Postoperative instructions (Rhinoplasty)

What to expect

Immediately post op – You will wake up with a splint over the top of your nose and some gauze under your nose. Your breathing through your nose is usually reasonable good immediately after the procedure.  The pain is usually not significant because there is a lot of local anaesthetic in the nose.

Day 1

Overnight some blood will ooze out of your nose. This is normal. It does not represent active bleeding. It is an ooze of blood and serous fluid, which is a normal reaction to having an operation. Your nose is normally more blocked on than it was immediately after the operation because of this ooze of blood. You will also notice that there are 2 clear splints inside you nose, which are stitched in. If you had cartilage from your ear taken you will have a dressing on your ear.  Change the gauze under your nose, but don’t remove the splint over the top of your nose or from your ear.

The nurses will give you a wash bottle to use in your nose. Start this today. You can’t do any damage with the wash bottle. After you have filled the wash bottle with water that has been boiled then allowed to cool add the solvent then insert the bottle into you nostril and apply pressure to the bottle. Do this with your head over the sink. A lot of the wash will come out of your nostril, which is normal. Use half of the bottle on one side of the nose and half on the other side. Do this at least 4 times per day.

At night – Take some pain relief when you are about to go to sleep on the first night. This will ensure that you have a comfortable sleep.

You will go home with some ointment. Use the wash bottle in your nose then apply the ointment to the small incision that is on the underside of your nose. You need to apply the ointment morning and night for the first 2 weeks to the incision.

When you go to bed lie on 2 pillows with a towel over the pillows and put the gauze or nasal bolster under your nose. The function of the gauze is to catch any fluid coming out of your nose, which can be very irritating to your upper lip.

Day 2 – 7

You will feel like you have a cold during this period. The swelling also gets worse for the first week then gets better. It is during the first 5 days that some bruising under your eyes may appear. You may also notice some numbness over the tip of you nose and upper lip, both of which are normal.

Day 7 – 10

At the first follow up with Dr Robinson he will take the splints out of your nose and dressing off your ear if there is one. You will notice an immediate improvement in your breathing and the feeling of congestion will abate. The splint over the top of your nose will stay on.

Day 14

The splint from over the top of your nose comes off today.  If the operation was planned to make a change to the appearance to your nose you will notice it today. It is important to understand that the nose will still be swollen and that the swelling will gradually reduce with 90% of the swelling gone by 3 months.

Further follow up

Dr Robinson sees rhinoplasty patients for a total of one year. The other follow up times after surgery are, 6 weeks, 3 months, 6 months and one year post operatively. At each of these visits Dr Robinson will perform a nasoendoscopy and at 3 months will repeat the photos that were taken pre operatively.  The repeat nasal airway testing and questionnaire are done at the 3-month and one year visits.

If you have any concerns or change in how you feel don’t hesitate to contact the office and Dr Robinson will see you in a timely manner. He and the staff are here to help and are more than happy to see you in the postoperative period.

Pain relief

A rhinoplasty is not an overly painful operation. Most people have a feeling of fullness post operatively but don’t feel they are in significant pain. Often the part of the procedure that is the most painful is the taking of the cartilage from the ear, which can give a feeling of tingling.

Take regular pain relief for the first 24 hours post operatively and then as needed after that.

Panadeine Forte

Take this regularly for the first 24 hours regardless of whether you are in pain or not.

Ibuprofen [Nurofen]

You can take Nurofen if the Panadeine Forte is not effective pain relief for you and provided you are not allergic to it or have asthma. Dr Robinson recommends you take the Nurofen no more than 3 times a day and to take it during a meal as it can cause significant stomach upset.

Endone

Take this pain relief only if you are in significant pain and the other medication is not working adequately.

Antibiotics

Take a 7-day course of antibiotics after having a rhinoplasty.

Dexamethasone

Dexamethasone is a steroid that Dr Robinson will usually give for the first 5 days post operatively. The steroid will help reduce the swelling of the nose and aid in the recovery significantly. You must stop taking the steroids after 5 days.

Ointment

You should use the ointment on the incision under your nose morning and night for the first 2 weeks at least.

What should I eat?

You can eat and drink anything you like provided it does not cause a rush of steam up your nose. Anything that causes steam to go up your nose may precipitate bleeding

What are the activities I shouldn’t do?

  • No heavy lifting – 3 weeks
  • No stenuous exercise – 3 weeks
  • No blood thinning medication – 2 weeks
  • No sexual intercourse – 2 weeks
  • No very hot showers or baths – 2 weeks

How much time do I need off work?

As a general rule most people have one week off work. You can go back to work at any time however you may not feel up to it for the first week.

What do I do if I get bleeding?

Use a wash in your nose if you have bleeding. Sit with you head forward, mouth open applying pressure at the opening to your nose for 10 minutes. If this is unsuccessful after 10 minutes then give yourself another wash and if the bleeding continues then make your way to the Gold Coast public hospital where there is an ENT surgeon on call 24 hours per day.