Patients like to know the details of an entire recovery process. What does rhinoplasty look and feel like post op after a few days, a few weeks, months, and even years? With over 40 years experience on the job as a rhinoplasty surgeon I can expand on all facets of the recovery process so that you can feel comfortable and know exactly what to expect through each phase of the recovery timeline.
Patients can go home right after rhinoplasty to begin their recovery. The bruising will diminish every day. The swelling will continue to abate. Remember, the swelling at the bridge and the upper parts of the nose will go down quicker because the skin is thinner. The nasal tip swelling will take a little longer because as the swelling moves from the bridge down to the tip, it then has to dissipate from there, but it always goes away. There are other factors, including the thickness of the skin and how much work had to be done to narrow the tip of the nose.
Rhinoplasty swelling is common and its resolution is a function of complexity. If people have had many broken noses and had a deviated septum and the whole nose has to be basically disassembled and rebuilt, of course, there is going to be a little more swelling and bruising. But, again, it goes away. It does not take 3 or 4 weeks. It is always a matter of 7 to 10 days typically. Every day you look better. In my own rhinoplasty experience, within 9 to 10 days after surgery the appearance of my nose was very improved but not as good as it was a week or 10 days later. The swelling continues to go down.
The basic healing process of rhinoplasty is just like any other operation of the body. It is really a matter of 3 months, 100 days, but it is not that you do not look good at 3 weeks or 4 weeks. You look excellent, but the nose keeps getting better and better, meaning more refinement, more finesse, and more in accord with the predicted results. Remember that nature does best when there is no manipulation, when there is no massaging, and when there is no putting various tapes and things on the nose. Nature likes to be left at rest to encourage the best healing.
In short, the typical rhinoplasty recovery time is under 10 days. There are many other factors to consider, such as rhinoplasty type; procedures like liquid rhinoplasty for example has zero recovery time, common in revision rhinoplasty. Typically, there will be a splint on the outside of your nose to protect it for 5 days or so and in 5 more days the nose has healed so well and you can return to all normal activities, including your exercise program. The only limitation is no contact sports, such as soccer or rugby where injury to the nose could be very unpleasant. For the nose to be rock-hard, solid, and all the tissue welded together takes 6 weeks. So, how long does it take to recover from rhinoplasty surgery? The average recovery period is typically 7 to 10 days, but it always depends on the individual.
Some rhinoplasties are accompanied by correction of a deviated septum to improve breathing or reduce the turbinates to also improve breathing and improve symptoms of allergy. That means you have had two operations; the external rhinoplasty and the internal breathing operation; so, there is going to tend to be a bit more swelling and bruising, but generally 10 days is, again, the landmark for looking good and being able to go back out into the world and resume your normal activities.
There is very little chance of major problems after one hits that 10-day mark. Going out in public, even if there is a little bruising, is still feasible using a little bit of makeup.
Looking normal is a process that takes place every day. The swelling continues to go down. Generally, it is maximum on the second day. How well one cares for themselves after the rhinoplasty, including taking the medications that are provided such as arnica and icing over the eyes and cheeks immediately after surgery, all contribute to the rapidity of the recovery as evidenced by less swelling and bruising.
From the get-go, immediately after your rhinoplasty, in the recovery room, ice application is of great help in preventing or at least reducing swelling and bruising. We recommend as much icing as possible in the first 48 hours. The early-on care of your nose after rhinoplasty is the key to a faster rhinoplasty recovery time.
The first night, sleeping slightly upright, two to three pillows, helps drain any blood in from the nose. This promotes less swelling and bruising.
After surgery, the top Rhinoplasty surgeons provide recovery tips to ease recovery and accelerate healing.
The outside plastic protector is in place for anywhere from 4 to 6 days. Once that comes off, one can already see the changes that have been made. If you had a bump, it’s gone. The profile already is a big improvement. The tip is more refined and so you have a very good idea of the outcome. Each day the swelling recedes and if bruising present, it lightens in color and evolves from purple to green to yellow. This is good news, because both green and yellow are easier to conceal cosmetically.
The nose has gotten better. The swelling is going down. The bridge swelling has mostly disappeared and a little bit of swelling on both cheeks and the side of the nose has continued to diminish.
At 3 months, 85% to 90% of the refinement has taken place. Remember that in rhinoplasty, it involves changing the shape of the nose by altering the bony and cartilaginous structure, so it is required that the skin that has been raised continue to shrink down to the new dimensions. Typically results at 3 months are considered very close to the end result, although at 6 months it will look even better and even more at a year.
