Rhinoplasty Boston

Boston Plastic Surgery

Preparation and After Care

Every plastic surgeon has his personal pre-operative rhinoplasty regimen and care plan after nasal surgery. While preparing for your rhinoplasty, you should be well-informed about your cosmetic surgeon’s routines. Most experienced surgeons understand that excellence in before and after-care is a vital factor that can determine the overall success your rhinoplasty.

Recovery time from a nasal reshaping procedure varies but is usually around 1 ½ weeks. Prepare yourself well for the recovery as most people live active lives not accustomed to spending such a relatively long time period away from the busy life. Having support from your significant other or a good friend is highly recommended.

Please find below a summary of a few things you can expect – your own doctor’s schedule may differ slightly.

Before Your Rhinoplasty

Preparations before a rhinoplasty or any nasal procedure are determined with your safety as the top priority and to ensure a smooth operation and a swift recovery. Therefore, it is important that you take medications exactly as instructed and follow all of your doctor’s instructions closely. If you decide to deviate from your doctor’s recommendations, you should discuss it with him beforehand.

In preparation for your rhinoplasty procedure, your nose surgeon will ask you to discontinue any medications that could cause increased bleeding and bruising, i.e. Aspirin and aspirin-like products (ibuprofen, naproxen etc.), Vitamin E, blood thinners etc. The nose has a very rich blood supply as easily shown in nose bleeds that can be rather significant and even occur spontaneously. Limiting bleeding during the nose operation will give your rhinoplasty surgeon an opportunity to focus on the reshaping of your nose and not trying to stop bleeding. Given the technical finesse necessary to complete a rhinoplasty successfully, these little aspects can make a difference between a good and an excellent outcome. Although nutritional supplements may enhance our health when used on a daily basis, their role and impact on surgical procedures and their potential interactions with medications is poorly studied and understood. Therefore, their use in preparation of rhinoplasty is discouraged. There may be exceptions to this rule. Some plastic surgeons find Arnica Montana helpful; others have not seen a noticeable difference. You should continue most of your other prescription medications, especially any blood pressure, heart and asthma medications. If you take medications that could interfere with your healing, your plastic surgeon will decide with your primary care physician how to proceed.
You should not smoke. Smokers choke blood which is necessary for a rapid recovery. A nicotine patch or gum is also not advisable.

Some last-minute apprehension is expected given that you likely thought about this surgery for quite some time but you should also look forward to this procedure. A positive attitude combined with a thorough understanding of the expected recovery will help you in your recovery period.

After Your Nasal Reshaping Surgery

Rhinoplasties are performed safely as outpatient procedures. After your nose surgery, you will spend some time in the day surgery recovery room. Once you feel comfortable and your physical status meets discharge criteria, you will be released home with your companion. At home, a caring person should be with you so that you can rest to recover from the rhinoplasty operation. Some surgeons may prefer that the patient stays in the hospital for a night or two.

Routinely, your doctor will place a nasal splint on your nose. This is often made out of plastic material and is custom shaped at the completion of the rhinoplasty. This nasal splint will provide support of the re-aligned nasal structures and usually stays on for 6 to 10 days. The exact length this nasal dressing will stay in place varies depending on your nasal surgeon’s preference. Some plastic surgeons will use nose splints made of other materials like plaster or metal. Likely, there will be gauze material inside your nostril to minimize oozing afterwards. The dressing matters used by rhinoplasty surgeons vary widely from extensive packing to small non-stick gauzes. The length of time your doctor will want this material to stay inside your nose varies widely from hours to days. Your nose surgeon will explain his particular preference. You will receive prescriptions, commonly for pain medications, antibiotics and others. Some cosmetic surgeons recommend the use of homeopathic Arnica Montana for faster recovery. Hard evidence for the usefulness of this remedy is slim but some surgeons report anecdotal success.

Swelling and bruising around the eyes are a normal part of the rhinoplasty recovery process. You can minimize the swelling by keeping your head elevated at all times. Ice compresses placed on the eyes will further decrease bruising and swelling. After a few days, warm compresses can promote faster resolution of remaining bruises. In order to support your recovery, most doctors recommend avoiding exercise, straining, heavy lifting and alcohol during the early rhinoplasty recovery phase. Swelling will limit your nasal airway. You may have to breathe through your mouth for the first days or even weeks.

Your doctor will advise you, if and when you can take a shower. He also will recommend certain foods he may prefer for you. Pain after rhinoplasty is usually limited to soreness of the nose. Some patients develop a temporary headache for the night after the nasal surgery. After approximately one week, the nasal splint will be removed. At this point, your nasal breathing is improving but it will be not at its best yet. At this time, you may resume some regular activities such as walking outside. Exercise has to wait longer; your doctor will inform you when you can resume your full activity level.

Healing after rhinoplasty takes quite some time. The good news is that the nose appears usually normal by day 7 but it takes much longer for the final result to unveil. The reason for this lies in swelling of the nasal skin which camouflages the ultimate definition of the nose, especially in the tip region. Tip definition is determined by the underlying cartilages that need to show their configuration through the overlying skin. Therefore, just a touch of skin puffiness will initially conceal the majority of the final nasal shape. Because the tip skin is thicker than the remainder of the nasal skin, it may easily take 9 to 12 months for the ultimate tip contour to show.

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Written by cosmetic surgery specialist and boston rhinoplasty surgeon Dr. Fechner.
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