RHINOPLASTY

• Sleep with your head elevated.

• No nose blowing, and Sneeze with mouth open - FOR 2 WEEKS.

• If you have packing/splints in your nose - they will be removed in the office in 1 week. You will likely feel congested, and it may be difficult to breathe through your nose until then.

• NOTHING should touch your nose. If you need an icepack - keep it away from your nose and nasal tape.

• NOTHING SHOULD TOUCH YOUR NOSE - including glasses. If you have to wear glasses to see - tape them to your forehead. Contacts are good alternative. Various devices, such as LINK, are also available to keep the glasses off the nose.

• Keep the cast dry - no hot steamy showers, wash your hair backwards (salon style)

• If the cast falls off - DO NOT tape it back on - notify your doctor.  If it becomes loose - do NOT reinforce it - just let it fall off on its own.

• You may have some bloody drainage from your nostrils over the first few days - use a drip pad as needed.

• Notify your doctor if your bleeding soaks through more than 4 pads in 1 hour.

• Notify your doctor of any worsening pain, fevers or foul smelling drainage

• Facial pressure, ear pressure and discomfort with swallowing are possible during your recovery period.

• Your eyes may be bruised - this is normal and will resolve.

• Typical medications prescribed:

  • Percocet - take as needed for pain. It contains Tylenol/Acetaminophen. Total limit for all Tylenol/Acetaminophen containing medications is 4000mg in 24 hrs.

  • Medrol dose pack - steroid to help with swelling and inflammation.

  • Antibiotic. Ocean/Saline nasal spray - use regularly, even if it's not getting in. Also, you can use over the counter

  • Afrin nose spray - ONLY FOR THE FIRST 1-2 DAYS, and ONLY if you're still bleeding.

Most patients have soft plastic splints in each nostril and a cast on top of their nose for the first week. These are removed at one week - during the first follow up. Immediately after surgery, patients are given pain medicine, antibiotics, and nasal saline spray. Often times a steroid pack is given to help with swelling and discomfort. Most patients are able to switch to plain Tylenol after about 3-5 days. Most patients feel at or near 100% by 2-3 weeks. However, healing and swelling resolution continue for quite a bit longer. It takes on average 1 year for all the swelling and healing to be completed and for the nose to achieve it’s final result.

Your first follow up will be at 1 week – splints and external cast will be removed. We will then see you at 6 weeks, 6 months and 1 year postop. We will obviously also see you at any point for any interim concerns. After your first year, we prefer to continue to follow you on an annual basis.

If work is done on nasal bones, the chance of bruising around the eyes is much higher. This typically resolves within 2 weeks – like any other bruise you may have.

Patients are typically comfortable going out and are “restaurant ready” within 3-4 weeks after surgery. However we recommend you give yourself about 3 months between surgery and any major life events, like weddings.

For patients with desk jobs, they’re usually comfortable returning to work within 7-10 days after surgery, although for jobs requiring a lot of personal interactions, like sales, your bruising may not be yet resolved at that time. Patients working physical jobs will need at least 2 weeks off work. It takes about 6 weeks for the nasal bones to regain their strength back, and special care will be needed during that time to avoid new injury to the nose. For people playing sports, especially contact sports, 6 weeks recovery is recommended. Face shields can also be helpful, but certainly no guarantee against re-injury. Repeat injury of the nose following rhinoplasty will often require revision surgery (see below), which is certainly feasible, but often a more challenging undertaking.

Swelling resolution and internal tissue healing after rhinoplasty typically takes a full year to complete. In very thick skin, this may take even a full 2 years. However, by the end of the first month, the swelling is typically 50% improved. Therefore, we usually reserve our final result judgements until your 1 year follow up. The nose continues to change during the postop period and can look different almost every day, especially in the initial postoperative period. Therefore patience is key during this time.

Common Concerns Treated:

• Tip asymmetry, collapse, droop, deformity

• Pollybeak deformity

• Retracted nostrils

• Deformed/crooked nose

• Saddle nose deformity

• Nasal valve dysfunction or breathing obstruction

• Irregular dorsum, residual humps or scoops

Expected Recovery: Initial swelling and bruising typically subside within 2–3 weeks. Full results evolve over 12–18 months. Because scar tissue can slow healing, patience is essential.

Risks: Include prolonged swelling, need for further revision, nasal obstruction, and cosmetic dissatisfaction. Choosing an experienced and thoughtful surgeon is critical to minimize these risks.