Typically the day the cast comes off, the nose looks somewhat acceptable for public exposure. There may be very fine indentations in the skin from where the tape was present, which usually resolves within a few hours. There is some rebound swelling which may kick in by that evening, but depending on your skin type, it may not be that significant. You may have some redness of the incision, again depending on your skin type. If there is bruising, it is in the yellow phase at this point and can be covered by makeup. I have pictures in my office that I show potential patients of other patients the day they had their cast removed. It helps to relieve some of the anxiety of exactly what you are concerned about. Perhaps ask your surgeon if they have any such pictures so that you can be adequately prepared. Your surgeon also may be able to give you an idea of what his/her patients look like that day.
Most patients have some degree bruising and swelling after the procedure which takes 10-14 days to subside. The amount of bruising and swelling is quite variable, and unpredictable. You will still have visible bruising and swelling one week after the surgical procedure. At 4 weeks, and are certainly able to return to school without anybody having to detect that you had nasal surgery. Anticipate at least a week or 2 of congestion and stuffiness after the septoplasty procedure. The open rhinoplasty procedure will leave an incision along the columella that may take several months to settle down, depending upon skin coloration. For many examples of close rhinoplasty and septoplasty, please see the link below
In a closed rhinoplasty with no alar base reduction, it may be difficult to tell that surgery has been performed after the splint is removed. You really need to ask your surgeon, because he or she will have a better idea of how the nose will look at one week after an open approach with the maneuvers that will be utilized.
Kenneth Hughes, MD