Caring for Yourself after Rhinoplasty (Dr. Ben Marcus)
You have just had surgery to your nose (rhinoplasty). There are incisions inside your nose. In some cases, there is a small incision in the tissue between your nostrils. All of your incisions, both inside and outside, have been closed with sutures which will dissolve. The cartilage in your nose, and often the bones, have been carved apart. Then, they were reshaped and repositioned. There is no packing in your nose. You have a molded plastic splint glued to the outside of your nose. The purpose of the splint is to hold your cartilage and bone in their new position while they heal. This will lessen the swelling that you will have. The splint will protect your new nose.
This guide was written to give you instructions for the care of your new nose. It will answer questions that you will have as your healing moves ahead. Refer to this handout for the next month as questions arise. Do not hesitate to call our office if you have more questions.
- Sleeping in a recliner chair is ideal. If you sleep on your side, your nose will swell closed on the “down” side. Sleeping on your back with your head slightly raised for the next week is best.
- Keep ice packs across the splint and both of your eyes until you go to sleep tonight. Use the ice packs all day tomorrow. This prevents bruising of your eyes, lessens the swelling of your nose and face, and makes you more comfortable.
- Your nose will drain some mucus and a bit of blood for the first day or two after your surgery. This is normal. We will send you home with a drip pad of gauze under your nose to absorb the drainage. Please change the gauze as needed. We will clean out your nose at your first clinic visit.
- For the first week,
- Walk as much as you like.
- Do not blow your nose. You may sniff backwards.
- Do not run or do any aerobic exercises.
- Do not lift anything over 10 pounds (including a child).
- Do not bend forward with your head down.
- Do not strain in any way.
- Sexual activities should be limited.
- Ask our staff if you have any questions about a certain activity.
5. Our staff will show you how to manage this. Wear the lightest weight pair of glasses that you have. You may insert your contact lenses two days after surgery. After removal of your splint, you should limit the time that you wear your glasses. Keep wearing light-weight glasses. Do not wear plastic-framed glasses that rest all the way over the top of your nose. If your glasses have very small nose pads, you may wish to ask your optician to install larger, softer pads. You may expect some soreness on the sides of your nose after you have worn your glasses for awhile. This is normal. It may last 3 to 4 months. When your nose becomes tender, remove your glasses for an hour or two. Contact our staff if you have questions about your glasses or contact lenses.
6. Do not drive for 24 hours after your surgery. Until that time, you will still be affected by the drugs you were given during your surgery. It is not safe for you to drive. After a day, you may drive limited amount.
You may eat a normal diet after surgery. You may find that swallowing solid food is a bit hard while your nose is stuffy. Your sense of smell may not be too good for the first week, but will soon return to even better than before. Drink lots of liquids to help your body recover from anesthesia and surgery.
- You will be given pain medicine to take only if you need it. Do not take it more often than instructed. Do not take it if you do not have pain. These pills contain a mild narcotic and may make you light-headed or even nauseated. We would prefer that you take one or two 200mg ibuprofen tablets every 4 to 6 hours to control your discomfort.
- You may be given antibiotic pills to take. If you are given these pills, take them as instructed. They are important for proper healing. Take them until they are completely gone.
- You may be given dexamethasone to take for a week. This helps reduce swelling and discomfort. Take them exactly as the directions tell you.
- You may be given a packet of Arnica Montana pills to prevent bruising. Take them exactly as instructed on the package.
- Resume taking all of your normal medicines the day after surgery. It is wise to take a multivitamin pill during the month after surgery.
- You will start using a saline spray in your nose two days after surgery. You can buy a saline spray over-the-counter in your drugstore. You may use any brand. Two common brands are Ayr® and Ocean Spray®. Use 2 squirts in each nostril at least 4 times a day. You may use it as often as you like. The saline helps reverse the drying effect that the surgery has on your nasal lining. It should be used for at least the next 3 months. Do not use any other sprays in your nose unless you are given specific instructions to do so by our staff. Contact us if you have questions about using your nasal spray.
- If you do have a small incision in the tissue between your nostrils, we will give you an ointment to apply there. Apply it with a cotton swab and rub it in well. Do this 3 times a day. We have used dissolving sutures to close your incision. The sutures dissolve only if kept moist with ointment. Continue to apply the ointment until the sutures have dissolved. This will take about a week.
- You may have had some cartilage taken from your ear to put in your nose. If so, the incision in your ear has been closed with the same sutures as those used in your nose. Apply the ointment to your ear sutures 3 times a day with a cotton swab. Continue to do so until the sutures have dissolved. This will take about a week. You will also have a dressing on the front of your ear and one on the back. These dressing are sewn to your ear. We will remove them at your first clinic visit. Don’t try to remove or change these dressings.
- If you have had an implant inserted into your chin, you will have a dressing taped to your entire chin. Once this dressing is removed, you should apply ointment to the incision line 3 times a day. The stitches will dissolve in about a week.
- We will remove the plastic splint on the outside of your nose about a week after surgery. You may wash your face and shampoo your hair the day after surgery. It will not damage your nasal splint dressing if it gets a bit wet. Do not run water directly onto the splint. You may wash around all of the incisions in your face the day. If they happen to get wet, this will cause no problems.
Visits to the Clinic
- Two days after surgery, you will be seen in our office. Your nose will be gently cleaned out. You will be started on a nasal saline spray. If you have a dressing on your ear, that will be removed during this first visit.
- One week after your surgery, we will see you again in our office. At this time, your outside nose splint will be removed and your nose once again will be gently cleaned out.
- Your next visit will be one month after your surgery.
- As a rule, we will then see you at 3, 6, and 12 months after the surgery. There is no charge for these visits. You may have postoperative pictures taken at these visits.
- Swelling of your nose and the area around your cheek and upper lip is normal. The swelling will slowly go down over time. When your plastic splint is removed you will see some swelling. This swelling at the upper part of your nose between your eyes should be gone by the end of the second week. The same is true for the minor swelling of your cheeks at the sides of your nose. You may have some swelling in your upper lip and even on your gums above your teeth. The mild tenderness and swelling here will be gone within 2 weeks. There may be minor swelling and a feeling of stiffness in the tip of your nose that goes on beyond the 2-week period. In many cases, the tip may not appear just as we want it for up to 6 months after surgery. In some cases, we may inject a small amount of cortisone into the tip to help make the swelling go away.
- Bruising around your nose in your cheeks and lower eyelids is very common after this type of surgery. It should go away completely in two weeks. If this bruising is a problem in your return to work, we can provide you with some cover-up makeup.
- Numbness over your nose is also quite normal. You will slowly regain sensation over the top of your nose. But you can expect the tip to be slightly numb and “stiff” feeling for up to three months after surgery.
- Breathing through your nose will slowly improve after we clean your nose out at your first clinic visit. After a week, your breathing should be much improved. It is vital that you spray the inside of your nose often with saline spray.
- You may be instructed in a set of nasal exercises. These exercises keep your nose narrow and straight as the nasal bones heal back to the facial bones. If you are told to do these exercises, make sure you do them for the first month after surgery. In most cases, they are not needed beyond that point of time.
- You must protect your new nose from the sun for 3 months. Sun exposure will cause swelling in the nose and will slow the healing process. The skin of your nose will be very likely to burn from sun exposure. Good protection for this 3-month period means both a brimmed hat and a sun block of at least SPF 15.
For any other questions that may arise, please do not hesitate to contact us at (608) 263-6190. We would rather answer your questions than to have you worry perhaps needlessly. We very much hope that you enjoy your new nose both in function and appearance.
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The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 09/30/2010
Copyright © 09/30/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7087
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