Rhinoplasty is a delicate surgical procedure aimed at enhancing the aesthetic appearance and function of the nose. Recovery is a critical phase that significantly influences the final outcome of rhinoplasty surgery. Understanding what to expect and how to care for yourself during this period is essential for a smooth and successful recovery.

Dr Turner, a Specialist Plastic Surgeon in Sydney, provides this comprehensive guide to help patients navigate the postoperative journey with confidence.

What to Expect Immediately After Surgery

Postoperative care begins as soon as the rhinoplasty procedure is completed. Patients may experience a range of sensations and symptoms, all of which are normal parts of the healing process.

Day Surgery or Overnight Stay

Depending on the complexity of the procedure and individual patient needs, Dr Turner may recommend either day surgery or an overnight hospital stay. An overnight stay allows for close monitoring by medical staff, ensuring immediate attention to any concerns. For day surgeries, patients are discharged once stable, with instructions on caring for your nose until your first follow up visit with Dr Turner at 1 week.

Nasal Splints

Nasal splints are an essential component of post-operative care following rhinoplasty, and Dr Turner’s approach ensures optimal support and protection for the newly shaped nasal structure.

Internal (Doyle) Splints

The internal splints serve a dual purpose:

Support: Internal (Doyle) Splints are placed inside your nose to support the septum (the wall between your nostrils) as it heals.
Breathing Aid: The splints are designed with small air passages to allow for some airflow, though these can become blocked over time due to mucous buildup. While this may result in temporary nasal obstruction, it’s a manageable part of recovery until the splints are removed by Dr Turner during a follow-up appointment.

External (Thermoplastic) Splint

The external splint is vital for protecting the nose, particularly when osteotomies (bone adjustments) are performed. This external structure ensures the nose remains protected from accidental trauma and supports the healing process during the critical first week.

Transition to Micropore Tape: At the first-week post-operative appointment, Dr Turner replaces the external splint with brown micropore tape. This continues to provide gentle support while allowing the patient to transition to a more flexible and less obtrusive recovery phase.

Swelling Management and Bruising

Swelling and bruising are natural responses to surgery, particularly around the nose and eyes. It typically peaks within the first 2-3 days and gradually subside over the following weeks. Reducing swelling can speed up your recovery, lessen pressure and pain, and minimize potential distortion of the nasal framework.

Swelling

Elevation: Keep your head elevated at all times, including during sleep, to promote drainage and minimize swelling.
Cold Compresses: Apply cold compresses gently around the eyes during the first 48 hours, being careful to avoid direct contact with the nose.

Bruising

Bruising varies among individuals but usually fades within two weeks. To prevent excessive bruising:

Avoid Blood-Thinning Medications: Unless prescribed by your doctor, avoid medications that thin the blood, such as aspirin and certain anti-inflammatories.
Arnica Gel: After 72 hours, you may start applying arnica gel to any visible bruising around the lower eyelids and cheeks, provided you are not allergic to it.

Nasal Care

The gauze taped under your nose may need changing 3-4 times overnight. Most patients only require the gauze in the first 24 hours to catch a little ooze from the nose.

Maintaining nasal hygiene is essential for preventing infections and promoting healing.

Cleaning: Gently wash the nasal cavities with a saline solution (FESS), every 4 hours for the first week. This helps keep the nasal passages moist and prevents crusting.
Nasal Decongestants: To assist with swelling and nasal obstruction, you can use a nasal decongestant, like Drixine (1 spray each nostril) twice a day for the first week.
Avoiding Trauma: Do not blow your nose for at least two weeks after surgery to prevent disrupting the healing process. If you need to sneeze, do so with your mouth open to reduce pressure on the nasal structures.
Dressings and Splints: Keep any external splints or internal dressings in place until Dr Turner removes them during a follow-up visit. Do not attempt to adjust or remove them yourself.

Medications

Upon discharge from the hospital, you will be provided with the following medications:

Bactroban Ointment: This ointment treats skin infections and promotes healing.
Antibiotics: These are crucial for preventing postoperative infections. Please ensure to complete the full course.
Pain Management: Mild to moderate discomfort is normal. Use prescribed pain medication as directed. Avoid over-the-counter medications not approved by Dr Turner, as some may increase bleeding risks.

Bactroban (Mupirocin) instructions

Place a small amount onto a cotton bud and apply it a small distance (5mm or so) up your nostrils over the front of the internal silicone splint. Do this twice a day, starting on the first day after surgery. This helps reduce crusting, so the nasal splints are more easily remove at your appointment with Dr Turner. Continue the ointment for 2 weeks after your surgery.

Sleeping Arrangements

You need to sleep on your back with pillows under your arms and your head elevated on 2 or 3 pillows. Neck support pillows like you wear on plane flights are also helpful. You can turn your head side to side but not roll onto your side to sleep as it can push your cheek and distort your nose.

Eyewear Precautions

While you have your external nasal splint covering your nose, you can wear glasses until it is removed by Dr Turner at 1 week. For the following 2-4 weeks, do not wear glasses as they will leave impressions / depressions on your nose, if possible, it is better wear contact lenses. If you must wear prescription eyewear, tape the glasses up to your forehead or place some extra tape over the nasal bridge to distribute the weight (1/2-inch micropore). Try and minimise the time you need to wear them as much as possible. Don’t wear sunglasses for 6 weeks post-op.

Exercise and Physical Activity

Physical activity should be limited to facilitate healing.

