Rhinoplasty Recovery What to Expect Following Your Rhinoplasty Procedure

Swelling After Rhinoplasty

Every operation, no matter how minor, is accompanied by swelling of the surrounding tissues. The amount of swelling varies from person to person. Because of the looseness of facial tissue, the swelling is more pronounced in this area, and your facial features may appear distorted. Medication will be recommended to minimize swelling. Continuous adequate hydration and elevation will help.

Typically, the swelling will peak the second or third day after your surgery. Generally, it will be worse when you first arise in the morning—proof that it’s better to remain elevated as much as possible. This is not serious, and is not an indication that something is wrong. Swelling always eventually subsides, and your face will return to normal. You can help the swelling to subside in several ways:

• Keep your face elevated with your head above the heart, even while sleeping. A recliner comes in handy. Pillows will work, but your head may slip off your pillow while sleeping. This will only cause increased facial swelling and may prolong your nasal stuffiness. The main goal is to keep your head above your heart, as swelling, bruising, and blood all follow gravity and flow downhill towards the heart.
• Avoid bending over or lifting for about two weeks. Besides aggravating swelling, these activities may raise the blood pressure and cause bleeding.
• Avoid hitting or bumping your new nose. Do not pick up small children or pets, and you may need to sleep alone for two weeks after your operation.
• Continue to sleep with the head of your bed elevated for at least two weeks, or until your swelling and stuffiness have subsided to your satisfaction.
• The application of cool therapy to your eyes and forehead may soothe discomfort and somewhat reduce swelling for the first couple of days. Apply gel ice compresses or baggies of frozen peas across each eye as continually as possible during the first night and next day when you return home. But be very careful that the weight of the compress(es) does not put pressure on the splint or cause the tape to become wet with condensation.
• Avoid tanning your face for several months.
• When showering, try to minimize water exposure to the nasal dressing. Wash below your neck first, then shampoo and wash your face and promptly exit the shower. Dab your face and dressing dry gently. Do not soak the dressing. Water coming in contact with your face should come from the tap, not from bath water or basin.
• Avoid constant “sniffing”, that is, constantly forcibly attempting to pull air through the nose as some people do when their nose feels blocked. This will not relieve the sensation of blockage; it will only aggravate it because the suction created on the inside will cause more swelling.
• Do not forcibly blow your nose for several weeks after surgery, or until instructed to do so. This could precipitate bleeding.
• Beginning the morning after your rhinoplasty surgery, attempt to flush out each nostril with Afrin exactly four times each day. This will reduce bleeding, swelling, obstruction, and crusting. Failure to use the Afrin as instructed will result in complete nasal obstruction from large crusts and scabs, which can be uncomfortable to remove. In theory, the Afrin should pass all the way through both nasal passages and be expelled through the mouth. For the first few days, the Afrin will not readily pass all the way through the nose. This is expected. So, in order to minimize crusting until you can sniff the Afrin all the way back, simply lie flat on your back, and apply two big drops of Afrin into each nostril, and allow it to percolate into the nose for a few minutes. After a few days, you will succeed at sniffing the Afrin all the way back through each nostril. Typically, one side will open a day or two before the other side. Avoid any forcible blowing of the nose for several weeks. When you eventually do sniff, DO NOT compress the opposite nostril as you might normally do. If you attempt to do this, you might tear some delicate internal sutures. Also note: manipulating your nasal tip might cause a twisted nasal tip.
• The night of your surgery and for the first day or two following, there will be nearly constant blood-tinged nasal drainage. This is entirely normal, since no nasal packing is typically used. It may be quite bloody soon after you arrive home from surgery as the vasoconstrictors used during surgery wear off. Simply remain calm, quiet, and elevated, and change the drip pad as instructed as often as necessary. As long as you remain calm and quiet, within a few hours, the bleeding will slowly diminish in quantity and will become more watery. Apply and change the 4x4 gauze as necessary, as we will teach you in recovery. Do not use a tissue. If you are tempted to use a tissue, it’s time to re-apply the drip pad. Tissue is paper, and paper has wood chips in it. Frequent dabbing with a tissue can actually abrade the delicate nasal skin. Most people can discontinue using the drip pad after a day or two.

Finally…

Remember the things you were told before your operation, including:

• When the bandage is first removed, your nose will appear fat and turned up too much. This is due to operative swelling over the nose and in the upper lip. This swelling will subside to a large extent within a week; however, it will take up to one year for all the swelling to disappear and for your nose to reach its final contour.
• The discoloration will gradually disappear over a period of 7-10 days in most cases. We have yet to encounter a case where it persisted permanently.
• The thicker and oiler the skin, the longer it takes for the swelling to subside.
• Your upper lip may appear stiff for a while, and you may feel that it interferes with your smile. This will disappear within a few weeks.
• The tip of the nose sometimes feels “numb” after a rhinoplasty, but this eventually subsides.

If you have any further questions, please feel free to call us. You can reach us 24 hours a day, and we are here to help you. We hope this helps you and reassures you during your recovery.