RHINOPLASTY FAQs

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.

Sleeping on your side after rhinoplasty is fine after the first night. You should be comfortable and, therefore, whatever your preferred position is, that is where you should be.  It will have no influence on the outcome of the nose except, again, you may notice a little more swelling on the side on which you sleep but by late in the afternoon following that evening it tends to go away. This is all a function of gravity and never permanent. If you slept on the other side, that side will become a bit more swollen from the overnight position.  

Patients should not worry if they get up one day and there is a little more swelling on the right side or the left side. That is all a variable of what position they sleep in. While the first-night people should sleep face up, halfway between sitting and flat, after that whatever position is comfortable is fine and will have no negative influence on the outcome.

An infection after rhinoplasty is extremely rare. It is rare because the nose itself is resistant to infection. Our duty as surgeons is to reduce the chance to next to zero. We do that by providing antibiotic ointment to be used not only before, but after surgery.  After the anesthesiologist puts you to sleep, again the inside of the nose is prepared with an antiseptic solution. During surgery, the anesthesiologist gives one large strong dose of an appropriate antibiotic so that during the operation the antibiotic circulates through the body. 

The signs of infection are redness, swelling, and soreness to the touch. This should be reported to the surgeon immediately.

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 nonsteroidal 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. 

Kissing after nose jobs is less of a risk than sex for the first 10 days. Sex causes a rise in blood pressure, which of course increases the chance of bleeding. The theme of no exercise-induced elevation in blood pressure includes sex but after 10 days you are free to get back to your usual activities. It is a good question that is rarely asked, but practices should provide that information in a written handout and have that information on the website. Remember that the doctor should be available to you at any time. Our practice is to give the patient my home phone and cell phone numbers so I can be reached at any time, even just to ask about kissing after a nose job.

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.

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.

Dr. Kolter reputation for delivering the “Natural Nose” is worldwide. That is why patients from all over seek out Dr. Kotler to be their surgeon.

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.

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 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. 

Dry skin can happen for a variety of reasons after nose surgery. Disinfectants, tapes, and materials placed on the nose in rhinoplasty may cause some patients reactions such as dryness. To prevent dry nose after rhinoplasty, drink lots of water and stay hydrated. Good skin hygiene is key. Patients can also try Vaseline for decreasing irritation and hypoallergenic moisturizing lotion. Within weeks of your nose healing, dryness from your rhinoplasty should have subsided. If you’re still experiencing dryness months into your recovery, check in with your surgeon because they have evaluated you in respect to your preoperative condition. 

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.

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.

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.  

If you have just had a rhinoplasty and have not had the septoplasty and turbinate resection you should be able to breathe quite well. Our practice is to, of course, 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 unoperated 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.

Most patients tell us, in our detailed surveys, that their 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 pain 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.

Often patients decide to go back to work after rhinoplasty in as little as one week, despite a small amount of bruising or swelling. Depending on your own personal comfort level, this may be an option for you because after one week, discomfort has decreased significantly and can be maintained. More often, patients take two weeks off of work. It’s possible your rhinoplasty only requires subtle changes. Every case is unique, so it’s best to consult with your doctor to determine how much time to take off given the gravity of your rhinoplasty surgery and your job activity.