Rhinoplasty (Nose Job) Post-Operative Guidelines

Instructions

• Have someone drive you home after surgery and help you at home for 1-2 days.
• Get plenty of rest.
• Follow balanced diet.
• Decreased activity may promote constipation, so you may want to add more raw fruit to your diet, and be sure to increase fluid intake.
• Do not drink alcohol when taking pain medications.
• Even when not taking pain medications, no alcohol for 2 weeks.
• If you are taking vitamins with iron, resume these as tolerated.
• Do not smoke, as smoking delays healing and increases the risk of complications.

Medications

• Mupirocin antibiotic ointment will be prescribed. Begin applying the ointment inside the nose with a Q-tips 3 times daily starting 3 days before surgery. Continue for 7 days after surgery.
• Dr. Khosh may instruct you to take the herbal supplement Arnica-Montana. This is intended to minimize bruising. Start this supplement the night prior to surgery and continue taking after surgery, as instructed on the package.
• Take any antibiotics as instructed. Start the antibiotics on the evening after surgery unless your surgery occurs in the afternoon. In that case, you may start antibiotics on the day after surgery.
• It helps to eat cultured yogurt or take over the counter Acidophilus tablets while on antibiotics to minimize intestinal side effects.
• You will be prescribed steroid tablets (Methylprednisolone) to minimize post operative swelling. Take them as instructed on the packet, starting on the morning after surgery. Note that steroids can make you feel anxious; this is a common side effect.
• Take pain medication (Hydrocodone or Ketorolac) as prescribed immediately after surgery. If the pain is not server, you may take Tylenol. Do not take aspirin or any products containing aspirin.

What To Expect

• Your nose will have scant bleeding for up to 2 days.
• You may be up and about in 2 days, but it will be several weeks before you are entirely up to speed.
• Feeling depressed is normal.
• A splint or tape is applied immediately after surgery for 7 days. Internal nasal stents may also be used.
• Minimal postoperative pain in the nose. Pain or numbness of the front teeth or palate for two weeks.
• Your nose may ache and you may have a dull headache.
• Temporary swelling and bruising around eyes and nose will increase at first and peak after 2 or 3 days. Black eyes and swollen nose and eyelids rarely occurs and lasts for 7-14 days.
• Most swelling and bruising should disappear within 2 weeks. Some subtle swelling (noticeable only to you) will remain for several months.
• Healing is a slow and gradual process.
• Some numbness may be present around the operative areas.
• For the first 7 to 14 days you may experience some discomfort with breathing.
• Swollen nasal tissues may cause nose to seem “stuffed up” for several weeks.

Activities

• Stay in bed with your head elevated (except for going to the bathroom) for the first afternoon and night.
• On the first post-operative day, you can begin walking more; this helps to reduce swelling and lowers the chance of blood clots.
• Do not drive until you are no longer taking any pain medications (narcotics).
• You can return to work in 1-2 weeks.
• Avoid strenuous activities or any activity that increases your blood pressure for 2-3 weeks.
• Avoid body contact sports, hitting or rubbing your nose, and sunburn for 2 months.

Incision Care

• You may shower on the first post op day. The cast or the tape on the nose can get wet, but dry the area gently. If the tape or the plastic cast on your nose fall off, do not be alarmed.
• Avoid exposing scars to sun for 6 months.
• Always use a strong sunblock, if sun exposure is unavoidable (SPF 30 or greater).
• Keep incisions clean and inspect daily for signs of infection.
• Cold compresses will reduce swelling. We recommend using frozen peas in a Ziplock bag.
• Use over the counter Saline nose sprays: 4 puffs each nostril, 4 times a day.
• If there are sutures visible under the nose, apply an over the counter antibiotic ointment three times a day. Use a Q-tip applicator. Apply the ointment to the inside the nostrils in the same manner.
• Avoid blowing your nose for 1 week.
• Be gentle when washing your face and hair or using cosmetics.
• Do not use facial makeup on external incisions until advised by surgeon.
• Contact lenses can be worn as soon as you feel like it, but ask Dr Khosh if you plan to wear eyeglasses.

Appearance

• New nose looks better in 2-3 weeks and usually continues to improve for many months.
• Nasal tip drops to its permanent position in 3-6 months.
• Final results may not be apparent for a year or more.

Follow-Up Care

• If you have nasal splint, it will be removed after a few days.
• Any visible sutures are removed in 5 to 6 days. Dissolvable sutures are used inside the nose.
• Frequent follow-up visits should be scheduled.

When To Call

• If you have increased swelling or bruising.
• If swelling and redness persist after a few days.
• If you have increased redness along the incision.
• If you have severe or increased pain not relieved by medication.
• If you have any side effects to medications; such as, rash, nausea, headache, vomiting.
• If you have an oral temperature over 100.4 degrees.
• If you have any yellowish or greenish drainage from the incisions or notice a foul odor.
• If you have bleeding from the incisions that is difficult to control with light pressure.
• If you have loss of feeling or motion.
• If you have a nosebleed or any unusual symptoms.
• If you have any concerns at all you may reach Dr. Khosh at 212-339-9988.