Will I be able to massage my nose possibly quickly after my dorsal hump rasping procedure?

Question

Will I be able to massage my nose possibly quickly after my dorsal hump rasping procedure? Also I would like to know if such procedures can help with preventing or breaking down possible bony callus along with getting rid of swelling? How long after rasping will I be able to resume gym activity?

Semih Yildiz, MD, FEBOPRAS · Answer

Early pressure can increase bleeding and swelling, irritate the periosteum, or disturb healing tissues. Some surgeons prescribe a specific gentle massage after the first few weeks for selected swelling or a minor soft-tissue irregularity, while others avoid it completely. The timing, direction, and pressure should come from the operating surgeon after an examination.

Massage does not reliably prevent or “break down” bony callus. Callus is part of normal bone healing, and a firm area in the early months may also be swelling, scar, or an edge from the rasping. Repeated forceful manipulation can make matters worse. A persistent hard contour should be assessed after swelling has settled; if it is truly bone, observation or a later targeted correction may be more appropriate than massage.

Walking is encouraged soon after surgery. Light exercise may often resume around two weeks, more strenuous gym activity around three to four weeks, and heavy lifting or contact activities closer to six weeks or later, depending on the extent of surgery and healing. Avoid anything that markedly raises blood pressure, risks a blow to the nose, or requires tight equipment over the bridge until your surgeon clears you.

Eric M. Joseph, MD · Answer

When a dorsal hump is removed in the operating room, this leads to a wider nasal appearance. This is called creating an open roof deformity. Narrowing of the nose is then performed by utilizing osteotomy techniques. We do not recommend the nasal massage in any of our patients. In our practice, unrestricted physical activity following rhinoplasty may be considered around 3 weeks postoperative.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. I do not recommend massage at all after surgery. I don’t recommend having rasping performed under local anesthesia. This will usually make the nose look better for 1-2 months and then it will actually get much worse long-term afterwards, with contour irregularities developing. This is because the skin of the dorsum is extremely thin. A much better approach is to do a formal revision with rasping and placement of a dorsal onlay fascial graft to help smooth the dorsum.   Here is some general advice when considering a surgeon.

I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up.  Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results with standardized lighting and standardized background. If your surgeon is posting mostly on-table results without real long-term follow up results, that is usually a major red flag.  If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, or all patient selfie’s without real longterm in-office formal pictures that can also be a red flag.   Long-term results are much more meaningful than on table results or 1 week post-op results. Selfie’s can also be fun to look at, but these can often have a filter and do not represent true longterm results because of this and are not as valuable as real longterm in-office before and after photographs on your surgeon’s website.

I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Will I be able to massage my nose possibly quickly after my dorsal hump rasping procedure?

Answers (3)

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