We like to see our patients at the 6-month mark and at the 1-year mark and we will compare their appearance with the preoperative photographs which is always of great interest to the patient, particularly because by that 6-month mark they often forgot exactly what their nose looked like before.
While by 3-6 months the rhinoplasty “healing” is considered complete, there is even further maturation and improvement up to the one-year mark. Typically the tip of the nose becomes even more refined until 12 months after surgery. Likewise, the width further narrows as the very last vestiges of swelling under the skin recedes. Just like fine wine, time makes the nose even better.
At the one-year mark and milestones after, visits are offered at these stages on an as-needed basis, and most patients find them unnecessary. Over this time, final results become apparent, and you will be able to truly enjoy your rhinoplasty – by forgetting you ever had it. Your nose will seem like it has always been a part of your face, and looking back on your old nose in photos will seem foreign.
Our practice provides all of the supplies and non-prescription medications that should be used to speed the recovery. This includes a 10-day supply of Arnica, which patients start taking just before surgery day. We provide antibiotic ointment for use inside the nose. Also, saltwater or saline spray mentioned above is important to use to keep the nose refreshed and speed the healing, particularly in the first several weeks, which is very refreshing and can help reverse the dryness of the nasal lining due to the procedure.
The main precaution after rhinoplasty is to avoid any injury to your nose. The second precaution, of course, is to avoid those things that would interfere with blood clotting. For example, we do not recommend going on large doses of aspirin or even non-steroidal anti-inflammatories like Advil or Motrin because they could interfere with the proper healing and kick up the possibility of some bleeding. Only in the first 10 days is one at risk for that particular situation.
Stay away from situations where your nose could be bumped. If you are going to be flying on an airplane, do not plan on lifting your luggage overhead and stay away from people who are lifting their luggage over your seat. You do not want anybody’s luggage to bump your nose.
Depending on the surgical procedure (open vs closed rhinoplasty), there might be scarring. The majority of Dr. Kotler’s procedures are performed using the closed technique. In closed rhinoplasty, the incision is internal and there is no visible scarring.
A moderate amount of alcohol meaning 1 or 2 drinks a day is certainly tolerable. Any greater volume of that runs the chance of some instability. Drunkenness is a risk because of the chance of a fall and contact damage to your nose.
Smoking is one of the biggest no-no’s because it slows healing. Dryness is the enemy of the nose and so is heat, so it is a double loss here. We do not recommend it and most people are wise enough to know that they would tamper with rapid healing by smoking. It is a good time to consider stopping smoking since for the first 10 days if you can get through that, you will be on the road to ridding yourself of an unhealthy habit.
If the nasal bones have been repositioned, as in the case of 90% of rhinoplasties, glasses should not be worn for typically 5 weeks or so. However, patients are instructed on how to suspend them with small pieces of clear transparent tape such that it would be very hard to see that the glasses are suspended just above the bridge so there is no pressure. Of course, those who wear contact lenses may put them in the day after surgery.
The nose will not grow after rhinoplasty. One might think their nose looks bigger after rhinoplasty for the first 7 to 10 days because it is a little swollen but the truth is, it does not grow. As a matter of fact, as people get older and the noses tend to droop either because of an overactive depressor muscle pulling the tip down or just due to the effect of gravity, and there is less chance of that if you have had a rhinoplasty because the internal scar tissue keeps the nose tight.
The external plastic splint or protection is typically removed anywhere from 4 to 6 days. It does not hurt to remove it. It is gently slid off the skin and, at that point, there are no external signs that you had any surgery, particularly if you had the closed rhinoplasty approach which demonstrates no external incisions.
Sometimes there is a little bit of itching. Be gentle. Use a Q-Tip. Also remember the skin can get a little oily after surgery so we recommend using witch hazel, as well as an antibacterial hand soap. There is a small chance of getting a little outbreak of acne which can occur after rhinoplasty because there can be trapping of oil on the skin due to swelling. If you follow the typical post-op instructions, that will not be a problem.
In the first 10 days, we do not recommend it because the veins will become filled with blood and are more likely to leak. Rather than bending over, just bend the knees. Be careful if you are lifting children also because remember that the young infants will tend to buck their heads back and if they do you will not be a happy parent.
