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What’s the recovery process following rhinoplasty like?

What’s the recovery like post-op for rhinoplasty? I'm thinking of getting it done but want to know as much as possible before so I can prepare properly.

This is a common question that I get asked all the time. It is good that you are asking these questions ahead of your surgery to prep properly. Plastic surgery is a journey and part of it requires you to be patient to give the body time to heal. 

Every surgery goes through the same stages of healing - hemostasis, followed by inflammation then proliferation and finally maturation.  I routinely provide this advice to my patients:

WHAT TO EXPECT AFTER YOUR RHINOPLASTY SURGERY:

Swelling varies from patient-to-patient and it also depends on what was done - simple dorsal augmentation with an implant versus tip-pasty. Generally speaking, your nose will be swollen after the surgery and it is usually worst in the first 3 days before it starts to settle. I routinely review my patients on the 5th post-surgery day to remove the stitches.

When the nasal splint is removed at this point, the nose may still appear more swollen and up-turned. This is to be expected. Most of the swelling should resolve over the next two weeks. At the end of the two weeks, most patients will be comfortable with returning to their work or school or social functions. The swelling will continue to improve over the next few months with the best results at 12 months. Do expect minor fluctuations in the swelling of the nose over the course of the next few months. 

Bruising will vary like swelling from person to person. Most bruising, if it occurs should resolve over the first 10 days. It will turn from pink/red to a purple/bluish colour before it becomes green and finally orange and then it fades away.

Nasal Drip. Some patients have allergic rhinitis or persistent nasal drip after rhinoplasty. We will prescribe a course of antihistamines to help you to reduce the nasal drip. 

Numbness. Your nose will be numb following surgery. This is normal and the numbness willl subside over the next few weeks to months. Occasionally you will feel pins and needles and this is a sign of the body healing. The nose will be hyper-sensitive during this time and accidental brushes against the nose may cause pain that is more severe than normal. 

Bleeding. Depending on the surgery performed, you may have some residual bleeding from inside the nose. This may trickle to the back of the throat or through the nose. If bleeding occur, lie down with your head elevated. You may pinch the sides of the nose gently and swallow the blood. Cold compression over the forehead in-between the eyes will help. Most of the bleeding should stop within 10 to 15 minutes. If bleeding continues, please contact our nurses or clinic.

RHINOPLASTY POST-OPERATIVE CARE INSTRUCTIONS 

1. Apply cool compress across the nose for the first 48 hours after surgery. This involves multiple washcloths and a basin of ice water. These washcloths should be changed out of the basins every twenty to thirty minutes to keep them cool. The washcloths should be applied diagonally over each eye and crisscrossed over the forehead. The nurse will demonstrate how to do this before you leave recovery.

2. The suture lines should be cleaned 3-4 times a day just before you apply the antibiotic cream. There will be absorbable stitches inside the nostril. You may apply antibiotic cream to the suture line inside as well. 

3. Patients may shower the second day following surgery, but it is important to keep the tape and splint on your nose dry at all times. 

4. You should try and avoid wearing eyeglasses for 2 weeks after your surgery. If necessary, eyeglasses may be worn with the nasal splint in place. If you are wearing glasses after the removal of splint ensure that the nose pads are not compressing the nose.

They should be either suspended from the forehead or supported on the cheek for a period of six weeks or until the swelling subsides. This is extremely important as the pressure on the nose may change its final shape. 

5. Avoid taking traditional medicine such as garlic, ginkgo and ginseng as these may increase the risk of bleeding. Avoid a high salt diet as this may cause increased swelling. Most other foods are fine as long as you do not have any food allergies.

I hope this answers your question. Have a great week ahead and all the best!

Dr. Terence Goh

Plastic Surgeon, Singapore 

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