General Exercise: Light activities like walking can resume after a few days to promote circulation.
Strenuous Activities: Avoid strenuous exercises, heavy lifting, and activities that raise blood pressure for at least six weeks.
Swimming: Do not swim for at least six weeks. Chlorinated water can irritate the nasal passages, and swimming poses risks of injury and infection.

Sun Exposure

Protecting your nose from the sun is vital during recovery.

Stay Indoors: Minimize sun exposure for the first few weeks.
Protection: When outdoors, apply a high-SPF sunscreen and wear a wide-brimmed hat. Sun exposure can cause prolonged swelling, discoloration, and can affect scar healing.

Recovery Timeline

Understanding the recovery stages after rhinoplasty is essential to managing expectations and ensuring optimal healing. Below is a detailed timeline of what to expect at different phases of recovery.

First Week

Swelling and Bruising: Apply a cold eye mask for the first three days to reduce swelling and discomfort. Expect some bruising around the eyes, which will gradually subside.
Infection Prevention: Apply Bactroban (Mupirocin) ointment inside the nostrils twice daily to prevent infection.
Rest and Activity: Rest is critical during the first week. Sit upright as much as possible to reduce swelling and engage only in light walking around the house. Avoid strenuous activities and anything that raises your heart rate for at least four weeks.
Medications and Hydration: Take prescribed antibiotics and pain medications as directed. Drink plenty of water and avoid very hot or spicy foods, which can increase swelling or irritation.
Hygiene: Gently clean your face with a cool, damp face cloth, avoiding the nose area. Keep the nasal tapes or cast completely dry. Avoid washing your hair until the cast is removed (typically at 7-12 days post-op), unless done at a hairdresser’s basin. Take warm showers, keeping your face dry, and avoid baths to reduce the risk of swelling or bleeding.
Avoid Supplements: Refrain from taking vitamins, oils, or herbal remedies for the first two weeks, as these may interfere with clotting and healing.

First Month

Cast Removal: At your second postoperative visit (10-14 days), the cast and any external hard glue will be removed. Most internal stitches dissolve on their own, but any residual sutures may be trimmed at this time.
Nasal Support: Your nasal breathing should feel significantly improved. If necessary, Dr Turner may recommend Nose Cones—silicone stents that support nasal structure and improve breathing during healing. These are typically worn full-time for 1-2 weeks, transitioning to nighttime use for 2-3 months, depending on your needs.
Skin Care: Two weeks after surgery, you can gently wash your nose with a mild soap or cleanser (e.g., Dove). Avoid scrubs, pore strips, sunscreen, moisturizers, or makeup during the first month, as your skin needs time to heal. Protect your skin from direct sun exposure to prevent irritation or discoloration.
Numbness: The nose may feel numb and firm due to scar tissue and internal stitches (which take about six months to dissolve). Numbness typically subsides over 4-5 months in primary rhinoplasty cases, though it may persist longer in revision surgeries. Firmness is a normal part of the healing process and will gradually diminish over time.

First Year

Appearance: By six months, the nose typically achieves over 90% of its long-term appearance. However, the final results may take 12-18 months to become fully apparent, especially for patients with thick skin or extensive surgery.
Softening: Around six months, the nose begins to soften, become more flexible, and the skin feels more supple. By this stage, the upper lip stiffness and any lingering discomfort will have resolved.
Residual Swelling: Minor swelling, particularly in the nasal tip, may persist for a year or longer. This is part of the gradual refinement process, and most patients will notice subtle improvements over time.
Structural Considerations: If rib cartilage or other structural grafts were used, the nasal tip may feel slightly stiffer. This stiffness is often desirable, providing necessary support and durability to the nose’s framework.

What NOT to Do After Rhinoplasty

Certain activities and substances can impede healing and increase complications.

Smoking or Vaping: Nicotine constricts blood vessels, reducing oxygen flow necessary for healing. Avoid smoking for at least six weeks before and after surgery.
Alcohol Consumption: Alcohol can thin the blood and increase swelling. Refrain from consuming alcohol for at least two weeks post-surgery.
Medications: Avoid non-prescribed medications and supplements that can affect healing. Always consult Dr Turner before taking any new medication.

Emergencies and When to Contact Dr Turner

While complications are rare, being vigilant about potential issues is crucial.

Signs to Watch For:

Excessive Bleeding: Some oozing is normal, but persistent or heavy bleeding requires immediate attention.
Severe Pain: Increasing pain that is not relieved by medication may indicate a problem.
Fever: A temperature above 38°C may signal an infection.
Breathing Difficulties: While mild congestion is expected, significant breathing difficulties are not normal.

Immediate Actions:

Contact Dr Turner: If you experience any concerning symptoms, contact Dr Turner’s office immediately.
Emergency Services: In severe cases, proceed to the nearest emergency department.

Conclusion

Recovering from rhinoplasty is a gradual process that requires patience, diligence, and adherence to postoperative instructions. Dr Turner and his team are committed to supporting patients throughout their recovery journey.

By following this comprehensive guide, patients can facilitate healing, minimize complications, and achieve the best possible results from their rhinoplasty procedure. Regular communication with Dr Turner ensures personalized care and addresses any concerns promptly.

To Learn more about Rhinoplasty Surgery with Dr Turner

Schedule a Consultation: Contact us at 1300 437758 or visit drturner.com.au to book your appointment.
Prepare for Surgery: Follow any preoperative guidelines provided, such as avoiding certain medications and arranging for post-surgery care.
Plan for Recovery: Set aside time for rest and healing and arrange for assistance during your initial recovery phase if needed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a qualified healthcare professional to determine the best treatment options for your individual needs.

Comprehensive Guide to Recovery After Rhinoplasty