Blowing Nose After Rhinoplasty

Question

I had a Rhinoplasty/Septoplasty and I was told not to blow my nose until 3 weeks post-op but I find it really hard to resist doing so. What kind of damage can gently blowing cause? And how damaging can this be? I have not put pressure on my nose except the one time I accidently sneezed through my nose at night. Also, how can I avoid blowing my nose any further? I really want it to heal properly but having a stuffy nose extremely irritates me.

Jon E. Mendelsohn, MD, FACS · Answer

Blowing your nose after a rhinoplasty is often restricted for a variety of reasons:

1.  It avoids blowing bactieria throught the internal nasal incision into the soft tissue of the nose and potential setting up a situtation for infection.

2.  The mechanical act of pushing or distorting the nasal structure after a rhinoplasty may disrupt sutures and create a problem with the intended outcome of the procedure.

I will typically allow gentle nose blowing WITHOUT closing one side of the nose.

We also  recommend the use of Afrin for 1-2 days postoperatively to help with the nasal congestion as well as nasal saline to assist with removal of any possible nasal crusts and mucous.

Additionally, you may find that using nasal decongestatnts (ie Sudafed) a useful adjunct for congestion and a Medrol Dose Pack (steroid) for swelling to useful if indicated.

Eric M. Joseph, MD · Answer

Nasal congestion is common for the first 2-4 weeks after Rhinoplasty Surgery. In my practice, I will allow light nose blowing 1 week after surgery in most cases. If congestion is severe and unresponsive to saline nasal washes, I may perform a painless turbinate injection with triamcinolone acetonide in the office. I will also allow most of my patients to use a topical decongestant for 7 days or less.

	You may just need to have some old blood and mucous removed from your nose, so it's best for you to follow up with your surgeon to see what's causing the blockage.

	I hope you find this helpful.

Richard W. Fleming, MD (retired) · Answer

Follow your surgeon's instructions regarding post-op nasal care and blowing your nose. You can do significant harm. You ask how to avoid blowing your nose; thats easy, just don't do it. Why waste a lot of time and money to clear your nose?

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