What is the typical rhinoplasty recovery like?

The "downtime" following rhinoplasty is variable depending on what rhinoplasty techniques are used such as whether the surgery was performed open or closed, whether any tip work was performed, and whether the nasal bones were broken (osteotomies). Patients who undergo open rhinoplasty typically have more edema (swelling) that persists longer compared to patients in whom closed rhinoplasty techniques were used. If the nose was surgically broken by performing osteotomies then there is usually more swelling and bruising.

Patients are generally encouraged to take a week of from work or school. After two weeks, most patients can gradually return to strenuous activities such as exercising.

SWELLING

The nose undergoes significant changes in the first 2 to 12 weeks following rhinoplasty. The swelling gradually dissipates over the first several months and thus the appearance of the nose changes gradually.


When the cast is removed after one week, the nose will look swollen.

Usually by the end of the second week, the swelling and bruising have subsided enough that the casual observer will not readily notice that the nose has been operated on.

To the patient, the nose will look swollen or "puffy" for several months.

By about 3-4 months, the majority of the swelling will be gone but will look larger in photographs.

It can take as long as a year for the final shape to become apparent.

You should give yourself several months if if there are any work or social engagements that would cause concern.


Swelling can persist during this time, particularly in the tip and over the area where a boney hump was removed. Following a hump removal during a rhinoplasty, it is very common for there to be excessive swelling over the central portion of the nasal bridge overlying the area where the boney hump was removed. This area often appears more swollen that the rest of the bridge and can remain swollen for several months. As a result, patients frequently worry that the bump will be permanent.

Taping the bridge of the nose and the supratip area (area above the tip) can significantly reduce postoperative edema (swelling). Gentle pressure from the tape does two things. First, it can help 'press' out some of the swelling that results from trapped fluid in the tissues. Secondly, and perhaps more importantly, pressure on the tissues causes the collagen fibers in scar tissue to become more organized, which reduces the volume of the swollen area.The most effective for taping is in the first six months after surgery. You should still get a benefit even if you havent started taping until 2 months after surgery.

It is very common for rhinoplasty patients to report (in the first several weeks after surgery) that their upper lip feels stiff and that it is difficult for them to smile. Fortunately, this resolves by itself in the first several weeks after surgery as the swelling subsides. Be patient, your smile should return to normal.

BRUISING

Bruising and swelling are a normal part of rhinoplasty recovery. They are dependent on several factors related to both the surgical technique and the patient. Techniques that increase bruising and swelling include whether or not the nasal bones were broken (osteotomies), the extent of soft tissue dissection/elevation from the bony-cartilaginous framework, and whether the surgery was performed open or closed. Patient factors include age, skin thickness, nutrition, bleeding tendencies/disorders, and medications that thin the blood.

Obviously, not many of these variables are within the control of the patient; however the extent of the bruising and the severity of swelling can be minimized by following these tips:


Avoid any medications that thin the blood for a minimum of 2 weeks before surgery and do not resume them until your physician directs you to. These medications include (but are not limited to): aspirin, ibuprofen, anti-inflammatories, heparin, lovenox, coumadin, plavix.

Avoid multivitamins/herbal remedies/teas etc that contain high levels of Vitamin E, Ginseng, Ginko -- these can cause you to bleed more freely.

If you have a tendency to bleed or bruise easily, have a history of a bleeding disorder, or have a family member with a bleeding disorder, you should discuss this with your physician before surgery.

Ice packs to applied to the cheeks for the first 48 hours

Keep you head elevated higher than your heart. This will help minimize the amount of edema (swelling).

Avoid smoking

Herbal supplements such as bromelin, papaya extract, and arnica may be of benefit, but few studies have proven their effectiveness.

Sun exposure in the first several months following rhinoplasty can cause the skin of the nose to become red or "splotchy". It can also predispose you to getting sunburned more easily. For the first several months after rhinoplasty, patients should wear sunscreen and/or a hat to prevent the above mentioned problems.


CAST / SPLINT / PACKING

Surgeons frequently place an external splint on the exterior of the nose after surgery. The casta can help preserve the operative result and also can aid in reducing swelling. Most surgeons leave the cast in place for one week.