If you have just had a rhinoplasty and have not had the septoplasty and turbinate resection you should be able to breathe quite well. In our practice, of course, we have the Kotler nasal airway in place, which is guaranteed to be able to breathe whether there is packing in your nose or not. Remember, today’s contemporary packing materials both dissolve and also do not stick. When the non-absorbable packing is removed, liquid anesthetic is put into the nose.
The purpose of packing is to speed healing, reduce the chance of infection, and also minimize the chance of any bleeding, so packing is very important. However, if the nose were packed without having the little plastic air tubes in place, which do not hurt and sit in an un-operated area, it would not be quite as pleasant. The combination of packing with the airway, and those can be in place for up to 4 to 5 days, gives you the best prospect for having a satisfactory postoperative experience.
With a specialized rhinoplasty surgeon, breathe immediately after rhinoplasty or nasal surgery. As one of the most specialized rhinoplasty surgeons in the U.S, Dr. Kotler is also an inventor. The Reltok Clear-Flo™ Nasal Airway System. was created to advance post-operative care for rhinoplasty for breathing and comfort. Speak with your surgeon about a homecare kit to learn how you can breathe clearly after nose surgery.
One can shower even the day after, as long as the splint is protected from the direct spray of the water. We recommend taping some saran wrap to your forehead and therefore providing a nice little cover. The splints are well adhesed to the skin so there is not much chance they will separate even if a little water gets in there. Certainly, shower and shampoo and be comfortable.
Most patients tell us, in our detailed surveys, that their nose pain after rhinoplasty was less than they feared. And even if there is significant pain, of all of the things that doctors do, pain control is the easiest. There are a variety of medications that can be used. Many people are happy using just extra strength Tylenol or even plain Tylenol – just no aspirin, please. However, it is wise to have something stronger on hand and our practice typically provides Tylenol with Codeine as opposed to an opioid because we think that is a better medication and you are only going to use it for a couple of days.
Patients are concerned about nose pain after rhinoplasty in the tip of the nose because it tends to be the most sensitive area. On the contrary, the tip of the nose tends to actually be a little numb and is less painful than the bridge, but it is not great pain.
I can tell you from my experience as a rhinoplasty patient, I never even took a pain pill. I was waiting for the big pain to “show up” and it never did. I got up the next day and felt fine and never took a pain pill. However, everyone is different and some people have a higher or lower tolerance to pain and that needs to be taken into account. We do not want you to suffer because the physician’s job is to prevent suffering. Equally important is that if you have pain the blood pressure goes up. If the blood pressure goes up, there is a greater chance of bleeding within that first 7 to 10 day critical postoperative period.
After rhinoplasty, not uncommonly, the usual nasal mucus glands tend to reduce their production. This results in dryness that while not a threat to the result nor likely to cause other problems, is a bit of a nuisance. Nasal surgeons anticipating this temporary condition provide moisturizing solutions to be used after surgery. There are many brands and varieties, e.g. Neil Med, Pretz. The common ingredient is salt water; the same solution used for intravenous solutions. These products, sprayed into the nasal passages will minimize dryness, soften some internal crusts and hasten healing. Since the inside of the nostrils may also be a bit dry, bland ointments are recommended.
For those patients with naturally dry skin, some minor skin care is recommended. The skin will be a bit flaky and since patients are rightly reluctant to be vigorous about cleansing the skin of the recently operated nose, there can be a build-up of the surface skin’s unremoved shed layer. The remedy is simple, gentle washing and then application of a light moisturizer. The dryness and flakiness will gradually disappear as the patient becomes more comfortable with skin washing. The moisturizer is safe, practical and is used as needed.
The patient whose skin tends to be oily will have different issues than a patient with dry skin. The oily skin combines with the skin that normally flakes off to form a film that can clog pores and even lead to a skin condition known as acneiform dermatitis. Little red bumps, a la acne develop as some bacteria invade the very surface and thrive in the oily-dead skin environment.
This is not a serious condition and does not threaten the nose. However, it should be dealt with so that the appearance is more normal for the healing stage. Further, if left untreated, the condition can advance to the more invasive acne. Removal of the oil and skin using a variety of astringents such as Witch Hazel is very helpful. Also, the use of an antibacterial soap will eradicate the bacteria and hasten the resolution.
For patients with often oily skin, after the dressings come off a few days post rhinoplasty, skin is oilier. Why does oily skin happen post-nose surgery? Shiny nose after a rhinoplasty is common and happens as a protective response from the skin. To treat oily skin or avoid oily skin during recovery time, wash your face more often with an antibacterial hand soap for hands, face, and nose. The use of witch hazel and toner will help to remove oil off the skin so you can prevent acne outbreaks. Rest assured, shiny noses are temporary and will go away as you heal.
