Post Operative: Rhinoplasty

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Instructions
  • Have someone drive you home after surgery and help you at home for 1-2 days
  • Use cold compresses for comfort and to help decrease the swelling for 1-3 days
  • Do not take aspirin or any products containing aspirin, as these cause bleeding.
  • Diet:
    • Have a light meal the evening of surgery
    • Follow a balanced diet, with plenty of fresh fruit and vegetables
    • Be sure to drink plenty of fluids. Pain medications and decreased activity promotes constipation
    • If you nose is blocked by splints your ears may pop when you swallow
    • Spicy foods may make your nose run and cause discomfort
  • Medications:
    • Take medications as prescribed, if you have excessive pain call your surgeon
    • Do not drink alcohol when taking pain medications
  • Showering:
    • You may shower day 1 post operatively, do not get too hot
    • If you have an External splint, keep it dry
  • Glasses:
  • No sunglasses or reading glasses for 6 weeks
  • Avoid blowing your nose or sneezing for 2 weeks
  • Do not smoke, as smoking delays healing and increases the risk of complications.
Activity
  • Get plenty of rest, you can have a postoperative bleed up to two weeks after surgery so it is very important to rest
  • Over the first 2 weeks you will feel tired and run down, so again plan on taking it easy for the first week
  • Your nose will feel very congested as if you have a flu
  • When in bed rest and sleep elevated
  • Try to keep your head up as much as possible, do not stoop over
  • To reduce swelling and lower the chance of blood clots, regular gentle walking around the home is highly recommended
  • No bending, lifting or vigorous activity for two weeks
  • Avoid straining activities which increase pressure to your head
  • Do not drive until you are no longer taking any prescribed pain medications, and until you can do it comfortably
  • No work exercise or sport for two weeks
  • Return to work in 14-21 days, or as instructed by Dr Zacharia
  • You will build up to normal activity over 4 weeks
Wound Care
  • Usually the nose will ooze for 24 hours and reduce by half each day.This may mean ther ooze stays for 3-4 days
  • Keep the Splint dry
  • You must keep your nose free from crusting by the following means:
    • Attend Nasal washes 6-8 times per day, this is very important.
    • Apply Nasalate or Antibiotic ointment, if prescribed, to both nostrils at least four times per day for two weeks postoperatively
    • Apply Vaseline to both nostrils as often as needed
  • Avoid exposing scars to sun for at least 6 months, always use a strong sun block, if sun exposure is unavoidable (SPF 30 or greater)
  • Avoid steam baths and saunas for several months
Support Garment
  • Wear your compression garment for 6 weeks post-operatively
Expectations
  • Expect more swelling on day 3 and 4 the maximum discomfort will occur the first couple of days after surgery
  • You may experience some headaches. Take the pain medication as prescribed. You will probably have some discomfort related to inability to breathe through your nose. Drink plenty of liquids and keep your lips moist with Vaseline or lip balm
  • You may be slightly more swollen in the mornings
  • Most noticeable swelling will subside in about 2 weeks
  • When the External Splint is removed the nose will swell up again as the pressure is released, this may last a further 3 weeks
  • Bruising, swelling, numbness, tightness and tenderness of skin are normal and continue up to 12 weeks post-operatively
  • Final result is not fully realized for approximately up to 18 months post operatively
  • The last part of the nose to heal is the bridge (swelling of the bone may persist) and the very tip area (scar tissue). These areas may require steroid injections to lessen the swelling
Follow up Appointments
  • Day 1-2 with the Registered Nurse for removal of Nasal packing if used
  • Day 7 with the Registered Nurse for:
    • Removal of silicone internal splints
    • Removal of External Splint
    • Removal of or Assessment of sutures
  • 4 weeks after Surgery for Follow up with Dr Zacharia
When to call
  • If you have increased swelling or bruising
  • 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 38C degrees
  • If you have any yellowish discharge from the incisions
  • If you have bleeding from the incisions that is difficult to control when sitting in an upright position and with light pressure applied to side of nose, oozing can be expected
  • If you have loss of feeling or motion, some numbness may be present immediately post operatively
Shopping List
  • Normal Saline
  • Hydrogen Peroxide 3%
  • Cotton Buds
  • Fess Spray
  • Vaseline
  • Prescription medications
  • Support Garment (you will be advised where to purchase this)