Nose Recovery

Recovery Basics

• To reduce swelling, the head needs to remain elevated (above the lower torso) for a few days.
• Recuperation time varies by patient, but you should count on 1-2 weeks to be on the safe side.
• If packing is used inside the nose, it will usually be removed the following day after surgery. Nasal splints required to help set the bone and cartilage to guide the healing that promotes the new shape is generally removed after a week.
• After surgery, there is little discomfort which cannot be controlled by oral medications.
• The objective of this procedure is to balance your facial features, never to make you look like someone else.
• If you also have a septoplasty, your breathing will improve noticeably, especially at night.
• This procedure is for people seeking to look and feel better, not for people who believe in perfection, an objective that  God (or Mother Nature) rarely attains.

Rhinoplasty Instructions Post Surgery

We cannot possibly answer all the questions that you could have post-operatively. You will need to check with the surgeon you select for those instructions. Below, you will find the most commonly asked questions patients have following surgery.

Week 1 Activity

Most importantly, during the first week post surgery, do not do anything that could hurt your nose. The tissues inside your nose need to heal without any kind of physical trauma to the surgical area. Imagine that the healing nose is like a loaf of bread baking in the oven. At first, it will be soft and malleable and if you touch it, it could leave dents before the hard crust can form. What does this mean practically?

• Don’t pick up pets, children, or do any activity where you cannot predict what will hit your nose (tennis, racket ball, fishing, karate, etc.). In spite of our precautionary recommendations, you will hit your nose once or twice during the first week, and this will hurt but not cause any problems unless it was done with a racket, a golf club, or any instrument that can bring lots of force on a small area.
• No gardening or any activity where you have to bend down from the waist, because bleeding may result (harvesting strawberries, hunting for sea shells, yoga, etc.)

• At night, sleep on your back with several pillows to keep your head high. Do not roll on your side. If you cannot sleep on your back, you can use something like a football helmet or a fencing mask to wear, just in case you fall on your nose, should you fall asleep on your side.
• Depression following surgery is normal but doesn’t last long, especially after you see the results. So if you feel anger, anxiety, or a need to cry, remember that it’s a passing phase and avoid it because it can lead to bleeding and swelling.
• Drink lots of liquids and eat foods that don’t require much chewing. Gerber baby food would be exaggerating, but a lean and tough flank steak is not a good idea.
• Cleaning the wound: yes, but not more than 3 times daily with a Q-tip soaked in hydrogen peroxide. Just after this cleaning, swab a smidgen of petroleum jelly or antibiotic ointment around the nostrils so they do not get dry.
• Swelling of the nose will make it difficult to breath for a minimum of 2 weeks. If you are in a dry climate, or the heating system where you reside lowers the humidity, a humidifier could help your nasal passages to remain moist and consequently help you breathe.
• If you must sneeze, keep your mouth open to avoid the pressure that is created in your nose with a sneeze.
• No smoking or being around people who smoke
• Beginning with the second day you can bathe or shower but wash your face only with mild soap using clean wash cloths and or cotton balls around the nose.
• Alcohol should be avoided during 2 weeks to prevent possible bleeding

Second Week

Don’t forget that it takes up to a month and a half for the internal tissues in your nose to heal completely and you should not try anything rough, like contact sports, until after 6 months. Beginning with the second week you need to listen to your body. Generally, strenuous exercises like running, weight lifting, or swimming cannot be resumed until after 6 weeks. If you are outside in the sun, always wear the best sun screen possible. We recommend Neutrogena with an SPF of at least 45 Plus or with Helioplex in the formula.

Post-operative Bleeding & Pain

During the first 1-2 days you will experience some bleeding which you should try not to swallow to avoid nausea. The majority of patients tend to be bothered more by nasal/sinus congestions than from pain, which should be easily alleviated with the prescribed medicine you will receive from the doctor. After the first day you will most likely only need over the counter pain medication like Tylenol extra strength (Do not use aspirin based products because these are blood thinners that could re-start the bleeding). Should the pain not be stabilized with over the counter medication after the second day, you should call your doctor and have them prescribe more of stronger pain killers.

Post-operative Swelling

Swelling is due to blood vessels that were severed during the operation and bled post operatively underneath your skin. This is normal and varies from person to person and you should try to remember that this will not affect the overall result after you are healed. You are allowed to use ice packs during the first 48 hours to reduce the swelling but you should never put ice (or any freezing object) directly in contact with your face and on your nose in particular. Ice packs should not be used longer than 10 minutes on, 10 minutes off. Ice directly on the skin (in particular nose, fingers, and ears) can cause frostbite if left longer than ten minutes. Frostbite will leave a permanent scar.

Post Op Bleeding

Post-op bleeding for 12 hours is normal, so you should be ready to change out the gauze many times during these initial hours; 10 to 15 changes would be considered normal. Also expect to have a small light-reddish discharge from your nose and possibly your throat for the first few days which should gradually go away after the fourth to the fifth day. After this time, should you have a heavy bleeding episode, lie down with your head supported and held high by several pillows. Using a small ice-cooled washcloth on the back of your neck or over your eyes could be helpful. Nasal decongestants used moderately and as directed are very often helpful to stop the bleeding. If none of these suggestions are effective please call your doctor’s office.

Post Op Medications

As we mentioned before, for up to three weeks following surgery you need to avoid blood thinners like Aspirin, Advil (ibuprofen) and Vitamin E. Only use the pain medication that has been prescribed by your doctor and use only as needed. Please read the warnings on all pain medications you take since these will affect your reaction time doing common activities like driving. And, if the medication provided by your doctor is not effective, you will need to call the office. Nausea is a common side effect of strong pain medication which can be alleviated by taking this medication with food. All these reasons make it important for you to switch to over the counter pain medication like Tylenol as soon as possible.

Post op Infections & Fever

Infections are unusual after a rhinoplasty but happen infrequently, unless an artificial graft made with a product like Gortex was used during the operation. Even then, these latter become rarely infected and if they do, antibiotics can be used to cure the infection. In still rarer cases, the body’s immune system can reject an artificial graft, in which case, a second procedure will be required to remove the graft and replace it with your own body tissue. If you develop a fever that exceeds 100 ° F, or if you have excessive pain and swelling combined with redness, these could be the signs of an infection and you should immediately call your surgeon. If an itching develops due to these symptoms, please avoid rubbing or scratching that area because this will aggravate the redness and swelling.

Post-Op Visits

All Plastic Surgeons have somewhat different Post-op visit schedules but here is what you can generally expect:

• Nasal packs are removed the day following surgery.
• Sutures, splints, and or casts are removed after 7 days, after which your nose will be taped for another week.
• You will probably be asked to do some nasal exercises to help your nose heal in proper alignment; expect to do these daily one to two dozen times for up to 6 weeks.

During this healing time, the most important virtue is patience. You will not be able to see the final result for 3 to 6 months but you will look better than before the operation after just 2-3 weeks. Very infrequently, injections will be required for swelling. Touch up surgery is also a possibility but cannot take place until at least six months unless there is an infection that cannot be controlled by antibiotics.

Great Expectations; getting back to average

After the major medical post op side-effects have abated, you will feel much better about yourself. In fact, during the first 6 months you may even feel slightly euphoric. This lasts for a year or so until which time your new nose will be so much part of you that you will have forgotten what it looked like before. And, that’s what your goal should be, to have a nose that neither you nor anyone else notices. With respect to noses, we want them to be average and to disappear in the crowd. The changes to your nose will be permanent, however, as you get older, you can also expect your nose to age like it would have without a rhinoplasty, but with its new shape.