Is It Safe to Use a Nasal Rinse After a Rhinoplasty Surgery?

Many patients experience transient bleeding or crusting in the first several weeks to months after rhinoplasty. Topical nasal saline spray is a safe and an effective way to clean the nasal passages and to provide moisture. Over the counter decongestant sprays such as Afrin (oxymetazoline) should be avoided - they can cause constriction of the blood vessels to the lining of the nose and potentially result in a septal perforation.

It’s not uncommon to develop crusting and scabbing following nasal surgery. This is especially common when rhinoplasty surgery is performed in combination with septoplasty and the use of nasal splints. This crusting can result in nasal airway obstruction and post-operative discomfort.
                In an effort to minimize crusting and scabbing plastic surgeons frequently recommend nasal saline rinses or hydrogen peroxide rinses. This approach keeps the nasal passage clean and moisturized and is extremely safe. In contrast we avoid Afrin spray because of the increased potential for complications with this agent.

                In most cases it’s probably reasonable to blow your nose after three months, but it’s important to discuss this with your surgeon before proceeding. Your surgeon should be able to make recommendations based on the specifics of your procedure. 

It is important to use saline nasal spray for 4-6 weeks or longer. I do not advise the use of Afrin spray as this is only recommended for very short term use.

Blowing your nose is usually fine several weeks following rhinoplasty. Saline nasal sprays or irrigation is helpful for some patients following septorhinoplasty. You should avoid long term Afrin use.

If you had a Rhinoplasty 3 months ago, I have no problems allowing patients to blow their noses. Nasal rinse with ocean or afrin are also fine.

After rhinoplasty, activity restrictions are generally made to prevent bleeding and swelling. Bleeding is generally a risk for the first 2 weeks after surgery. If turbinate surgery is also done, then there may be additional risk for up to 3-4 weeks after a procedure.
Many patients that have rhinoplasty also have concurrent functional nasal problems, including a deviated septum, turbinate enlargement, chronic sinusitis, or nasal allergy. Specifically, those patients with sinus or allergy conditions tend to benefit from nasal irrigation in order to improve their baseline nasal hygeine and decrease nasal irritation symptoms.
I allow patients to go back to regular saline irrigation and nose blowing by 2-3 weeks after surgery. By 3 months you should be able to blow your nose and irrigate without significant concern for problems. Remember that even in a non-operated nose, blowing hard enough and frequent enough can cause some bleeding.
I suppose the more important question is this: Why do you feel the need to blow your nose so much right now? Is your breathing obstructed? Is your nose running?
Perhaps nasal allergy testing and treatment or a steroid containing nose spray would benefit you significantly. Talk to your doctor about your symptoms to see if things in addition to saline irrigation would help you.

Hi Lila,
I recommend nasal rinses to most of my patients after rhinoplasty or septoplasty, and even to many non-nasal surgery patients.
Alkalol is mucus cleaner and expectorant. We ask patients to get plain nasal saline spray (45cc, Ocean, Ayr, etc.), take off the cap and add the Alkalol to the saline. Recap the spray bottle and then spray into the nostril multiple times until the solution is felt in the back of the throat. At that point, the solution is spit out and the spray is continued on the other side.
Patients should go back and forth between nostrils a few times two to three times per day. When they run out of solution, we ask that they refill the spray bottle with 1/2 Alkalol plus 1/2 water, it is not necessary to re-buy new saline each time.
Good luck and enjoy your new nose.
DR. P

It is very safe, and also encouraged, to use nasal rinses starting one week after the surgery. Normal saline is the best nasal irrigation to be used and should be used at body temperature. After two weeks from the time of your surgery, it is okay to blow your nose as often and as hard as you wish. Spot bleeding in the nose is nothing to be concerned about unless there is a true hemorrhage.

It is usually safe and even recommended to use saline spray after rhinoplasty. If the spray has Afrin (oxymetazoline) in it, it should not be used for more than 4 - 5 days. I would discuss this with your surgeon, since he knows exactly what was done and how it affected your nasal passages.