Back to regular after Rhinoplasty

Rhinoplasty recovery is different for everyone. A lot of the ease vs. extent of your recovery depends on the amount of bone manipulation that was done as well as how much work was done on the internal structures responsible for your nasal breathing (septum, turbinates).

Average recovery is about 7 to 10 days. Some level of bruising and cheek and eye swelling is to be expected. After approximately the first three days, comfort level improves dramatically.  Comfort often times is related to headache or pressure sensation and/or congestion.  Some say it feels like they have a cold with occasional headaches. Many have no complaints at all or if so , handles with pain medicine, icing, and Motrin.

Overall, rhinoplasty recovery is easily tolerated and not as bad as you may think.

Talk to your doctor about how he feels your specific recovery will be based on what exact techniques your surgery will require.

Like any surgery, Rhinoplasty is a little bit different for everybody. That’s why it is useful, and we encourage you, to talk to others who’ve had the procedure to get a sense of their experience. There are some common themes though, as far as recovery goes.

Whatever technique is used (see our Blog on Open vs. Closed Rhinoplasty), you can expect to have some dull aching and headache afterwards for a short time. In the absence of an infection or other problem, severe pain is very uncommon. Most of our patients may take some pain medication for the first day or two after surgery and then are usually feeling well enough to switch to Tylenol or other non-narcotic pain medication.

The most obvious and slightly annoying symptom after rhinoplasty is congestion. Because there is internal swelling in your nose, you will experience some congestion in the first few weeks afterward, until the swelling slowly subsides. This is usually at its worst in the first few days after surgery and then starts to get better.

Some patients who had major breathing problems before surgery will notice an improvement immediately after surgery, even with all the swelling. Others may take some more time to start noticing the positive changes. Those of you who did not have breathing problems to begin with will probably notice this congestion more.

It can sometimes interfere with sleep in the first few nights after surgery and so, a light sleep aid is often provided. It is helpful in the first weeks after rhinoplasty to avoid dry environments and nasal irritants, and to use a saline (salt water) spray and some ointment in your nose several times a day as necessary to help with dryness and crusting. But, you should avoid blowing your nose until your doctor says it’s OK to do so.

Swelling and bruising on the outside of your nose and cheeks is seen after surgery as well. This can sometimes be moderate and sometimes almost non-existent, but usually falls somewhere in the middle of those extremes. The extent of bruising and swelling depends on your body, on what was done, and on how carefully your tissues were handled. If it was necessary to fracture your nasal bones to move them inwards, your chances for bruising are a little higher. Even in the worst cases, bruising is usually mostly gone by 7 days or so after surgery. Your doctor may advise some remedies or herbal medication to help with bruising, but don’t take anything without first consulting him or her.

Most patients plan to take about a week from work and other major activities. You will usually have a cast on your nose and you may have some stitches that need to be removed. This is all usually done about 5 to 7 days after surgery. While you’re probably going to feel well enough to work after a few days, you may not want to be seen with the cast on. Some patients work from home and other brave souls throw caution to the wind and just go in to work with the cast and all. Once the cast is removed, you will look presentable within 1 to 2 weeks after surgery, although it may be on the longer side of that for a revision procedure. You wouldn’t want to have your wedding the next week, but your friends and colleagues shouldn’t be aware of anything. You can wash your face gently and put on a little cover-up makeup or foundation after one week.

By 2 to 3 weeks after surgery, about 70% of the swelling is gone, so you’ll be starting to appreciate some changes. You won’t really see more of the details, though, until about 6 weeks after surgery when about 80 to 85% of the swelling has gone down. While you’ll be looking pretty good at 2 weeks, you might still feel a little self-conscious. That’s because your nose (especially your tip) will feel a little (or sometimes a lot) numb after surgery, no matter what technique was used. It can take anywhere from several weeks to 6 or more months for the feeling to return completely. For the first 6 weeks or so, your nose just won’t feel like your own. Things like smiling and animated talking will feel strange. You’ll feel the odd strange pulling or twinge of pain if you make a wrong move like rubbing, bumping your nose gently, or rolling over onto your nose. These are unfriendly reminders that you’ve had surgery, but they are all normal and expected parts of the recovery.

