Rhinoplasty – Post-operative period

Post-operative recuperation is considered to be an integral part of surgery; the achievement of desired results, as well as the success of the operation, depend on it. Therefore, post-operative visits play a pivotal role in the healing process as they allow the early detection and treatment of complications. They are usually held at 7, 14, 28 days, and 3, 6 and 12 months post-op.

Upon discharge, a letter with post-operative instructions will be provided, medication prescribed (antibiotics, anti-inflammatories, pain-killers) and any necessary precautions will be clearly described.

The operation is finalised by applying a splint or a cast to the nose and pads are inserted inside the nostrils; these structures remain in position for seven days. When the supports are removed, paper tape is applied to the nose for a further seven days. The cast and paper tape must not be wetted. Nasal pads are easily removed, quickly and without pain. Once pads are removed, careful irrigation of the nasal passages can be performed with saline, taking care not to blow the nose in the following two weeks.

During the first week after surgery, some minor, frequent bleeding through the nasal pads from the nose is to be expected. It is normal for bruises to appear in the lower eyelids and outer eye socket areas; bruises clear after approximately two weeks. In the days following surgery, some tenderness may be experienced in the upper jaw region and cheeks, as well as frequent headaches; this is easily controlled with pain-killers.

Swelling, more or less evident according to the individual’s predisposition and the extent of the procedure, subsides significantly in the first four weeks post-op. Typically, swelling clears from the bridge of the nose first and then from the tip. Chewing and heat can cause pain and worsen the swelling. Therefore, in the days following the operation, it is preferable to eat soft and cold/room temperature food. It is also advisable to sleep with the head facing forwards with additional support (e.g. additional pillows) and to keep the face cool, so to accelerate swelling resorption. Heavy spectacles are discouraged for a month, as they may cause indentations when the nose is still very swollen.

However, minor swelling may persist for more than a year. Therefore, it is necessary to wait for at least 12 months, before final results are realised.

Post-operation, patients are unfit for work for at least two weeks.  If prolonged or considerable physical exertion is required, a longer rest period is necessary.  Normal activities such as driving, house-work, sexual intercourse and socialising can be resumed after two weeks. Mild exercise may be resumed after three weeks, but for more intense exercise, it is preferable to wait at least six weeks.

As the nasal bones consolidate during the healing process, it is essential to avoid trauma to the nose during the months following surgery; in fact the nasal bones may become dislocated. Post-operative care continues with the application of sun-screen to the area for at least three months.

During post-op visits, starting from the first month, photographs are taken to monitor progress