What is the typical rhinoplasty recovery like?

This is a great question that every patient considering a rhinoplasty wants to know. The answer varies from patient to patient based on degree of surgery, revision vs primary surgery, and patient characteristics (thick vs thin skin) but in general:
- Week 1: You'll have a nasal cast, splints in the nose, and sutures underneath the tip of the nose. At this point, most patients complain more of pressure than pain. You will likely be very congested because of the nasal splints. At this stage it is very important to keep the nose clean (q-tips with hydrogen peroxide for nasal crusts, saline sprays to keep the inside of the nose moist, antibiotic ointment to the incisions). We typically have patients take tylenol, motrin, and oxycodone (a stronger pain medication). Patients typically take the oxycodone for around 2-3 days before they feel like they can manage with tylenol and motrin alone. Elevating the head of the bed or sleeping on a few pillows can help the swelling improve and will also keep you from rolling over onto your nose. Avoid nose blowing, bending over, or heavy lifting.
- Week 2: Around 5-7 days after surgery we will remove the nasal cast, splints, and sutures. We recommend eating something the morning of this procedure as some patients can become light headed when removing splints or sutures. After these are removed, patients typically feel a significant relief of the pressure sensation and nasal congestion they had in week one. At this point we switch from the antibiotic ointment to regular vaseline as you no longer need the antibiotic portion. It should be noted that you will experience some "rebound swelling" after removing the cast and splint and it is normal to feel more swollen/congested the day after splint and cast removal, but this will return back to normal over the following few days. At this point we encourage patients to continue to avoid blowing the nose, bending over completely, or heavy lifting (typically for around 4 weeks). Based on how you are feeling, it is okay to return to work at this point with the aforementioned precautions being followed. Some patients will have bruising around the nose or under the eyes which can be treated with arnica ointment or tabs to help resolve more quickly.
Week 3-6: By now, most of the bruising should be resolved. You should continue to use saline sprays and ointment to help with healing. We will typically see you back for a second follow up anywhere from 4-6 weeks after surgery to ensure everything is healing as expected. Around week 6, we have patients switch from vaseline to a scar cream like mederma. We will also clear patients at this point for more strenuous exercise. At this point, alot of swelling will have gone down, but it should be noted that it can take anywhere from 12-18 months for all of the swelling to completely resolve, particularly in the nasal tip. That being said, the majority of the swelling is completed in the first few months, and the subsequent improvement over the follwing several months will only refine the nose further.
Hope this helps and best of luck! Kyle Kimura, MD

Just with most surgeries, the first week is the toughest. We request that all patients take at least one week off of work. At one week, the internal and external splints are removed. At this point, the swelling would have come down a lot, and the bruises likely faded or disappeared. 4-6 weeks before restarting exercise to decrease the chances of bleeding or damaging the nose (it takes that long for the bones to heal if broken). I generally tell patients won't see the final result until the year mark.

One week post op the splint and sutures are removed. If no nasal bone fractures were needed than you're already looking good! With fractures there is usually some bruising but once the splint is off makeup can be worn. Mostly people can head out in public a week to 10 days post-op. Of course there is still plenty of swelling at this stage. Most (say 70%) of the swelling usually resolves by around 6 weeks but it can take up to a year or two to see the last of the swelling go.