POST-OPERATIVE RHINOPLASTY

Post-operative care is very important. Unnecessary pain and the complications of infection and swelling may be minimized if the instructions are followed carefully. Sometimes the after-effects of surgery are quite minimal, so not all these instructions may apply. Common sense will often dictate what you should do.  However, when in doubt, follow these guidelines or give us a call any time for clarification.

Rhinoplasty is a common surgery that not only can give a great cosmetic outcome but also can improve nasal breathing.  The success of the surgery lies in the hands of the patient as well as the surgeon. The best surgeon on earth will not obtain satisfactory results if the patients do not properly care for themselves after surgery. In order to take advantage of all the positive changes associated with the Rhinoplasty, the patient must pay close attention to the recovery process.

Immediately after Rhinoplasty

  • You will stay overnight in the hospital and cared by our care staff and nurses. When you wake up after the surgery you may feel dizzy. You may vomit or some small bleeding may occur. Please ask nurses for help for using the toilet or other requirements.
  • You should rest with your head elevated in a recliner or with at least 2 pillows for at least the first week after surgery.  Try not to sleep on the side of your face but rather sleep with the back of your head on the pillow.
  • Take the prescribed medications before you begin to feel discomfort.  It is easier to prevent pain than control it.
  • After general anesthesia, clear liquids should be initially taken. Over the next several days a high calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Keeping well hydrated also prevents nausea and vomiting. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.  Decreased activity may promote constipation so you may want to add more raw fruit to your diet and be sure to increase your fluid intake.  Avoid straining when going to the restroom. Getting a laxative or a stool softener may be beneficial.

FIRST WEEK after Rhinoplasty

  • Ice: During the day and evening of surgery, cold compresses are used continuously over the nose and eyes to minimize swelling and control bruising. The ice packs should be used for the first 2 to 3 days as much as possible.  A good way to do this is to crush up the ice and place it into a zip lock bag. Wrap a thin towel around the ice pack and place it over the nose and over the eyes.
  • Puffiness: Puffiness or swelling of the eyelids is always most pronounced on the second morning following any facial plastic surgery (e.g. surgery on Monday, most swelling on Wednesday). It usually regresses quickly in the next few days. This normal and expected observation is no cause for concern.
  • Bruising: Bruising and discoloration around the eyes is extremely variable. However, the majority of patients do experience minimal black and blue. Careful adherence to the recommended pre-operative medication instructions is imperative. A few patients, despite taking all precautions, will develop marked bruising in the eyelids. Even this bruising is usually resolved by the end of the first week.
  • Nasal Appearance with Cast: During the first week, you may notice that the nasal tip is slightly elevated. This is a constant, temporary factor following all rhinoplasties. The position of the nasal tip at this time has little relationship to the final result. The tip will slowly drop to its new lower position over several days or weeks. The nasal splint will be removed at the end of the first week.
  • Exercise: Exercise must be limited during the first week. While relaxed ambulation about the home and local shopping, dining or visiting is encouraged: any lifting, pulling or straining must be avoided, as it may cause bleeding.
  • Stiches will be removed at 1 week.  After all stitches have been removed, the scar will appear a deep pink color. There will be varying amounts of swelling in and around the scars themselves. With the passage of time, the pink will become white, the firmness of the scar will soften, and they will become less noticeable. Each individual varies with respect to healing, but it takes approximately one year for these changes to occur in most scars.

SECOND WEEK After Rhinoplasty

  • Activity: Though the bones are firmly healing in place, even a slight blow could cause movement. Avoid any situation where a potential for ‘nasal trauma exists. Exercise which increases the heart rate can begin at 14 days post-up. Exercise during the first week post-up can cause bleeding. During the second week post-up it will increase edema or swelling. At 14 days, you can begin fast walking and light weights. At 21 days, you can begin running and heavier weighty. At 30 days, full exercise can begin. A frequent question is “…when can sexual activity resume…” As a moderately exertional activity (caloric expenditure), sexual activity can safely be resumed at 12-14 days following facial plastic surgery.
  • Sun Exposure: It is wise not to sunbathe for about 60 days. A sunburn will cause the nose to swell and delay the final result. Walking about between sun and shade or sitting with a hat, is permitted. It is always best to apply a waterproof factor 25 sunblock to the nose if strong sun exposure is anticipated.
  • Nasal Appearance: At the time of nasal splint removal, you will have your chance to see the new nose. It will appear quite swollen but, in most cases, even in this swollen condition, the improvement can be appreciated. It is not a time for critical evaluation since, over the next few weeks, daily changes progress toward the final result.
  • Wearing Glasses: You should not wear glasses for about one month. If glasses must be worn, taping the central bridge of the glasses to the forehead will allow as little pressure as possible on the nasal bones.
  • Make sure you finish the antibiotic even if you feel like you are completely better and do not need it. Sometimes taking antibiotics with yogurt can help prevent diarrhea.  If you take birth control pills, the birth control may become ineffective; use back up form of birth control.
  • Small irregularities may be felt below the smooth skin, especially over the nasal bones. These irregularities are common. Most noses, even without surgery, have palpable bone irregularity beneath smooth skin.
  • In most cases, the appearance at six to eight weeks approximates the final shape. Many factors determine how quickly, or slowly, the nose assumes the final appearance. The most influential determinant is skin type. Skin that is thicker and oilier is certain to retain edema and swelling longer that skin that is drier and thinner. Individuals vary in healing potential. The nose will continue to heal over a long period of time with subtle changes occurring over years of surgery. Our goal is to provide a long term result which will last the person’s entire life.

Restrictions

  1. No strenuous exercise for at least two weeks.
  2. No heavy lifting for three weeks.
  3. No pull-over clothing for two weeks.
  4. Avoid hard chewing foods for two weeks.
  5. Avoid yawning or wide mouth opening for two weeks.
  6. Avoid nose blowing or sniffing through the nose for two weeks.
  7. Use a baby toothbrush on the upper teeth for two weeks following surgery.
  8. If sneezing, sneeze with the mouth open for two weeks.
  9. No driving for one, preferably two weeks after surgery.
  10. No contact sports for six weeks.