Pain and Recovery Time Vary with Type of Rhinoplasty?

Question

Within traditional surgical Rhinoplasties, are there some that hurt more/require more time to heal? For example, would narrowing the nose hurt more than raising the nasal bridge? How about making nostrils smaller, or making the tip fuller? I've tried to look for more specific information, but most sites give answers that say moderate to severe pain, and 2 weeks recovery time for all Rhinoplasties.

Michael A. Persky, MD · Answer

Hi Vivi,Rhinoplasty should not be a painful procedure no matter what type of procedures are carried out. Most patients complain of the pressure and uncomfortable sensation of having packing in their nostrils for 2 to 5 days following rhinoplasty.
Many rhinoplasty surgeons no longer find it necessary to use post-operative nasal packing which makes the recovery period much easier for the patient. I tell my patients that they will feel some pressure, at worst sinus headache type pressure. I ask that they take Tylenol, two tablets every 4 to 6 hours for the first two days. We do give our patients a narcotic pain reliever to take a night before going to sleep, or if the Tylenol is not doing the trick.
After the first two days, it is rare for patients to continue taking their "pain" pills. 
Good luck and be well.
Dr. P

John Diaz, MD · Answer

I am always amazed by how little pain my patients feel after rhinoplasty. For some reason, most people don't have much pain associated with this operation.
There is definitely some discomfort and mild pain. That is inevitable. However, what I have found is that it varies with how much work is done. Also, in general, work done on the bone causes more discomfort and recovery than the other areas.
Thus, someone with a large and wide bony bridge of the nose will require substantial rasping and fracturing of bone. This usually leads to more discomfort and bruising.
Someone who only needs a minor change to their tip will probably experience slightly less pain and bruising.
In summary, rhinoplasties tend not to be very painful. The amount of discomfort and recovery depends on how much has to be done on the nose.

Toby Mayer, MD · Answer

Nasal surgery should have the most minimal amount of pain. The most common complaint of our nasal surgery patients is Discomfort--not pain. There is less swelling if you do not have to break the nasal bones.

Edward Buckingham, MD · Answer

The longer the procedure the more pain and recovery time. To do a simple hump reduction and osteotomies takes very little time and doesn't have much post-operative pain. The recovery to looking better is essentially immediate. Once you start opening the nose and manipulating the tip or septum the discomfort increases as does the recovery. The nose can still look better immediately after splint removal, but it will take longer to look great. In general even after this kind of surgery the patients still only take prescribed pain meds for a day or two and then transition to Tylenol. As you get more complex, say harvesting a rib for a revision case the discomfort and recovery become longer. The pain from harvesting a rib is much more severe than the nasal pain as every time you breath it hurts. Patients requiring this degree of complexity are ready for such inconveniences however and are grateful. In general, even with a complicated surgery, patients take a week off work, 2 weeks off strenuous activity and 6 weeks off any activity that could injure the nose.

Eric M. Joseph, MD · Answer

Dear Vivi,
Most of my Rhinoplasty patients do not use the pain meds prescribed. Most post-surgical pain is related to packing. If no packing is placed, there is very little discomfort. In my experience, the type of surgery performed on the nose does not influence the level of pain afterwards.
I hope this helps, and best regards.

Jeffrey E. Schreiber, MD, FACS · Answer

Pain and recovery all depends on the amount of work you get done on your nose. Small touch-ups are easier than major bone work, of course, but pain killers these days are fantastic at relieving pain. A typical rhinoplasty requires 1-2 weeks for recovery and the pain gets much better after 1 week. Good luck!

William Portuese, MD · Answer

The rhinoplasty procedure is not painful as long as packing is not placed inside the nose. If packing is placed inside the nose it will be a very painful operation. Nasal packing is no longer used and has not been used in our practice in over 20 years. Building up the nasal bridge is less painful than the actual osteotomies or narrowing of the nasal bones. Since it has been seven months after the rhinoplasty, the majority of swelling should be down at this point. If your surgeon told you that you had a lot of scar tissue, that meant that you have had previous nasal surgery in the past, probably more than once. There is lymphatic edema that gets trapped inside the nose and takes a very long time to resolve. Cortisone shots, a low-salt diet and time will help.

Parham Ganchi, PhD, MD · Answer

Pain is one of the most difficult things to predict for any individual. However, compared to most procedures, rhinoplasty is minimally painful. Most don't require narcotic pain medication.
Also, it shouldn't really matter if a certain change to the nose hurts more than another.  You should plan your rhinoplasty based on what it will take to give you an aesthetically pleasing shape and most functional result, not what maneuvers are least painful!
Don't worry about the pain. Good luck!

S. Randolph Waldman, MD · Answer

There should be very little discomfort after a routine Rhinoplasty regardless of the specific maneuvers required. Usually pain is caused by the use of intranasal packing. I have not used intranasal packing in over 25 years and I believe that is the current trend.

Philip Young, MD · Answer

This is a general rule. The technique used also makes a big difference. When your procedure is done through the natural planes the pain is less because less nerves are involved. But as a whole, the more you do the more sensitive the procedure is. The area that is worked on also makes a difference. The whole face is more senstive than other body parts. The nose is less sensitive than the lips and eyes in general.

Pain and Recovery Time Vary with Type of Rhinoplasty?

Answers (12)

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