After Rhinoplasty (Nose Surgery)
The First Week After Surgery:
During the day and evening of surgery, cold moist compresses are used continuously over the eyes to minimize swelling and control bruising. Puffiness and bruising can occur but if present usually regresses quickly over the next few days. There are several techniques for icing which are effective. The one glove technique is preferred, but the frozen pea method, or cool compress methods are acceptable as well.
If an external incision is present, care must be taken to clean the incision with hydrogen peroxide for the first three days only. During that time, antibiotic ointment is applied to the incisions so that it is covered at all times.
Invariably, there is some nasal stuffiness during the week after surgery. The external edema (swelling) is reflected internally, but the mild blockage will improve steadily. It is imperative to avoid extensive manipulation in the inside of the nose. DO NOT BLOW THE NOSE. DO NOT USE NOSE DROPS.
For the first few post-operative days, you may expect a small amount pink-colored water nasal discharge. Usually, a facial tissue touched to the nostrils is all that is required.
Discomfort following rhinoplasty is usually limited to the two or three hours just after the procedure. It may best be described as a headache. The prescription for pain tablets that you have received is more precautionary that necessary, but please have it filled and available at your home bedside. Take codeine with milk to avoid any stomach upset. Most patients switch to extra strength Tylenol on the first day of recovery.
During the first week, it is best to sleep with the head elevated by at least two pillows, both to decrease the amount of swelling and to aid in the resolution of any swelling that does occur. Avoid: Blood thinners and moderate exercise during the first week of recovery.
After the First Week of Surgery:
At the time of nasal splint removal, you will have your chance to see the new nose. It will appear quite swollen but, in most cases, even in this swollen condition, the improvement can be appreciated. It is not a time for critical evaluation since, over the next few weeks to months, daily changes progress toward the final result.
During the second week the nose must not be bumped, (elbows, doors, etc.). Though the bones are firmly healing in place, even a slight blow could cause movement. Avoid any situation where a potential for ‘ nasal trauma exists. Exercise that increases the heart rate can begin at 14 days post-up. At 30 days, full exercise can begin. We suggest wearing a baseball hat in public to both protect the nose from other people as well as from the sun.
You should not wear glasses for at least one month. If glasses must be worn, taping the central bridge of the glasses to the forehead will allow as little pressure as possible on the nasal bones.
It is wise not to sunbathe for the first 6 months after surgery. Sunburn will cause the nose to swell and delay the final result. Walking about between sun and shade or sitting with a hat, is permitted. It is always best to apply a waterproof factor 25 sunblock with both UVA and UVB protection.
A natural reaction of all types of nasal skin to this surgery is a pronounced increase in nasal oiliness. Even skin that is usually dry will need to be wiped with an astringent on a cotton pad once or twice a day for two weeks or more. Another universal observation is the presence of flaking or peeling of the skin, much like that caused by sunburn. This also abates in about two weeks. Most discoloration is resolved in 7-10 days. However, though unusual, this may persist longer as pigmentation beneath the eyes. Occasionally, olive-skinned patients may retain this pigment for several months.
Out of Town Patients
You must remain in the Washington metropolitan area for at least one week following surgery. We will help make hotel arrangements for out-of-state and foreign patients if you have no local residency.
Improvement not Perfection
Observe, in yourself and in those around you, that the two sides of the human body are not the same. Aesthetic surgery can never make them exactly the same. Our purpose and goal in facial aesthetic surgery is improvement and not perfection.
These may be required in very select cases to maximize result. Dr. Tien will describe how to perform these exercises as part of his postoperative instructions and on subsequent follow up visits if needed.
Dr. Tien typically likes his patients to tape the nose postoperatively to reduce swelling. Specific instructions on the correct way to place the tape will be explained to the patient after surgery and on subsequent follow up visits.