Rhinoplasty is medically known as “nasal reconstruction” and commonly as “a nose job”. It is a technically challenging specialist surgery procedure for altering and reconstructing the shape and function of the nose. The surgical procedures performed are usually a combination of reconstructive surgery that aims to restore the function of the nose, and cosmetic surgery that changes the outward appearance of the nose.
Nasal surgery may be suggested to improve air flow ( hence addressing breathing issues and aeration of the sinus cavities) which could include correction of a deviated or crooked septum (septoplasty), or repair an injury from facial trauma (broken noses or nasal fractures). Rhinoplasty procedures may also be required to revise the defects created by loss of tissue (secondary to skin cancer resection or congenital nasal deformities).
If you are considering a nose job for cosmetic reasons, it’s worth mentioning that nose
reshaping is one of the most challenging cosmetic surgeries to perform, so you should consider your decision carefully.
And, as with any surgery, there are always risks involved, so you should choose a fully qualified specialist surgeon who will speak to you honestly about the benefits and risks of this type of surgery.
Ideally, they should have specialist training in facial reconstructive and trauma surgery and hold specialist registration in either Oral and Maxillofacial, Plastic or Ear Nose and Throat surgery.
If you decide to proceed, here are some insights into rhinoplasty recovery. The rhinoplasty recovery timeline also differs depending on various factors, including the type of procedure you have done. However, here is a general guide on what to expect regarding rhinoplasty recovery time, what to do and what not to do.
Preparing for surgery
Your health professional team, including your surgeon, should be aware of your full medical history and your expectations in terms of the result, so it is vital that you follow their advice. This can include:
- Being as fit as possible to aid in your recovery process.
- Ceasing certain medicines, including those containing Ibuprofen or aspirin, at least two weeks before surgery.
- Quitting smoking.
When you wake from surgery, you will have a rigid external plastic cast taped over your nose, a small gauge taped under your nose and small silicone stents inside your nose that will keep everything in position. Typically, patients stay in hospital overnight so they can be monitored. During this time, an eye mask will continue to be applied, which will help to reduce swelling. These special eye masks are like an ice pack but with the eyes cut out so you can still read or watch TV as you recover.
These are generally also supplied (or you will be given a script to receive them) on your discharge from hospital. It is important that you use an eye mask continually for at least three days after surgery, as that is when swelling will increase. Less swelling will reduce pressure, pain and bruising, speed your recovery and reduce the potential for nasal framework distortion. This routine is the most important thing you can do in these first few days.
In terms of medications, you will be given antibiotics and pain medication, and the dosage and treatment will be guided by your health professional. You will typically also be given an ointment (like Kenacomb) that will relieve itching and inflammation.
Over this time, your nose may start to block, but be patient, and DO NOT poke anything up your nose to try and unblock it. After your stents are removed on your first visit to your specialist, this should start to improve.
In terms of recovery from rhinoplasty, continue to apply your cold eye mask for three days after surgery and apply Kenacomb ointment to your nostrils twice a day. Take antibiotics and pain relief as instructed and as needed. Refrain from taking supplements like vitamins, herbal remedies and oils like fish oil and evening primrose for two weeks as it may affect blood clotting and healing in the short term.
Keep well hydrated and refrain from very spicy or hot foods. It is also essential to rest, although during the day, try to sit up and read a book or watch TV. At night, it is recommended you sleep on your back with pillows under your arms and a neck support to keep you stationary. No side or stomach sleeping! You should also not exercise for three to five weeks to assist with your recovery.
You can clean your face with a cool face washer, however, it is crucial that you don’t get your cast or tapes wet. Warm (not hot) showers are OK but refrain from washing your hair at this stage. Also, refrain from baths, as they can increase the risk of swelling and bleeding.
It’s also critical that you don’t sniff, snort, blow your nose or try to clear it for at least two weeks. Nasal sprays and saline sprays and rinses should also not be used.
During this time, your nose will be swollen, you will probably have stitches and glue in the tissues, and an external cast and internal splints distorting the tissues. At your second post-operation visit (which is usually 10 to 14 days after surgery), your cast and the hard glue from the incision between your nostrils will generally be removed.
Your nasal breathing should have improved by now, but one of the rhinoplasty recovery tips recommended to patients is the application of nose cones. These are small silicone stents that can aid your breathing while your nose heals. They are often worn for one to two weeks after surgery and then nightly for two to three months, but your specialist will advise what is best for you.
Weeks three to four
For the first three to four weeks of recovery after rhinoplasty, your nasal framework will be soft and moldable, and your entire nose will probably feel numb. This numbness should settle to a small zone over and in front of the tip of your nose. This normally settles over four to five months, but in some instances, some degree of numbness can persist, although it is rarely bothersome. Your nose may also feel quite firm over the first month and stay that way for four to six months. This is due to internal stitches and scar tissue/healing.
Typically, after six months, your nose may have achieved over 90 per cent of its long-term appearance, but it does depend on the extent of your surgery. Your nose should also start to soften, the skin feels more supple and your upper lip stiffness decreases.
In the first week, when you have the external plastic cast over your nose, you can wear glasses until it is removed in the second week. However, it is recommended in the following two weeks, you don’t wear glasses as they can leave impressions/depressions on your nose that may become pigmented and take some time to fade. If possible, wear contact lenses. If you must wear glasses, tape them up to your forehead to take the weight off your nose. It is also recommended that you don’t wear sunglasses for six weeks after your surgery.
When to contact your specialist
The two to three weeks following surgery is a critical time in the healing process and can affect recovery time after rhinoplasty, so it’s vital that you contact your health professional if any of the following occur:
- You have increasing pain, notice any increasing redness or a bad smell in your nose or are concerned that an infection might be developing.
- You notice significant bleeding or a persistent ooze beyond three days after your surgery.
- You feel your cast is “digging in”.
- You feel very stressed or anxious.