Heavy Weight Lifting After Rhinoplasty- What's the Worst That Can Happen?

Question

I searched the board extensively , and you respected doctors , agree that stertorous exercise should be resumed from 2 to 6 weeks after rhinoplasty. My surgeon told me I can go to full activity after 2 weeks. I started lifting moderate weights after 3 weeks. But sometimes I feel pressure in my nose and face. But I am now obsessed that this pressure on my nose will increase tip swelling. Am I correct? Can exercise delay healing? Or docs advice to avoid it early on , just to avoid bleeding??

Richard H. Tholen, MD, FACS · Answer

You are right to be conservative in your resumption of exercise, and what you have done is absolutely what I recommend for my rhinoplasty patients: nothing to raise the blood pressure or pulse for 2 weeks after surgery, no nose blowing for 3 weeks, and nothing super strenuous for 3-4 weeks. When exercise is resumed I always stress GRADUAL return to your normal routines.

	What you are feeling is the normal engorgement of your nasal skin and healing tissues when you exert yourself. Your nasal tissues will take 6-12 months to fully heal, soften, resolve swelling, and restore sensation. During this first year I also advise avoidance of sunburn or frostbite, as your nose lacks the "normal" sensory warnings of "Too hot!" or "Too cold!" Even at three weeks bleeding risk is not higher than any one of us who can still have an occasional nosebleed. Best wishes and try not to obsess about your nose--it is truly a work in progress for the first 6-12 months. Trying to watch your nose healing is like watching grass grow--you have to leave for a week or two and then it obviously needs mowing. Nose surgery recovery is even slower, so too much daily observation will make you nothing but crazy!

Richard J. Bruneteau, MD · Answer

Patients who undergo rhinoplasty are often eager to resume their normal exercise routine.  Unfortunately, any maneuver that elevates blood pressure in the immediate post-operative period can result in bleeding.  This risk increases when septoplasty is performed in combination with rhinoplasty.
  
            For this reason, we recommend avoiding most exertion for about two weeks following surgery.  Strenuous activities such as running and weightlifting should be avoided for six to eight weeks following surgery.
  
            It’s important to discuss these issues with your surgeon before resuming exercise.  Your surgeon will be able to tell you when it’s appropriate to resume your normal exercise routine.

Jeffrey J. Roth, MD, FACS · Answer

It all depends on the extent of the rhinoplasty.  What did the surgeon see when he/she was in there?  Did they do extensive septum, turbinate, and bone work?  Did they do extensive tip work?  Best to contact your surgeon's office before stating on an exercise regimen.  We usually tell our patients at each visit what their restrictions are.  We tell them, (at the appropriate time),to start slowly and then progress from there.  Also, don't be frustrated if you lost endurance, or gains in lifting.  It will take a while to get back to where you were.

Thomas A. Lamperti, MD · Answer

The main reason surgeons recommend holding off on strenuous activity for the first couple weeks is the bleeding issue.

	You will find that even after 2 weeks your nose will swell, ache and throb when you get your blood pressure up with exercising. You likely won't hinder your overall result, though you will have more external swelling initially than you would otherwise. With time you should reach the same endpoint, though.

Kevin Sadati, DO · Answer

Dear Rhinoplasty Patient,

	Three week after rhinoplasty surgery, light exercises are acceptable. You must start slowly and build up to your previous duration over the next couple of weeks. Initially there will be slight increase in swelling as result of blood flow to nasal area. The key is going light in the beginning. These swelling associated with exercise will not affect the long term results. Good luck and good healing.

Houtan Chaboki, MD · Answer

Hi ZyzzMisc,

	Yes, most plastic surgeons will prefer their rhinoplasty patients to avoid all heavy activity for 2 weeks and contact sports for 6 weeks after surgery. Once allowed, patients should start light and gradually increase activity. However, nasal pressure or tightness may continue for weeks which worsens with physical activity. Speak with your rhinoplasty surgeon regarding any concerns you have. Best of luck.

	Dr. Chaboki

Steven Wallach, MD · Answer

The pressue you are experiencing is most likely from the healing process as you exert. It may very well increase swelling. I like my patients to avoid strenuous acitivity like weight lifting for about 6 weeks.

Richard W. Fleming, MD (retired) · Answer

The worst thing that can happen lifting weights after rhinoplasty is to drop the weights on your nose. I tell patients to avoid strenuous activity for three weeks, but also tell them to listen to their bodies. If you feel nasal pressure at this time, decrease yoiur physical activity. Why do anything that will delay healing? Most important, talk to your surgeon.

Francis R. Palmer, III, MD (retired) · Answer

Yes, it can IMHO.  Strenuous activity or straining causes the blood pressure, in the face, to increase.  This does several things.

	
		The increased pressure can cause bleeding inside the tissue that will show as bruising and or increased swelling.  Blood within the tissue is also very irritating and may lead to increased scar tissue after the Rhinoplasty.
	
		Increased blood flow to the face and nose will increase the amount of swelling that may again, increase the amount of scar tissue after the Rhinoplasty.
	
		The increased blood to the nose will prolong post Rhinoplasty swelling as any surgery disrupts the normal lymphatic vessels responsible for removing fluid from tissues.  These lymphatic vessels typically reconect at 6 months following the Rhinoplasty.


	2 weeks to resume weight lifting is to soon for my patients.  I'd have them refrain from that for 1 month after a Rhinoplasty.  After that, if swelling occurs in the nose with any strenuous activity, I advise my Rhinoplasty patients to apply ice to their nose to reduce the swelling.

Richard L. Dolsky, MD (retired) · Answer

The main concern about strenuous exercise after rhinoplasty is causing bleeding. At  2-3 weeks after nasal surgery, the chances of bleeding from exercise is very remote. The feeling of fullness when you strain will not cause swelling of the outside of your nose. If you were to hang your head below your heart, your nose and face would swell.

	Aerobic exercise may be limited for 4-6 weeks after rhinoplasty surgery. The inside of your nose will be swollen as a result of  surgery. The internal swelling of the nose may limit you breathing during vigorous aerobic exercise.

	The last concern with exercise after a rhinoplasty is " don't get hit in your nose for six weeks after the surgery". It takes about 6 weeks for the nasal bones to regain their strength after surgery.

	Richard L. Dolsky MD

Heavy Weight Lifting After Rhinoplasty- What's the Worst That Can Happen?

Answers (10)