Rhinoplasty recovery is common sense, more than anything. We will guide you. We provide all of the information, written material, and instructions, and supply all the medications, both prescription and non-prescription. This is all geared to having the most rapid and complication-free recovery. A little common sense goes a long way and most people know that the postoperative period is important so there will be no slowing of the healing, so there will be no chance of increased bruising or swelling, and therefore are motivated to do the right thing to have a successful outcome as opposed to an unpleasant experience.
Rhinoplasty recovery is extremely important in terms of avoiding complications and promoting a rapid and safe healing interval. Typically, the basic recovery period is ten days. During that period of time, in particular the first week, we are allowing nature to begin the healing process and welding process. The most important thing is that the patient does not “overdo it.” No strenuous exercise and diminish the chance of trauma to the nose following the rhinoplasty procedure.
The rhinoplasty procedure is an operation designed to change the external appearance of the nose.
Rhinoplasty renders a more satisfactory nose. The aim is to create a natural-looking, appropriate, and improved nasal architecture.
Rhinoplasty is the second most common operation in the world of cosmetic plastic surgery. It is the most popular of all of the facial procedures. It is commonly employed often in conjunction with operations upon the nasal passages to improve breathing.
Often minor changes are major changes in terms of perception of the patient. The rhinoplasty procedure has a bearing on the patient’s self-image. It has been proven by psychologists that people who have a better sense of their appearance fare better in life. The nose job is more than just a “pretty nose.” It is an operation that has significant ramifications on the patient’s psyche.
The rhinoplasty or nose job is an operation that can be done via one of two approaches. The first approach, known as “open rhinoplasty,” is whereby a horizontal incision is made between the nostril openings to gain access for the surgeon to alter the structure. In that case, the skin of the nose is raised for proper visualization and accessibility so that the procedure can be performed. The other approach is known as a “closed rhinoplasty.” In that case, access to the structures of the nose to alter the basic architecture of the bone and cartilage is through incisions that are hidden within the nose. No incisions are visible. Typically, the recovery period is the same. Again, through the internal or closed rhinoplasty approach, the ancillary operation of improving the airway can be performed at the same time.
A rhinoplasty or nose job is a strictly cosmetic procedure to alter the appearance of the nose. The nasal septoplasty is an operation that improves airflow through the passages. The recovery period is a little different from that of the latter procedure, being a bit longer if it is combined with resection of the turbinates to further enhance the airflow through the nose. It is wise to perform both together. The rhinoplasty procedure, the septoplasty, and the turbinate surgery can be performed at the same time. Combining the functional surgery of septoplasty and turbinate surgery typically has no bearing on the final results of the plastic surgery on the external nose. The septoplasty operation is done to “straighten” curvatures of the cartilage and bony portions of the nasal septum, which is the vertical partition separating the two nasal passages. Often, crookedness is due to an accident, and in that case, there may be a need to intervene in correcting malpositioned nasal bones also, but the aim is to relieve the baffle-like change in the nasal septum causing nasal blockage to improve the airflow and reduce the chance of the patient having complications such as sinusitis, dry mouth, and other issues that accompany impaired breathing.
A proper candidate for rhinoplasty is one who has architecture abnormalities that are amenable to change using reliable procedures. The most important thing is the final result, which looks natural. Not everyone needs all components of the rhinoplasty performed. Some people require only that the tip be narrowed. Often, a plastic surgeon is called upon to remove a bump only or to narrow the base of the nostrils. Regardless of the procedure, the healing process tends to be rapid and uncomplicated. Again, the typical recovery is seven to ten days. At the ten-day mark, people are free to return to normal athletic, social, and business activities.
People consider rhinoplasty because they are unhappy with the appearance of their nose. It may be a mismatch in the size of their face. It may overpower other excellent facial features. A nose job is an appropriate operation when the common problems they are presenting are amenable to improvement. Rhinoplasty’s popularity has increased over the years as good results are recognized by the public. Also, the procedure has become more popular as the bottom-line costs have been reduced since they can be done in an accredited outpatient surgery center or physician’s office surgical suite.