Rhinoplasty recovery is typically 2 weeks for bruising to disappear. Bruising is typically under the eyes and by the cheeks since blood collects here internally after the nasal bones get intentionally fractured and manipulated. More than 2 weeks off of work isn't needed. 1 week is okay too depending how comfortable you feel with putting on some makeup to cover up what's left of the bruising or even wearing glasses to not attract much attention.  
Results for the nasal profile are typically immediately obvious after the nasal cast is removed. Nasal swelling after a rhinoplasty takes some time to resolve especially in the tip, and longer in patients with thicker skin.  The majority of swelling is gone after 3 months, with continued improvement even up to 12 months. That's not to say that you won't like your tip at 3 weeks; results continue to improve as swelling goes down and the skin shrink wraps around the nasal tip cartilage construct that your plastic surgeon leaves you with. 
Best of luck,
-Dr. John Layliev. 

I typically tell patients that depending on the type of rhinoplasty that is performed that most of swelling decreases in the first 4-6 weeks.  Swelling does take up to a year to resolve ..

Recovery from rhinoplasty can vary from patient to patient. Some of these different are intrinsic to the patient themselves, such as their pain tolerance and anxiety levels and it also depends on the surgery that is performed. Not all rhinoplasties are equal, if you don't need osteotomies for example you can expect less bruising and pain. 
However, most patients are surprised by how little pain they have post operatively. I give all my patient a narcotic pain medication and anti nausea medication. Having pain isn't fun but when you're in pain and nausea then you're truly uncomfortable. 
You can prepare for your surgery by eating a highly nutritious diet with extra protein for two weeks before your procedure. You can also take OTC supplements like Arnica and/or Bromelain, that have been proven to reduce bruising. Most people plan on taking a week off from work. 
The procedure itself is performed at an accredited surgery center with an anesthesiologist. It can last between 2-4 hours depending on how extensive the rhinoplasty is. You will recover there for 1-2 hours afterwards and then be discharged home. 
I recommend that for the first 48-72hrs to rest and keep your head elevated. Icing for the first 48hrs can really minimize bruising and swelling.
There will be a nasal cast over the bony portion of the nose to protect the bones. I do not use packing, as there is no evidence to suggest it helps. I will have you place a small drip pad on the base of the nose to catch any bleeding. Frequently, an internal silicone splint is used to support the septum. 
On POD#7 the sutures, nasal cast and internal splints are removed, along with any steri-strips. 
Nasal congestions is common complaint as the internal tissue is also swollen. For patients that had nasal obstruction preoperatively they frequently notice a small improvement immediately but this continues to improve as the swelling goes down. For patients that could breath normally prior to surgery this can be bothersome as they're not used to it. It does improve though. Keeping the airways moist by using Saline spray is really helpful. 
The slow part of rhinoplasty surgery is the resolution of swelling. It can take 3-6 months to really appreciate the improvements and we often say a full year for the final result. While the swelling is resolving the nose and lip often feel stiff. This will improve as things settle out. Sometimes steroid injections can be used to help the process along but this isn't the norm. 
You should limit exercising for at least two weeks and then slowly resume your previous activities. It may take a few additional weeks before inversions and more aggressive activities are tolerated. 
The most important thing you can do is find a Plastic surgeon experienced in Rhinoplasty who you trust will be there for you throughout the process. They should go over the surgery and post op care routine with you in detail and listen/respond to your concerns. 
I hope this helps. 
 

Many of my patients believe that the recovery after rhinoplasty is difficult and painful. However, this is not typically the case in my practice. One reason is I do not use nasal packing. Nasal packing is still used by many surgeons, but is unnecessary and painful to remove. Also, it is uncomfortable having it in place because you have to breathe through your mouth. There is a splint on your nose and it stays on for 4-5 days. There is often some bruising of the cheeks. Most of my patients return to work 1 week after surgery. If you wish to learn more, you may visit my website. The link is attached below.

The healing process following rhinoplasty is unique to each individual. In general, you can expect swelling and bruising for about one week after your procedure. Most patients return to work in a week once the stitches and splint are removed. By this time much of the swelling has subsided and any residual bruising can be covered up with makeup. 

