Post-Operative Guide for Rhinoplasty Surgery

General

The recovery after rhinoplasty surgery varies for each patient, but this guide will provide you with an outline of what to expect.
If you are concerned at any point after surgery, please contact Mr Navaratnam’s team via his secretary or the hospital where the operation was performed (if out of hours).

DOWNLOAD THE GUIDE TO YOUR RHINOPLASTY RECOVERY

1. What to Expect:

After surgery, you will expect to have a plaster cast over the nose, which will be covered with brown tape. Sometimes Mr Navaratnam also uses internal nasal splints secured with a surgical stitch. This may make the nose feel blocked until they are removed. These are usually removed at your first post-operation appointment 7-10 days after surgery.
The day after surgery is often reasonably comfortable, but things will get worse before they get better. Days two and three post-surgery are the worst in terms of tiredness, nasal congestion, swelling or bruising.
You will experience some ooze of blood-stained secretions in the first 3-4 days, and you will feel tired to a variable degree after the anaesthesia. You need to rest and not overexert yourself.
You will see swelling and bruising under your eyes (you can use a fridge-temperature cooling pad to reduce swelling but it is not essential).
You will notice changes in swelling, especially in the morning. It is normal for the appearance of the nose to change from day to day in the first 6 weeks after surgery
You will see a daily difference in your nostril shape due to internal swelling.

2. Care Instructions:

Keep your head elevated and sleep with two pillows so you are at 45 degrees for the first week after surgery. Ideally, sleep on your back at this time.
You must keep the plaster cast dry. You may shower if the cast stays dry.
If you feel the need to sneeze, let it happen with your mouth open.
Use the ointments and drops which were dispensed to you.
You should make the most of the first week after surgery to rest, which will speed up the recovery process.
You should have 2 weeks off work after surgery.

3. Avoid:

Ideally, do not plan any air travel for the first 2 weeks after surgery.
Avoid very hot showers and hot drinks/food for 2 weeks after surgery.
Avoid any vigorous exercise in the first week. You do not need to stay in bed but limit activity to walking. Gentle exercise can start in the second week after surgery and you can build up exercise intensity slowly.
Avoid any strenuous exercise for 4 weeks and contact sports for 6 weeks after surgery.
If you usually wear glasses, please avoid this for six weeks after surgery. Please wear contact lenses or consider using a glasses holder.

Things to Buy to Use After Rhinoplasty

4. Medications that will be provided from the hospital:

Pain relief – paracetamol, ibuprofen, codeine.
Decongestion nasal spray/drops such as Otrivine.
Ointment – to use on the skin between your nostrils and around the inside of your nostrils.

5. Other medications to buy:

Sterimar nasal spray or Neilmed sinus rinse – to use after cast removal.
Factor 50 SPF sun cream.
½ inch 3M micropore tape – if taping indicated after cast removal.

6. Other items:

Cooling pads such as Koolpak – optional to help reduce swelling around the face.
Travel pillow – optional to help with stabilising head when sleeping on your back.

First 4 Days Post-Rhinoplasty: Day 1 (Surgery Day)

7. What to Expect:

When you first leave the operating room and begin to wake up from anaesthesia, you may feel disorientated, want to drink water or use the bathroom.
You may also initially have blurred vision or feel something in your eyes. During the operation, we use lubricating jelly in your eyes to stop them from becoming dry. We wipe this off after surgery, but it may feel like something is in your eye.
Swelling and bruising begin.
You will expect to have a plaster cast on the bridge of the nose which is secured with medical tape.
An internal nasal splint or dissolvable packing may be in place inside the nose.
If internal nasal splints are not used, you usually are able to breathe well through your nose initially. Swelling begins, and your nose may feel blocked for 2-3 weeks.
If internal nasal splints are used, your nose will feel blocked immediately.
Mild to moderate pain, congestion, and slight bleeding are normal.
The throat may be uncomfortable for the first two days after surgery. This is due to the anaesthetic device (tube or mask) that was used to allow you to breathe during surgery.

8. Care Instructions:

Use cold compresses around, but not on, your nose.
Take painkillers as prescribed.
Avoid blowing your nose or touching it.
Stick to liquids (soups, smoothies) and softer foods (soft rolls, soft bread sandwiches).