Many patients are very afraid that they will do something to harm their result. While it’s true that a major bump in the nose can cause unwanted healing problems, there aren’t too many things you can do to really harm the result, so don’t be too gun-shy about touching your nose. There are some things you can do, however, to speed up healing and get you back into camera-ready shape more quickly. First is to listen to your doctor and follow all the instructions to the letter. They are usually there for a reason. You will probably receive a list of medications and supplements to avoid before and after surgery, and you should follow this advice to avoid unnecessary anaesthetic problems, bleeding and swelling. Keep your head up after surgery. Keep some cool compresses over your eyes and cheeks in the first 48 hours. For a few weeks, avoid bending, lifting anything over a few pounds, exercise, or anything that gets your blood pressure up. This can increase swelling and cause bleeding. Get a lot of sleep. Get outside and take some light walks. Eat well. Stay attuned to your body and alert your surgeon if your healing seems to be different than expected. In the first weeks, things will not look perfect, so try to avoid staring in the mirror or over-analyzing small changes.

Some other symptoms are common in the months after surgery. Your nose may run more easily, especially when irritated. Nasal allergies can be better or worse for a time. Your nose will tend to swell up a little when you exercise or do anything exertional. The skin over your nose can break out more easily and can be more sensitive to sunburn. While all of these things are irritating, they do get better and your nose will return to a more normal state after the inflammation settles fully. It’s important to remember that with each subsequent revision surgery, this entire process of recovery is slowed down somewhat. So, it’s not uncommon to take up to 2 years or more to see some of the changes you seek if you’ve had a revision procedure.

No one will tell you that recovery was a blast. But, most Rhinoplasty patients will tell you that it was very bearable when they knew what to expect. It is the path you have to walk to get to where you want to be. And, hopefully, your surgical team can help make it a little easier for you.

The recovery after rhinoplasty varies for everyone. However, these are the general guidelines I give to patients.

1. It doesn't hurt as much as you would think. Most patients tell me the rhinoplasty wasn't as painful as they expected.

2. The first day is the most uncomfortable. You might have a little nausea and some discomfort which pain pills will take care of.

3. After about 2-3 days, you will feel pretty good.

4. The tapes and the protective splint need to stay on for at least 7 days. Most people prefer not to go out in public before these come off.

5. You will pretty good after 7 days, although you will still have a little bruising and a lot of swelling.

6. You could return to work after about 7-10 days. Most of your coworkers probably won't even notice you had anything done.

7. I recommend you avoid any important social interactions (wedding, big party, etc) for at least 2-3 weeks in order to allow most of the bruising and swelling to subside.

8. You'll look very close to your final result after about one month. It takes up to 12 months for all of the swelling and minor small changes to heal.

After rhinoplasty, most patients will require one week off work; primarily because of the obvious swelling and bruising around the eyes/nose, in addition to the splint which is removed at one week. From a pain standpoint, most patients will take narcotics for 3-4 days, but will likely stay away from most social/public interaction for 1-2 weeks due to the residual bruising/swelling that occurs.

Patients are also instructed to avoid strenuous activity in the first several weeks following a rhinoplasty to avoid any undue bleeding or swelling.

Most of the major swelling resolves within the first 2-4 weeks, however it can take up to one year to see the final contour.

In general the healing time for a rhinoplasty is a year and a revision rhinoplasty can take even longer. The actual downtime is about 1 week. Most people look great at about 7 days after surgery and go back to work at that time but the final results can take up to a year to see.

In most cases, recovery time with a rhinoplasty should not take more than one week before you can resume normal activities. This all depends on the type of surgery performed and whether or not an osteotomy was performed. My patients usually recover within 5 days.