Face Swelling After Rhinoplasty: What You Should Know

Along with many types of post-cosmetic surgery presentations I get to work with, Rhinoplasty can also present with facial swelling, which is one of the most common (and often most frustrating) parts of post-surgery recovery. While you may find many therapists claiming to work with lymphatic massage, as a therapist trained in Manual Lymphatic Drainage (MLD) through the Vodder Academy, I can help you achieve great results post surgery and help your body deal with excessive swelling, bruising, and, where it happens, even fibrosis. I

So in this article, I want to explain why swelling can last longer than expected after rhinoplasty, what the science tells us, and how MLD may help reduce swelling and limit the development of fibrosis during the healing process.

Why Does Swelling Persist After Rhinoplasty?

Rhinoplasty is a surgery that can be done for cosmetic or functional reasons, like improving nasal breathing, and is a surgical procedure that involves deliberate trauma to bone, cartilage, and soft tissue. This trauma triggers inflammation and a temporary disruption of the lymphatic system, the network responsible for clearing excess fluid from tissues.

Scientific research published in the Plastic and Reconstructive Surgery Journal shows that:

• Approximately two-thirds of post-rhinoplasty swelling resolves within the first month

• Up to 95% resolves by 6 months

• Residual swelling can still be present 12 months or longer, particularly in the nasal tip.

Now, two things about those data:

1. Those numbers are the results of a study done on 40 patients, so still, even if they are quite promising, more evidence is welcome for further comparison.
2. On the other hand, this prolonged swelling is a normal physiological response, but it can be uncomfortable and visually concerning.

The Role of the Lymphatic System in Facial Swelling

The swelling that you may present with post-rhynoplasty surgery is due to a temporary impairment of the lymphatic system, which acts as the body’s drainage mechanism. After surgery, lymphatic vessels can become overloaded or temporarily impaired, leading to fluid stagnation in facial tissues.

In another paper by Meade R et al. (2012), published in the Oxford Academic Journal, it is shown that postoperative facial surgery disrupts lymphatic flow, leading to prolonged edema in the head and neck region.

In more chronic cases, where lymphatic fluid stagnates for prolonged periods, patients may also experience tissue hardening and early fibrosis. 

What Is Manual Lymphatic Drainage (MLD)?

Manual Lymphatic Drainage is a gentle, non-invasive manual therapy designed to stimulate lymphatic vessels and redirect fluid toward functioning lymph nodes.

Unlike remedial massage or deep tissue techniques, MLD is a post-surgical lymphatic massage characterised by:

• Light Pressure
• Slow and rhythmic Movements
• MLD aims to stimulate superficial and deep lymph vessels, not muscle tissue

MLD is internationally recognised as part of Complete Decongestive Therapy (CDT), the gold-standard conservative treatment for lymphatic swelling. Lasinski B.B. et al. (2012).

How MLD May Help Reduce Swelling After Rhinoplasty

As mentioned above, the number of patients who undergone clinical trials for post-rhinoplasty swelling treatment is limited, but along with other studies available on PubMed, the physiological principles of MLD are well supported, and here is a breakdown of what you can come across while doing some research:

1. Supporting Fluid Reabsorption
   By stimulating lymphatic flow, MLD helps the body clear excess interstitial fluid more efficiently, which may assist in reducing facial puffiness and pressure.
   Marxen T. et al. (2023).
2. Improving Tissue Mobility
   Reduced fluid stagnation helps tissues remain softer and more pliable during healing, an essential factor for aesthetic outcomes.
   Masson I. et al. (2014).
3. Encouraging Symmetrical Healing
   MLD techniques can be adapted to address asymmetrical swelling, which is very common after rhinoplasty.
   Ulu M. et al. (2025)

MLD and the Prevention of Fibrosis

When the body goes through severe trauma, like a surgery, as part of its natural reaction, it may build tissue under the skin. This tissue is called: Fibrosis.

Fibrosis may feel firm to the touch and leave you with a feeling of tightness under the skin. When swelling is unattended, can leads to fibrotic formation and changes.

In this clinical study by Masson I. et al. (2014), they looked into post-liposuction and body contouring surgery, and how Manual Lymphatic Drainage, particularly when combined with other conservative therapies, can reduce both swelling and tissue fibrosis.

While facial tissues differ, the underlying biological mechanism is shared: improved lymph flow supports healthier tissue remodelling.

When Can MLD Begin After Rhinoplasty?

Timing is crucial, but MLD post- rhinoplasty should only begin:

• With surgeon approval
• Once acute inflammation has stabilised
• Using facial lymphatic drainage massage protocols appropriate for post-surgical tissue
• Once the antibiotic cycle is finished, and the risk of infections is no longer there anymore

At Melbourne Massage and Treatment in Fitzroy North, I tailor each session based on:

• Surgical date
• Healing stage
• Tissue sensitivity
• Presence of swelling or firmness

MLD is not a painful treatment, and it doesn’t matter how sensitive your skin is, or how good you are at tolerating pain, still, throughout the treatment, pain should not be experienced, as this would lead to increased inflammation, which is not what we need, when clearing off exceed lymph liquid to reduce oedema post-surgery.

My Approach With MLD at Melbourne Massage and Treatment – Fitzroy North

As a Vodder-trained MLD therapist, my focus is on precision, safety, and evidence-informed care.

Each session is:

• Gentle and non-invasive
• Individualised to your healing phase
• Focused on supporting natural lymphatic recovery
• Most clients benefit from a short series of treatments over several weeks or months, depending on swelling persistence.

Nothing can boost your healing, whether you went through a cosmetic surgery or just had a severe incident, but there are certain practices, like MLD or exercises, and even good food and plenty of rest, that can help in assisting your healing process and not make it worse or longer.

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FAQs:

Rhinoplasty — Frequently Asked Questions

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