I tell my patients to not look at the front view with scrutiny for two to three weeks by which time about 80% of swelling is gone. The profile will look better before the front view. Avoiding exercise and hot tubs and such stimulation and strategic post op taping can definitely limit and guide the swelling. Enough swelling is gone by two months that we should be able to take post op pictures with evidence close to the final result. In most people after 6 months there is less than 5% more to resolve and by one year it probably will not further improve. I agree with the answer previously posted that the nose takes longer to equilibrate than other parts of the body and there can be flare ups of swelling months later due to stress or excessive exercise or emotional or physical experiences.
By 6 months we should be able to assess if there needs to be a minor touch up. The possibility of a minor touch up after six months should be discussed before any surgery of the nose since a recent study indicates that the most successful rhinoplasty surgeons do such a second adjustment or refinement in 10-20% of cases. The reason why the better nose surgeons may do more touch ups than the less experienced operator is that, even though their results may be very good, they and their patients have a higher level of expectation…not unrealistic mind you…but a common goal to have the best nose for the long term. Since there are vagaries in the healing process and not everybody scars and heals the same…a commitment for an adjustment at 6-12 months at minimal cost is better understood at the front end. Rhinoplasty is part science and part art and, if there is legitimate room for improvement at minimal cost and minimal risk, than it is better to have your doctor respect your concerns and to recognize falling short of the goal. This does not mean that the doctor did not do an excellent job…it just means that despite his or her best effort, there is room for an improvement. Of course there are unrealistic patients at times and rarely a patient may be impossible to satisfy no matter how well the procedure is done. Yet most patients are reasonable and rhinoplasty is popular because the great majority of patients are happy with the improvement. After one year, significant improvement will not come by tincture of time and, if you feel you are not “being heard”, perhaps a second opinion is appropriate. I wish you success.