Sleeping Position After Rhinoplasty?

While keeping the head higher than your heart for the first few days post-op will probably minimize swelling, I also recommend it for comfort. When the nose is congested--as it will be after surgery--lying flat can sometimes make patients feel as if they're smothering.
It's doubtful that lying flat would cause any truly lasting harm, though. So if a patient is adamant about lying flat, I'd rather they get their sleep and rest than be up all night in an uncomfortable position.
I do caution them against lying on their side in a way that smooshes their cheek and face, since that could potentially shift repositioned nasal bones. I can't say that I've ever seen a bad result that was merely due to patient sleeping position, but it's prudent to minimize the chance.
All the best,
--DCP

Hello and thank you for your question. I advise my patients to sleep with two or three pillows under their head and try to sleep on their back for the first week. Afterwards you are free to sleep on your side. I recommend that you seek consultation with a 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

Postop instructions vary by surgeon, but in my practice, I provide detailed descriptions about how patients should sleep after surgery. I would expect that your own surgeon will do the same. There are some principles, however, that should be abided by, such as trying to elevate the surgical site *somewhat.* I recommend my patients sleep on their backs, with their heads elevated by pillows to about 30 degrees. This helps to facilitate drainage and decrease swelling. You should absolutely avoid sleeping on your face immediately after surgery, and for as long as possible postoperatively to help combat swelling. What I never instruct patients to do is to sleep in chairs! Why? Because what happens when people fall asleep while sitting up? The head tips forward, and the swelling and pressure will then build up in the front of the face and the nose. Wishing you a speedy healing process!

Thank you for your question. I recommend that my rhinoplasty patients sleep in their backs with their heads elevated for the first few weeks after surgery. Elevation helps to alleviate the post-surgery swelling that is common after nose surgery, while sleeping on the back prevents undue pressure on the nose that could impact your outcome. You will likely only need to elevate your head for a couple of weeks, but I usually advise patients to maintain the back sleeping position for up to six weeks to give the nose ample time to heal. Also, make sure you are working with a very experienced, knowledgeable, board-certified facial plastic surgeon to ensure the best possible outcome from your procedure.

Depending on surgery techniques different surgeons may recommend different positions, it is always best to seek the advice of your treating doctor.
While awake, keep your head upright, or if reclining do not lie flat. And general guidelines for sleeping after rhinoplasty are:

In the early recovery period it is beneficial to sleep on your back, with your head elevated on a pillow for at least two weeks to avoid lying on the side or front of your nose, (which would put pressure on and deform the operated area).
To minimize swelling and for increased comfort it is recommended to sleep with the head elevated on two pillows for the first 3-4 days after surgery until swelling starts resolving.  

Thank you for the great question. Sleeping with your head elevated, on your back, helps the swelling to go down a little quicker and more evenly. If you imagine laying flat for 7-8 hours a day (i.e., during sleep), the tissue fluid will take longer to make its way out of the nose. Sleeping on your side could, theoretically, lead to asymmetries in the swelling and healing. While this would almost certainly resolve over a long enough period of time, in the interim it could be problematic an aesthetically displeasing. Sleeping position and activity restrictions are by far the issues patients struggle with the most. But if you have committed to the surgery and want the best result possible, it is certainly worth it. Take care and best of luck!