People do have rhinoplasty or rhinoplasty and septoplasty to correct the deformities and malfunctions of previous injuries. A “broken nose” is often the stimulus for one to have the operation not only to breathe but to improve the appearance. The plastic surgery, meaning one that changes form and function, is a reasonable thing to do if one is unhappy with the appearance and the breathing.
People opt for the rhinoplasty if the nose is crooked and also exhibits breathing problems. Technically rhinoplasty is a cosmetic operation, however, a so-called functional rhinoplasty would typically include an operation on the outside to restore normal architecture after an accident or genetic malformation combined with internal functional surgery to improve breathing. It is necessary to literally “operate on all parts” to obtain a satisfactory result.
The advantages of rhinoplasty is that the patient may have a more gratifying appearance. The nose is the most prominent facial feature and it is important that it work in concert with other facial features. For some women, they may have excellent eyebrows, beautiful eyes, and lips and cheeks that are quite ideal and, yet, their overall appearance is compromised because of a large unseemly nose.
The risks of rhinoplasty are those that may accompany any operation. Bleeding and infection are the most serious. Today, both are quite rare. The control of bleeding has been facilitated by better techniques and the use of drugs that have proven themselves in other arenas, such as platelet-rich plasma and tranexamic acid; the latter is a drug that is very important to brain surgeons. The other risk for rhinoplasty is a bit more subjective, and that result is not totally satisfactory to the patient. It is not considered a complication; it is really considered an imperfect result. However, an imperfect result can be improved either by repeat surgery or temporary or, even more satisfactory, permanent non-surgical revision rhinoplasty.
Typically for young men 17 years of age is the low end. For young ladies the lowest end is 13 because today’s women mature sooner physiologically than their forebears. The best age also depends on the time of need. Some people do not see the need for it until some point later in life.
Before a rhinoplasty procedure, the patient needs to pass a preoperative medical exam or have their personal physician clear them. The physician performs standard tests such as blood counts, urinalysis, etc. Photographs are taken before, and computer imaging is done before. The latter is very important to share the doctor’s visit to see what can be achieved and what would be satisfactory. Likewise, the patient must be satisfied that the image portrayed on the computer screen is satisfactory to them.
During a rhinoplasty procedure, the patient is under anesthesia and has the appropriate changes made to the bone and cartilage underneath the skin that drapes the infrastructure of the nose. Typically, the bone may be shaved down using files. Cartilage may be shaved and removed. Cartilage can be softened to make it more pliable. Cartilage can be grafted as needed to replace missing or deformed tissue. A variety of maneuvers take place during the surgery. Whatever incisions are made, whether they are hidden on the inside or visible on the outside, are closed with sutures, and appropriate dressings are applied. A plastic splint is typically placed to protect the nose from any undue trauma in the first five to seven days after surgery. The patient is best served when the surgeon inserts the Kotler Nasal Airway to ensure clear breathing during the initial post-operative period.
Anesthesia is very important. Today’s safe and short-acting drugs, such as propofol, are bringing safety and patient comfort to the majority of patients. There is less nausea and vomiting than there was many years ago. Narcotics need not be used; therefore, post-operative nausea and vomiting can be avoided. The injection of local anesthesia during the case in combination with light sleep induced by propofol is considered ideal for this. There are many parallel approaches of propofol plus local anesthesia used in operations in other specialties.
Typically, a rhinoplasty procedure takes about two hours to perform. If a functional surgery to correct a deviated septum and trim the turbinates to increase the airflow through the nasal passages is performed, typically, it may be closer to three hours. This “time” includes total time in the operating room. A significant portion is taken by the “going to sleep” and the “waking up.” Much akin to an airline flight. Much time is spent in preparation and then landing and disembarkation.
Results are immediate. For most patients, in the operating room, while still asleep, and before the external dressings are placed, a photo is taken. This will be shown to the patient in the recovery room and sent to their phone or computer. When the splint is removed anywhere in the first five to seven days, one sees a much-improved nose. However, that nose is still swollen, and it is subject to the laws of nature, which means because there is swelling there, it will only be temporary. Typically, the result continues to evolve. At two weeks, the nose will start to look very good. If there is swelling or bruising, it will have dissipated by then.
Asymmetrical healing after rhinoplasty is where one side may be a bit more swollen and take longer to heal than the other side. It is not unusual and typically nature “evens things up with time.” If not, the use of drugs that can shrink thickened tissue and temporary or permanent fillers can be used to correct some asymmetries that are visible. Those must be employed after nature has conducted its complete healing process. The majority of the healing process is typically about 100 days after surgery.
