Is it necessary to take antibiotics after a nose job?

Current recommendations in the plastic surgery literature support a single dose of antibiotic, broad spectrum, within one hour of incision and no post-operative antibiotics.  Post operative infections should be cultured and treated appropriately.  I also recommend for my patients either betadine ointment applied to the nostrils along with Hibiclens showers three times before surgery and in high risk cases of rhinoplasty (prior history of Staph or MRSA) using Mupirocin 2% applied twice daily for five days before and two days after surgery

The chance of an infection after rhinoplasty is exceedingly rare. Some surgeons will use antibiotics and other surgeons will not, but it is very dependent upon the practice. In addition, some patients have medical conditions that may require  Antibiotics. When performing any type of implant surgery, antibiotics are necessary.

I believe prophylactic antibiotics are overused after surgery, and rhinoplasty is no different.  Infection after rhinoplasty is extremely rare, and a course of antibiotics after surgery does not guarantee you won't get an infection anyway.  If your nasal packing is removed soon after surgery (I usually remove it the next day) and you don't have an underlying medical issue like diabetes that would make you more susceptible to infection, I believe that a dose of antibiotics immediately prior to surgery and no antibiotics after surgery is the way to go.  This protocol is also unlikely to throw off your microbiome and create systemic issues.  

Rhinoplasty is a surgery to improve the shape of your nose for breathing or appearance.Antibiotics are given to prevent infection. Some surgeons use them. Others do not use antibiotics. There is a conscious effort among doctors to avoid unnecessary antibiotics in general and the risk of infection after a nose surgery is low. However, an infection can be catastrophic after a nose surgery. Many surgeons and patients want to avoid an infection at all costs, especially revision rhinoplasty patients. I recommend probiotics to all of my patients to avoid the issues that come with taking antibiotics. There is research to support using probiotics. They are very safe. 

There are Doctors that prescribe antibiotics after surgery, and others dont. Depends on a lot of things.I personally give oral antibiotics for a couple of days. Just follow your Doctors instructions.Best wishesDr Hernandez Pizzoglio

The recent recommendations from the American Academy of Otolaryngology does not recommend antibiotics routinely. 

xocarmella,
Thanks for the question.  Many of us (surgeons) prefer that our patients take antibiotics after a rhinoplasty because the incisions and dissection for a rhinoplasty involve making planned incisions on areas that are colonized with bacteria (which the entire upper airways are), and also for post-operative splinting.  Your body requires blood flow to areas in order to fight infection, and if any nasal splints or packing are placed post-operatively, then we prefer to treat with antibiotics.  I say "prefer" because I do acknowledge that there is medical literature that supports having splints in place without antibiotics, but many surgeons nonetheless prefer their patients take them.  I think that your surgeon's stance on this (as well as surgical plan and post-op plan) is worth bringing up with them to discuss your concerns.

Hello Xocarmella,
I would follow whatever your surgeon is recommending. However, I have all my patients on antibiotics before and following rhinoplasty. The nasal cavity has bacteria and there is always a risk of an infection occurring. If you were to not take antibiotics and get an infection this could jeopardize your health as well as the ultimate result of the procedure.
Take care,
Dr. Dominic