Good Question:  So there is the immediate recovery which is about a week.  At your first visit your splint, tape and stitches are removed.  Now your nose will Definitely be swollen but you will already be able to see some of your results.  You can return to work the next day.  Often I will tape the nose for a few days to weeks depending on the degree of swelling you have in order to help with the recovery.  The second phase of healing takes  around 4-6wks.  By then about 80% of your swelling has resolved and most people wont know you had anything done.  The final stage takes up to a year.  This is when the last 20% of swelling gradually resolves.  There are different things you can do like taping and injections which can accelerate your recovery.  Hope that helps

Dr Rahban

For a short time after surgery, patients may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week.

The results of rhinoplasty become gradually apparent as the days pass after surgery and swelling recedes. Swelling may reappear from time to time in the first year after the procedure. It is typically more noticeable in the morning and fades during the day.

Contact lenses can be worn immediately, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks.

 

 

When having a rhinoplasty done you should expect to wear a cast for about 6 days.  You will have swelling and some bruising for about a week.  There might also be light bleeding, and you will be congested for a few days.  Usually you can go back to work after your cast comes off but make sure you discuss it with your surgeon first.  You can usually return to strenuous activity after two weeks.  Most of the swelling is also gone in two weeks, but a small amount may remain for several months.

Hello and thank you for your question. The final results take at least 1.5 years for the swelling to fully resolve. This can require lots of patience and waiting. Steroid injections performed by your surgeon can be extremely helpful. I usually start steroid injections around 1 to 2 months after surgery and continue as needed. Most patients are able to return to work and resume exercise one week after surgery. I recommend that you maintain close follow up with your qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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

This is a great question that every patient considering a rhinoplasty wants to know. The answer varies from patient to patient based on degree of surgery, revision vs primary surgery, and patient characteristics (thick vs thin skin) but in general:
- Week 1: You'll have a nasal cast, splints in the nose, and sutures underneath the tip of the nose. At this point, most patients complain more of pressure than pain. You will likely be very congested because of the nasal splints. At this stage it is very important to keep the nose clean (q-tips with hydrogen peroxide for nasal crusts, saline sprays to keep the inside of the nose moist, antibiotic ointment to the incisions). We typically have patients take tylenol, motrin, and oxycodone (a stronger pain medication). Patients typically take the oxycodone for around 2-3 days before they feel like they can manage with tylenol and motrin alone. Elevating the head of the bed or sleeping on a few pillows can help the swelling improve and will also keep you from rolling over onto your nose. Avoid nose blowing, bending over, or heavy lifting.
- Week 2: Around 5-7 days after surgery we will remove the nasal cast, splints, and sutures. We recommend eating something the morning of this procedure as some patients can become light headed when removing splints or sutures. After these are removed, patients typically feel a significant relief of the pressure sensation and nasal congestion they had in week one. At this point we switch from the antibiotic ointment to regular vaseline as you no longer need the antibiotic portion. It should be noted that you will experience some "rebound swelling" after removing the cast and splint and it is normal to feel more swollen/congested the day after splint and cast removal, but this will return back to normal over the following few days. At this point we encourage patients to continue to avoid blowing the nose, bending over completely, or heavy lifting (typically for around 4 weeks). Based on how you are feeling, it is okay to return to work at this point with the aforementioned precautions being followed. Some patients will have bruising around the nose or under the eyes which can be treated with arnica ointment or tabs to help resolve more quickly.
Week 3-6: By now, most of the bruising should be resolved. You should continue to use saline sprays and ointment to help with healing. We will typically see you back for a second follow up anywhere from 4-6 weeks after surgery to ensure everything is healing as expected. Around week 6, we have patients switch from vaseline to a scar cream like mederma. We will also clear patients at this point for more strenuous exercise. At this point, alot of swelling will have gone down, but it should be noted that it can take anywhere from 12-18 months for all of the swelling to completely resolve, particularly in the nasal tip. That being said, the majority of the swelling is completed in the first few months, and the subsequent improvement over the follwing several months will only refine the nose further.
Hope this helps and best of luck! Kyle Kimura, MD