Rhinoplasty Post-Operative Instructions
Immediately after surgery
Minimize your activity (non-strenuous) during the first week following surgery. It’s OK to walk around the house but avoid bending at the waist or lifting heavy objects. Exertion may result in bleeding, swelling and delayed healing. When you rest or sleep, keep your head elevated on 2-3 pillows and try to avoid turning on your side. Please drink plenty of fluids and eat soft foods. Keep your diet soft. You may carefully clean around the nostrils with a Q-tip and hydrogen peroxide(50/50) three times a day. A humidifier may help you sleep by allowing you to breathe through your mouth more comfortably. Do not blow your nose or sniff excessively as this will only irritate the healing tissues. If you must sneeze, open your mouth.
Showering is allowed on the second post-operative day. Keep your dressings dry. A bath may be easier. You may carefully wash your face with a mild soap and a clean washcloth. Avoid cigarette smoking or even being in an area of excessive smoke as this irritates the nasal tissue and impedes healing.
Week 2 and beyond
It takes six weeks for the nasal bones to fully heal. Slowly resume your activity. Strenuous exercise may be resumed in 5-6 weeks. Build up to this level slowly and use your best judgment. When outside, wear sunscreen with a SPF of at least 15.
Pain, Swelling, Bruising, or Bleeding
Mild bleeding or oozing is common the first 2 days. Avoid swallowing the blood, as it will make you nauseated. Most patients complain more of discomfort from nasal and sinus congestion than from pain. Any pain should be controlled with the prescribed medication. After the first day, you may consider using over the counter pain medications as you see fit i.e Tylenol, ibuprofen etc.. Swelling and bruising about the eyes and cheeks is variable. Swelling maximizes at about two days then subsides over the next week. An ice pack or bag of frozen peas to the eyes for the first 48 hours may help decrease the swelling about the eyes and cheeks. This will clear completely and will not adversely affect the result. Bruising (discoloration) may persist a few days longer. Remember, this will all subside in time and has no bearing on your final result. You should discontinue all ice packs after 2 days and then may start warm compresses on the third to fourth day after surgery. A wet wash cloth that has been warmed in the microwave and placed in a zip-lock bag is a simple technique. Be sure to test the temperature before placing it on your face.
It is normal to have bleeding over the first 12 hours after surgery. It may be necessary to change the gauze a dozen or so times over this period. It is normal to have a pinkish-reddish discharge from your nose and throat for the first 3-4 days. This will gradually subside. If you have profuse nasal bleeding after this time, immediately lie down with your head elevated on 3-4 pillows. Iced washcloths on the back of the neck and over the eyes may help. Using nasal decongestants (such as Afrin) as directed will often help with bleeding. Please call our office if these measures do not suffice.
Bleeding is more likely if you take medications such as Vitamin E, aspirin or ibuprofen and herbal supplements such as ginko, ginseng and garlic. Please avoid these products for 2-3 weeks prior to surgery. Pain medication will be prescribed. Take it as needed. Please remember that pain medication may impair your reactions. Avoid driving or performing hazardous activities while taking this medication. If the prescribed medication does not control your symptoms, please let us know. Nausea may occasionally be related to the above medication. Taking the medication with food may help alleviate the nausea. After the first 24 hours, Extra-Strength or regular Tylenol may be sufficient.
Infections are unusual, but occasionally occurs. Fever over 100 ° F, excessive pain and swelling with redness may signify a developing nasal infection and should be reported. Infections generally clear up quickly with appropriate antibiotic treatment.
The nasal packs will be removed between 1-5 days after after surgery depending on your specific situation. The cast and any sutures will be removed after one week. Paper tape may then be applied to your nose and removed in one week. When the cast is removed, the nose will be quite swollen and the nasal tip will be turned up. This will settle down over the next few weeks, then more gradually thereafter. Remember that the nose does not assume its final shape until many months after surgery, depending upon the type of nasal skin you have. It will probably look better than prior to the operation within two or three weeks, but the final result takes longer. Be patient. Occasionally, an injection is necessary to reduce the swelling in one area. Minor touch up surgery that may be necessary is not preformed for at least six months.