patients are recommended with a big event upcoming to wait for at least 3-6 months. The final portion of swelling takes a much longer time to resolve, up to a year or longer after surgery.

Since we are all different, everyone will have a variable response to rhinoplasty. Some patients will have limited swelling, while others will have more swelling which takes longer to resolve. Rhinoplasty swelling varies greatly and is largely based on the areas of the nose treated, surgical approach to the nose (open or closed), skin thickness, postoperative care, and your healing ability. The more extensive the surgery, the more you will swell and the longer the swelling will last. The tip of the nose holds onto swelling longer than the other parts of the nose. Open rhinoplasty, where there is an external incision at the base of the nose, swells more and longer than a closed rhinoplasty. Patients with thicker skin will have more swelling.

Persistent swelling is managed in the office setting and often involves taping the nose (if the skin can tolerate tape), diet modifications, and may also require steroid treatment into the nose known as Kenalog injections.

Sunscreens are all the same. Or are they?

With warmer weather in full swing, the natural response is to slather on the sunscreen and get prepared.  However, is it possible that the sunscreen you are wearing could be doing more harm than good?

Recently, several studies have suggested that the active ingredients in some sunscreens (Oxybenzone, Benzophenone, Octocrylene, OctylMethoxycinnamate) may be linked to an increased risk of melanoma.  Melanoma is a type of skin cancer that is less common than other skin cancers, but is responsible for at least 75% of the deaths caused by skin cancer.  Sunscreens with PABA can cause DNA damage in skin which can also promote cancer.  In addition, some of the ingredients listed sunscreens can cause estrogenic effects, since some of the ingredients in sunscreens can mimic the hormone estrogen.  

So what is the average person supposed to do?  First of all, it is important to understand that sunscreen still serves a purpose for more patients. The sun's harmful rays lead to dark pigmentation, wrinkles, aging, and skin cancer. However, balance the strength of the sunscreen with the potential effects.  A sunscreen of 30 blocks 98% of the sun's rays.  The stronger SPF sunscreens may provide a small amount of additional protection, but with more potential chemicals.  Avoiding the sun is probably the best defense against sun cancers.  If that is not possible, think of using protective hats and clothing as well.  Finally, you can check out how your sunscreen fares on the Environmental Working Group's website a fantastic resource. Our office recommendation is that many mineral sunscreens can be too thick and make the skin look too chalky.  We use Daily Physical Defense SPF 30+ from Skin Medica on active days in the sun.  Its product applies to the skin a thin layer which does not diminish the protection it provides to your skin.

Avoid in Sunscreen:

• Oxybenzone (Benzophenone-3)
• Benzophenone (Dioxybenzone, oxybenzone)
• Octocrylene
• OctylMethoxycinnamate
• PABA
• PABA esters (ethyl dihdroxy propyl PAB, glyceryl PABA, p-aminobenzoic acid, padimate-o, octyldimetlyl PABA)
• Cinnamates (cinoxate, ethylhexyl p-methoxycinnamate, octorylene, octylmethoxycinnamate)
• Salicylates (ethyl hexyl salicylate, homosalate, octyl salicylate)
• RetinylPalmitate