Reduction in Postoperative Rhinoplasty Edema with Time

INTRO:

The final result of rhinoplasty may be masked for several months following surgery due to postoperative edema; however, no objective evidence supports this time estimate. The purpose of this study is to 3-dimensionally quantify the decrease in post-surgical nasal edema following rhinoplasty over the first postoperative year. 

METHODS:

            This was a retrospective, 3D morphometric study of primary, open rhinoplasty patients. Subjects with at least 3 postoperative 3D images up to one year were included. Patients were excluded for closed or secondary procedures or cleft deformities. Images were assessed using 3D stereophotogrammetry (Vectra) and volumetric analysis (Geomagic). Baseline nasal volume (T0) occurred at the first postoperative visit at 1-2 weeks.  All subsequent nasal volume measurements were calculated as a percentage of T0. Data points from all patients were pooled and a 6-point moving average was used to create a inverse function line of best fit.

RESULTS:

            40 patients were included, with 146 3D photographs quantified.  The equation for the inverse function line of best fit of the 6-point moving average was y = 1.484 (1/x) + 0.844 (R² = 0.85, p<0.01).  According to this equation, approximately two-thirds of edema resolves within the first month with the majority of the remainder resolving within the first year, reaching a plateau of 84.4% of the original postoperative volume.

CONCLUSION:

            This study provides quantitative evidence to predict decrement of rhinoplasty edema with time.  3D morphometric assessment demonstrated a two-thirds decrease in edema at 30 days, with subsequent swelling gradually resolving over the remaining year.