One should expect to do ice compresses. Use pain pills and sedatives to be comfortable. There may be some swelling that can even evade ice packs, but the main use of ice packs around the eyes, which is where bruising and swelling tend to occur, is very effective. One should not have severe pain but certainly should have medications at hand to control any pain. Typically, nausea and vomiting are not a problem, and one can expect to eat and drink the day following surgery.
The second day is usually accompanied by a little more swelling and possibly bruising. Typically, that is the apex of that phase of post-operative healing, and if there is pain, it tends to be at the highest level that one could expect it to be. Of course, pain should be controlled with the medication since pain automatically induces elevation of blood pressure and increases the chance of nosebleeds.
The surgeon will give very precise instructions to avoid complications. One should not engage in athletic activities for fear of a rise in blood pressure, which is automatic during strenuous sports, and therefore, the risk of nose bleeding is increased. One should take the medications as prescribed since pain medicines also help avoid the automated rise of blood pressure. One should sleep in certain positions for the first night or two to reduce swelling. All of these things are important. The doctor’s intention is for problems to be avoided and good results to be encouraged to evolve quickly.
It is important to pay attention to body signals because they may be a subtle warning that one is not conducting themselves properly, not providing pain medication, or not sleeping well because they are anxious. All of these matters can be detrimental to healing. You need to listen to what your body says.
Here are the two most common reasons why people have trouble sleeping after rhinoplasty. First, they are having pain. Now, pain is relieved by medications. There is no reason for anyone to suffer after any surgical procedure, particularly rhinoplasty, where the pain is generally not as severe as might occur with chest surgery or abdominal surgery. We provide pain medications to our patients, which are deemed adequate to control the pain. So, if you are having pain after rhinoplasty, you are likely not to be able to sleep. The best advice is to take the pain pills, don’t hold back, don’t feel like you have to be a “martyr,” and that will help you sleep better. The other reason that some people don’t sleep well is because, particularly on the first night, it is advisable to sleep in a semi-sitting position, halfway between full sitting and flat. This is to allow some drainage from the nose to come out and, therefore, to facilitate the reduction of swelling and bruising. If position is an issue, remember that it is only for a short period of time. Typically, the next night, there are no particular recommendations or restrictions regarding the position, and one can sleep in their typical or most comfortable position. Remember, there is a plastic splint placed on the exterior, so you don’t have to worry about accidentally bumping your nose during the course of sleeping.
Rest is important, particularly in the first week after rhinoplasty, because the body requires more rest. The body has had a moderate invasion, yet it must rally to provide the mechanism whereby healing is optimal. Understand that we now recognize that sleep is somewhat undervalued or underrated, at least in our society. Many people feel they can “get away” with less than seven or eight hours of sleep. However, that has been proven to be unwise because, typically, the body requires seven to eight hours of sleep to function well. It is particularly important for the brain. Remember, sleep is to allow the brain to rest and to even internally work out conflicts that are lurking within the brain. At night, muscles get to relax, the heart rate goes down, and the stress level in the body is minimal. One should calculate into their plan for the week after surgery more sleep, ideal nutrition, and control of pain, and if one is having trouble sleeping despite adequate pain control, then a mild sedative is certainly appropriate. One should not suffer, and one should not deprive oneself of all the mechanisms and habits that encourage the body to heal rapidly.
In the first day or two it is important because this allows gravity to help blood and mucus drain from the nose rather than accumulate within the interior of the nose. The capillary action of the packing one placed or the Kotler Nasal Airway encourages fluids to vacate from inside the nose and thereby lessen the chance of significant swelling and bruising.
Sleeping in a recliner is not ideal. It is better to sleep in your comfortable bed with several pillows or a polyethylene wedge to keep the head elevated horizontally. Patients should be comfortable and have proper soft padding, and this is only significant for the first two days.
Cold does inhibit the development of swelling. That is why in the first two days it is important to use ice packs or frozen peas or frozen corn kernels and have them applied to the eyes as much as possible. Sometimes, there is some discomfort associated with it, and it is necessary to take a mild or medium-strength pain medicine, but it is important.
The best way to protect your nose from the sun is to wear a hat with a broad brim. There are many highly fashionable and functional headpieces that are available to do that. In the summer, the sun is hot and strong, especially in certain climates, and therefore, heat is not the best friend of a healing nose. The nose likes it “cool” and not “heat.”
