Why did my surgeon stop me from using ice on my nose for my swelling after septorhinoplasty surgery?

Question

I'm two weeks post-op and I'm experiencing a big swelled nose tip that looks like it got pus inside it ready to pop! I just don't understand? I asked my doctor when he removed my cast off if I should put ice to decrease swelling faster and he said no. So how long will it look like this; it looks bigger than before the surgery. Also my hump looks like its getting bigger? Can anyone please help?

Patrick Simon, MD · Answer

Generally, ice is effective for the first 72 hours postoperatively, after this time period it will be of minimal benefit.  Ice is primarily beneficial in reducing the amount of swelling that is to occur.  Once the swelling is present the ice will do little to remove it.  Swelling is a byproduct of tissue trauma (i.e. a normal product of surgery) and your body releases cells and fluid into your tissue to start the healing process.  Eventually, once the wound is rehabilitated the fluid and cells will leave the tissue and hence the swelling will dissipate.  Swelling after primary rhinoplasty can last up to one year, in revision cases often longer periods of swelling occur.  The good news is usually 70-80% of the swelling will be gone at 1 month and >90% by 6 months.

Inessa Fishman, MD · Answer

Cold compresses are most helpful for post-surgical swelling for ~72 hours after surgery.  While you may be tempted to place cold compresses on your nose to decrease swelling, cold is unlikely to help at 2 weeks.  Furthermore, icing may be harmful, as you may get a freezer burn on the numb nose skin.  Swelling is very common after nasal surgery, and it usually increases a bit after the cast dressing is removed, as there's no longer compression on the nasal skin.  Post-rhinoplasty swelling is typically most pronounced in the tip, where nasal skin is thickest.  Most swelling will resolve in a few months after surgery, although it does take a year to a year-and-a-half for the nose to settle down fully.  Without photos, it's hard to comment on the risk of infection; if you're concerned about it, it's best to return to your surgeon.In all, have patience and allow your body to heal.  Keep a close follow-up with your surgeon, and allow him/ her to take good care of you and advise you about your healing and expectations.  Good luck in your recovery!

Paul Silverstein, MD (retired) · Answer

I believe that ice only helps reduce swelling and helps prevent bruising for a few days after surgery. Therefore I have my patients apply ice for only 48 hours post rhinoplasty.  I agree with your doctor.

Why did my surgeon stop me from using ice on my nose for my swelling after septorhinoplasty surgery?

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Why did my surgeon stop me from using ice on my nose for my swelling after septorhinoplasty surgery?

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.