Is rhinoplasty very painful?

It should not be a horrendous experience. There is some discomfort related to the use of soft plastic splints or packing in the nose. In my experience, patients with a very positive attitude have very little pain. Patients who are anxious have more pain. Most patients say they are "uncomfortable " from the swelling and congestion. Medications such as Percocet or Vicodin are usually sufficient.

Why does it take a full year to see final rhinoplasty results?

In any type of rhinoplasty the skin is elevated off the cartilage and bony achitecture of the nose. This interrupts the normal flow of blood and other tissue fluid in the skin. As the skin of the nose regains a more normal blood flow and as the the skin regains its ability to handle tissue fluid, the swelling gradually goes away. This process, on the nose, can take a year to 18 months. With a normal incision elsewhere on the face, it can take 6 months to a year. From a practical point of view, most of the swelling over the nasal bones is gone in 12 weeks or so. It is the tip of the nose and the area just above the tip, the supratip, that retain fluid longer. In addition, with some skin types, especially thicker Mediterranean skin, there can be a tendency to form thick scar in the supratip region. This may need to be treated with a small amount of a steriod injection and massage. Finally, while the nose should look pretty much like it is going to look at 18 months or so, the nose will continue to change lifelong. As you age, your skin thins. This includes the nose. Also, the skin tends to "shrink wrap " around the nose over time. This is not a problem as long as there is good and appropriate subcutaneous tissue, cartilage and bony support under the skin.