Smoking carries two factors. One, it heats the nose, which is antithetical to ideal healing. Secondly, it dries the nose, which makes mucus thicken and since blowing the nose is not wise for seven to ten days that only increases dry mucus within the nose which is not satisfactory. Dryness and heat are no-nos during the immediate recovery from rhinoplasty or even septoplasty and turbinate resection, any operation upon the nasal interior.
Nature takes time to do its work. The tissues must be welded together, blood vessels healed, and time must be allowed for the skin to shrink to the smaller framework. This does not happen overnight. Every operation is followed by some element of swelling of tissue. The good news about noses is that recovery is very fast. Typically faster than other operations of the body because of the preferable blood supply to the nose.
Avoiding anti-inflammatory medication is not an absolute. It can help reduce swelling but on the other hand it can also slow healing. It may, if the doses are excessive, make bleeding a greater possibility. Typically the best medicines to employ are pain medicines and not anti-inflammatory medicines. Over-the-counter pain medicines include Tylenol (acetaminophen). The anti-inflammatories, typically the nonsteroidal variety, are Aleve, Motrin, and generic ibuprofen.
No. Delayed rhinoplasty healing is not a factor of spicy foods within the diet . It is important to drink adequately and have a nutritious diet with lots of protein, which helps speed healing. Whether one has spices or not, that is a matter of personal preference.
The discoloration is caused by blood leaks under the skin from the bone or cartilage that has been operated on and travels around the eyes, where the thin skin provides less resistance to the spread. It will go away because nature will digest the red cells. However, using certain medications plus icing after surgery reduces the chance of major discoloration. Today, patients, on average, have much less than years ago because of newer techniques and medications that are specifically very effective in reducing discoloration.
One should call their surgeon immediately. They can make an assessment either on the telephone or via Facetime and then decide if you can control the flow at home with the supplies and medications that you are typically given. If not, they will recommend seeing you in the office or in a hospital emergency room. Do not wait to report a significant flow of blood from the nose. What is a significant flow of blood? It is a constant river that is presenting at the nostril opening and shows no signs of abating, even by pushing a small piece of cotton into the nostrils.
The upper lip may be swollen. Behind the lip is where certain procedures are performed to release the downward pull of the tip of the nose and to correct a deviated septum. One must still speak and eat and so the limitations on lip movement are relatively limited.
Dry lips are not unusual since often there is more temporary mouth breathing. The simple and safe solution is applying Vaseline, Aquaphor or other petrolatum-based ointments to the dry lip skin. Such an application may have to be done two to three times per day.
A slight temperature rise to under 101 degrees is considered normal because the body responds to an invasion, whether it be elective or traumatic, by raising the temperature as part of the healing process. That is a “slight” temperature rise. 101 or higher often requires an examination by your surgeon.
Lightheadedness typically may be caused by low blood pressure. Some people have low pressure and pain medication can lower the pressure. Sedatives can lower pressure, which is the most common cause. It should be addressed by checking the blood pressure at home if you have a blood pressure monitor. If not, one should report to the doctor’s office or an emergency room to be evaluated. One does not wish to have fainting after surgery. It is rare, but it can also apply to some unrecognized blood loss where there is bleeding in the throat and down into the stomach. That is far less common.
The most common period is seven to ten days. By seven to ten days, the healing process is rapidly progressing. The chance of a nosebleed or infection is very low. Typically, the bruising has faced away, and the swelling has subsided such that one does not look particularly strange or abnormal. One needs to understand that the final result is not yet available. It will take several months for the nose to ripen, just like fine wine, but it will. At ten days, people are generally okay with their appearance and return to work or school and normal activities.
Pets have injured patients’ noses after rhinoplasty. You just have to be careful. Particularly, large dogs are heavy, they carry a lot of weight behind them, and they are not always “man’s best friend” after surgery, where the operative site is readily visible and available for injury.
The first thing to do is consult your physician, either be seen in the office or do a FaceTime but get your nose checked out if you are concerned that there is a change in shape, a change in breathing, significant bleeding, or pain increase.
For some people increased blood flow into the tip of the nose may cause the skin to be red. Typically that occurs the first couple of days. However, if it is accompanied by swelling and pain and soreness one must consider the possibility of infection and therefore this must be monitored closely by the rhinoplasty surgeon.
The nose is swollen. There is no other reason. Swelling will abate spontaneously. Some medicines may be available to help but typically it is all about time.
