Postoperative Edema Resolution following Rhinoplasty: A Three-Dimensional Morphometric Assessment.

BACKGROUND: The final result of rhinoplasty may be masked for several months after surgery because of postoperative edema; however, no objective evidence supports this time estimate. The purpose of this study was to three-dimensionally quantify the decrease in postsurgical nasal edema following rhinoplasty over the first postoperative year.

METHODS: This was a retrospective, three-dimensional, morphometric study of primary, open rhinoplasty patients. Subjects with at least three postoperative three-dimensional images up to 1 year were included. Patients were excluded for closed or secondary procedures or cleft deformities. Images were assessed using three-dimensional stereophotogrammetry (Vectra) and volumetric analysis (Geomagic). Baseline nasal volume (time 0) occurred at the first postoperative visit at 1 to 2 weeks. All subsequent nasal volume measurements were calculated as a percentage of baseline values. Data points from all patients were pooled, and a six-point moving average was used to create an inverse function line of best fit.

RESULTS: Forty patients were included, with 146 three-dimensional photographs quantified. The equation for the inverse function line of best fit of the six-point moving average was y = 1.484 (1/x) + 0.844 (R = 0.85, p < 0.01). According to this equation, approximately two-thirds of edema resolves within the first month, 95 percent after 6 months, and 97.5 percent after 1 year. A plateau is reached at 84.4 percent of the original postoperative volume.

CONCLUSIONS: This study provides quantitative evidence to predict decrement of rhinoplasty edema with time. Three-dimensional morphometric assessment demonstrated a two-thirds decrease in edema at 1 month, a 95 percent decrease at 6 months, and a 97.5 percent decrease at 1 year.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.