What to Expect After a Rhinoplasty

by

If you’re considering getting a Rhinoplasty (nose reshaping), you may be wondering about the long- and short-term effects on your body. Of course recovery is different for every patient, but there are some common post-surgical effects many patients experience. Because there are very specific activities and situations you should avoid after surgery, studying the recovery time and physical limitations will help you schedule your surgery to fit your schedule. It’s important to schedule your surgery to allow ample recovery time so you can get back to your normal social and physical activities.

Pre-Surgical PreparationBefore your surgery, it is extremely important that you begin preparing your body to help the healing process. Decrease any smoking habits, as patients who smoke have a slower healing time and can actually lose skin during the healing process. Stop drinking alcohol and do not take aspirin or aspirin compounds until 1 week after the surgery. Stop taking any vitamins or herbs such as Gingko Biloba, and any hormone or birth control pills.
These medications can cause excessive bleeding during the surgery because they may act as blood thinners. Avoiding these medications will also improve your healing time by reducing swelling and bruising.

The night before your procedure, do not eat or drink anything after midnight – this will prevent regurgitation while you’re under anesthesia. The morning of your procedure, you can take most of your daily medications (discuss with your physician) with a sip of water only.

Post-Surgical Recovery TimeRhinoplasty procedures require several months to fully heal, so you should schedule your social engagements accordingly. Most nose reshaping procedures require a cast, splint, or taping for the first -10 days of recovery.
However, you should be aware that the final results may not be seen for 6 months up to two years. If after 6 months your healing does not progress as usual, small irregularities can be corrected at that time.

For the first 1-2 weeks after surgery, you also may experience post-operative depression, but this is very normal and should pass quickly. If your anxiety or depression does not decrease after this time, you should seek a physician.

Swelling, Bruising and NumbnessThe extent of your bruising and swelling will depend on the exact procedure used. For example, if your surgeon had to break any bones during the procedure, bruising and swelling will be increased compared to just shaving the cartilage down. You may experience noticeable bruising and swelling of the nose, eyelids and cheeks during the first 2 weeks. It is extremely common for there to be excessive, bulbous swelling on the bridge and tip of the nose, because these are the most heavily-operated areas. Do not fear--this swelling will go down over time. You can help reduce swelling on your eyelids by using iced gauze pads on every hour for the first two days post-surgery (take care to keep your nose dressings dry).

You should also know the swelling inside your nose can cause congestion and breathing problems for the first week. Expect to breathe and sneeze from your mouth during the initial recovery time. It is recommended that you sleep sitting up or elevated on 2-3 pillow to decrease swelling and for easier breathing.

It is also extremely common to have trouble smiling for the first few weeks after surgery because of numbness and swelling—your smile should return to normal after the swelling subsides.

All operative sites might be numb to the touch and internally for 2 weeks up to two months. For the first year or so after surgery, you may also experience some abnormal sensations such as tingling and itching.

AftercareFor a speedy and healthy recovery, make sure you follow your physician’s specific aftercare instructions. During the procedure, incisions are made inside the nose, and occasionally, one across the skin near the nostrils. These incisions are wounds, and it is important to care for them as such. Moderate bleeding is normal for the first several days, so dress your nose with gauze and change as often as needed. If your nostrils feel dry, you can lubricate with Q-tips and Bacitracin ointment 3 times a day for the first two weeks. As the incisions are healing, you may experience a strange odor. If you do experience this, you should consult your surgeon as soon as possible. Though this is usually caused by the wound “crusting” and can be easily treated with saline, it could be a result of infection. Your surgeon can evaluate the root of the smell and ensure you’re healing properly.
Because of drainage, you may feel tempted to blow your nose. However, you should avoid blowing your nose for the first week. After the first week, you may blow your nose gently, but avoid a lot of force to prevent a nose bleed.

You should also keep your nose completely out of the sun for 4-6 weeks and use a sunscreen for the first 6 months after surgery anytime you are outdoors. Otherwise, your skin may become blotchy and red and/or burn much more easily.

Right after surgery, you may rest your glasses on the provided cast or splint, but not on the actual bridge of your nose. The slight pressure your glasses give can cause slight deformities or depressions on the bridge of your nose. Because of this, you should avoid wearing glasses for at least 4 weeks post-surgery. If you can’t wear contacts to compensate, consider taping your glasses to your forehead or use foam as a cushion between your glasses and bridge of your nose.

For the first 48-72 hours post-surgery, eat a light, soft and cool diet as tolerated and drink plenty of fluids. Don’t consume anything spicy or warm in temperature, as these foods dilate your blood vessels and can cause swelling.

Exercise LimitsFor the first four weeks of recovery, you should avoid jogging, weight lifting or any other heavy activity. When you exercise your heart rate increases, resulting in a blood pressure increase. When your blood pressure increases, blood clots that have formed to help the healing process can “pop off” and cause bleeding and swelling. Per your doctor’s orders, light activity such as walking may begin 1-2 weeks after surgery. You also should avoid swimming for at least one month and avoid scuba diving for 2 months after surgery.

No SmokingFor 4 weeks after your surgery, absolutely do not smoke and avoid secondhand smoke. Tobacco contains nicotine, which is a vasoconstrictor and cuts off the blood supply to your tissues. This can cause scarring, infection and increased healing time.
As always, you should discuss all pre-surgical preparation and any possible side effects from your surgery, as every patient’s body is different. Although the recovery can take time, the end results can be wonderful.
Article by
Edmond Plastic Surgeon