One needs to stay healthy before surgery. Be well rested. If one is used to taking vitamins or supplements, take those which are not associated with ss such as bleeding. One wants to make sure they do not have an infection on their nose such as acne or pimples or inside the nose such as an infected hair follicle. These must be reported to your surgeon immediately since they may be a reason to delay surgery.
The nose may throb because of some swelling. This is not unusual for several days. Should it occur seven to ten days later then one needs to have an investigation as to why such is occurring.
Yes, for some people, it is normal to feel slightly depressed after rhinoplasty, as it is after any cosmetic procedure. The reason is that when you look in the mirror, you do not look like yourself, and you are fearful that somehow this appearance will not be temporary and will be permanent, which, of course, is not the case. One is also not participating in normal activities, not doing their athletic workout, not seeing friends and family. It is not at all unusual. You cope by understanding that this is normal and temporary and will resolve. Within the first several days after surgery, you can see the improvement and thereby be reassured.
Emotional healing accompanies because this is a happy occasion. Afterall, you now initiated self-improvement and it is something you wanted. It is elective but important. One needs to realize that as they are going through the procedure. Yes it is one step back but it is one step back to go two steps forward.
You should see your healthcare provider according to their schedule for post-operative visits. Depending on the operation, you may be seen on the first day after surgery and the third or fourth. Each patient has different requirements depending on what was performed, the complexity of the case, etc. The schedule should be presented to the patient so that he or she knows when the next visit is due. You should also see the surgeon if there are any issues at all that are worrisome.
The first follow-up appointment is typically anywhere between 1 to 4 or 5 days . This depends on the procedure. They are important to assess progress, check on healing, make sure there is no minor infection or potential for bleeding. The examinations are generally quick and painless and it is good to know when things are going well. Patient assurance is very important.
Most people look very good in a month. They are better at two months, and typically, 90% of the results are in by three to four months. Even in the last six months of the first year, there has been improvement. By tight standards, generally, twelve months after surgery, you have your final result.
The rhinoplasty is permanent. What the surgical procedure has done is to restructure the nose. In principle, this is no different than where orthopedic surgeons restructure shoulders and foot surgeons restructure and refashion large toes when bunions have developed. Hand surgeons can replace joints, and so basically, changes are made, and then nature takes over and heals the structures such that they become functioning forever. Surgical rhinoplasty does have a period of maturation, and while the nose may look very good and all the parts have welded together by three to four months, the reality is from a cosmetic standpoint, the nose will look better at six months, even better in a year, just like “fine wine will take its time.” Whether the rhinoplasty may be accompanied by nasal septoplasty and turbinate resection or even some minor sinus surgery, all this is to improve the airway and prevent consequences of bad breathing, but nonetheless, those are also permanent.
A surgeon’s technique can influence recovery, particularly if the technique is very time-consuming. A three to five-hour rhinoplasty instead of a two-hour rhinoplasty will generally be accompanied by more swelling and perhaps a little more bleeding and bruising. Efficiency in surgery, not speed for speed’s sake, is important. Other aspects are what instruments are used and how traumatic the movement of the tissues is. A lot of variables go into the equation. Some surgeons are very light-handed, and some are heavy-handed. Have faith that, in the end, the nose will heel, and the result is expected to be satisfactory.
Typically, the best advice consists of the following:
Rhinoplasty is a very successful operation when performed by the most specialized, most experienced facial cosmetic surgeons who further specialize in rhinoplasty exclusively. There are very few, but Dr. Kotler is a “superspecialist” in both Surgical Rhinoplasty and Non-Surgical Rhinoplasty. What sets Dr. Kotler apart is his unparalleled expertise in that extraordinary but not well-known Permanent Non-Surgical Rhinoplasty. With over 40 years of experience, he has successfully performed more than 5,000 nasal procedures, solidifying his position as one of the most experienced practitioners of both Permanent Non-Surgical Rhinoplasty and Permanent Non-Surgical Revision Rhinoplasty in the United States. Why not consult with a doctor at the top of the specialty totem pole?
We offer virtual consultations that include computer imaging, allowing you to preview the anticipated outcome of your procedure before deciding. Additionally, you can have a virtual consultation with Dr. Kotler through FaceTime, WhatsApp, or Zoom, which is an excellent option for including family or friends in the consultation.
Call us today, at (310) 278-8721. We’ll arrange that consultation. A great first step because all your questions will be answered. And, no doctor is more qualified to answer those questions than Dr. Kotler.
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