9. Avoid:

Bending over or lifting heavy objects.
Strenuous exercise.
Driving (if on pain meds).
Food that are chewy, very hot or spicy.

First 4 Days Post-Rhinoplasty: Days 2-4

10. What to Expect:

Swelling peaks and bruising become more visible.
Sometimes, the swelling is asymmetrical, and one eye may be significantly more swollen than the other.
Bruising will initially be blue and change to yellow.
Congestion persists, slight discomfort continues.
Nasal secretions will become congealed or dry in the nose. It is important to use the nasal spray provided to moisten the inside of the nose.

11. Care Instructions:

Make sure you start to use the nasal drops and the ointment to apply to the bottom of your nose and skin between your nostrils.
Keep nasal cast dry.
Continue cold compresses.
Eat anti-inflammatory foods, avoiding excess salt.
Light walking indoors is okay.

Next 1 Week: Days 5-10

12. What to Expect:

Swelling starts to subside.
Less pain, but mild discomfort persists.
Nasal cast removal usually occurs around days 7-10.
The dissolvable stitches will start to break down and drop off from the skin.
The medical tape used to secure the plaster cast may start to loosen, especially if it has become wet. Simply apply gentle pressure to reattach the tape to the skin.

13. Care Instructions:

Continue hydration and soft foods.
Gentle walking is fine, no strenuous exercise.
No direct water on the nose while showering.

14. Avoid:

Heavy lifting and intense exercise.
Public places where you might bump your nose.

Cast Removal

15. What to Expect:

At your first post-operative appointment, you will expect for the external cast to be removed, the internal nasal splints to be removed (if used in the surgery), the nostrils to be cleaned and any long sutures to be trimmed short.
Removal of the external cast can be uncomfortable but it usually only takes a few minutes.
When the cast first comes off, there may be a significant difference in swelling in different parts of the nose, eyes and rest of the face.
The position of the nasal tip and nostrils will be affected by how the nose was taped after surgery and this will change over the next few days and weeks.

16. Care Instructions:

Clean your face and nose as best you can prior to coming for your appointment.
It would be helpful for you to use the nasal drops provided 2 hours before you see me.
Have some pain relief 2 hours before the clinic appointment.
After the appointment, you may be advised to tape the nose especially at nighttime to reduce swelling.

17. Avoid:

Touching the nose excessively after cast removal.
Hot showers for a further week.

Weeks 1-8

18. What to Expect:

In the weeks after the cast removal, there will be a gradual reduction in swelling, both internally and externally.
Different parts of the nose and face may change at different times during this period as the skin and structures in your nose heal after surgery.
Facial swelling is usually worse in the morning. Applying tape to the nose at nighttime can help reduce this.
Usually your nasal breathing will improve after 3 weeks after surgery.
The incision on the columella (skin between your nostrils) will initially become red and then slowly fade with time.

19. Care Instructions:

Use a saltwater nasal spray/wash (Sterimar or Neilmed sinus rinse) to clean the nasal passages twice daily.
Stop using the decongestion spray/drops (Otrivine) one week after surgery. If you use this for a longer time, it may cause a rebound swelling in the nose, or you may become reliant on it.
Gradually increase intensity of exercise.

20. Avoid:

Contact sports or direct impact to the nose.
Carrying young children or babies who may reach and grab your nose.

Months 2-3 Post-Rhinoplasty

21. What to Expect:

Most swelling subsides, but tip swelling may linger.
Nose continues refining.

22. Care Instructions:

Moderate strength training is okay.
Swimming is usually safe after 2 months.

Months 4-6 Post-Rhinoplasty

23. What to Expect:

Swelling continues to diminish.
You can engage in more physical activities.

24. Care Instructions:

Be cautious with light contact sports.
Avoid direct impact to the nose.

Key Recovery Guidelines

Exercise: Gradually increase activity but avoid trauma.

Diet: Eat anti-inflammatory, nutrient-rich foods. Avoid salt & alcohol.

Make-up: Can be worn after 2-3 weeks, but be gentle.

Sun Protection: Always apply SPF 50. Avoid direct sun exposure.

Sleeping: After 2 weeks, you can sleep on your side. Avoid sleeping face-down until month 6.

Final Results: Expect full results within 6-12 months.

Avoid contact sports, extreme heat, and excessive nose handling.