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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Ear Nose and Throat

Caring for Yourself after Rhinoplasty (Dr. Ben Marcus) (7087)

Caring for Yourself after Rhinoplasty (Dr. Ben Marcus) (7087) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Ear Nose and Throat

7087





Caring for Yourself after Rhinoplasty
Dr. Ben Marcus

You have just had surgery to reshape and reposition the cartilage, and often the bones in your
nose (rhinoplasty). There are incisions inside your nose. In some cases, there is a small incision
in the tissue between your nostrils. All of your incisions, both inside and outside have been
closed with sutures which will dissolve. You may have dissolvable packing in your nose.
You have a molded plastic splint glued to the outside of your nose. The purpose of the splint is
to hold your cartilage and bone in their new position while they heal. This will decrease the
swelling that you will have. The splint will protect your new nose.

This guide was written to give you instructions for the care of your new nose. It will answer
questions that you will have as your healing moves ahead. Use this handout for the next month
as questions come up. Do not hesitate to call our office if you have more questions.

Wound Care
 Your nose will drain some mucus and a bit of blood for the first day or two after your
surgery. This is normal. You will have a “drip pad” of gauze in place under your nose to
absorb the drainage. Please change the gauze as needed. Gauze pads will be sent home with
you. We will clean out your nose at your first clinic visit. Do not pick the inside of your
nose.
 You will start using a saline spray in your nose two days after surgery. You can buy a saline
spray over-the-counter in your drugstore. You may use any brand. Two common brands are
Ayr® and Ocean Spray®. Use 2 squirts in each nostril at least 4 times a day. You may use it
as often as you like. The saline helps reverse the drying effect that the surgery has on your
nasal lining. It should be used for at least the next 3 months. Do not use any other sprays in
your nose unless you are given specific instructions to do so by our staff. Contact us if you
have questions about using your nasal spray.
 If you do have a small incision in the tissue between your nostrils, we will give you an
ointment to apply there. Apply it with a cotton swab 3 times a day. We have used dissolving
sutures to close your incision. The sutures dissolve only if kept moist with ointment.
Continue to apply the ointment until the sutures have dissolved. This will take about a week.
 You may have had some cartilage taken from your ear to put in your nose. If so, the incision
in your ear has been closed with the same sutures as those used in your nose. Apply the
ointment to your ear sutures 3 times a day with a cotton swab. Continue to do so until the
sutures have dissolved. This will take about a week. You may have a dressing on the front
of your ear and one on the back. These dressings are sewn to your ear. We will remove
them at your first clinic visit. Don’t try to remove or change these dressings.
 If you have had an implant inserted into your chin, you will have a dressing taped to your
entire chin. Once this dressing is removed, you should apply ointment to the incision line 3
times a day. The stitches will dissolve in about a week.

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 We will remove the plastic splint on the outside of your nose about a week after surgery.
You may wash your face and shampoo your hair the day after surgery. It will not damage
your nasal splint dressing if it gets a bit wet. Do not run water directly onto the splint. You
may wash around all of the incisions in your face the day. If they happen to get wet, this will
cause no problems.

Activity Restrictions
1. Sleep on your back with your head raised on two pillows for the next few nights. Sleeping
in a recliner chair is ideal. If you sleep on your side, your nose will swell closed on the
“down” side. Sleeping on your back with your head slightly raised for the next week is best.
2. Keep ice packs across the splint and both of your eyes until you go to sleep tonight. Use the
ice packs all day tomorrow. This prevents bruising of your eyes, lessens the swelling of your
nose and face, and makes you more comfortable.
3. For the first week,
 Walk as much as you like.
 Do not blow your nose. You may sniff backwards.
 Do not run or do any aerobic exercises.
 Do not lift anything over 10 pounds (including a child).
 Do not bend forward with your head down.
 Do not strain in any way.
 Sexual activities should be limited.
 Ask our staff if you have any questions about a certain activity.
5. You may wear your glasses if they rest lightly on your splint or are taped to your forehead.
Our staff will show you how to manage this. Wear the lightest weight pair of glasses that
you have. You may insert your contact lenses two days after surgery. After removal of your
splint, you should limit the time that you wear your glasses. Keep wearing light-weight
glasses. Do not wear plastic-framed glasses that rest all the way over the top of your nose. If
your glasses have very small nose pads, you may wish to ask your optician to install larger,
softer pads. You may expect some soreness on the sides of your nose after you have worn
your glasses for awhile. This is normal. It may last 3 to 4 months. When your nose
becomes tender, remove your glasses for an hour or two. Contact our staff if you have
questions about your glasses or contact lenses.
6. Do not drive for 24 hours after your surgery or while you are taking any narcotic pain
medicine.

Diet
You may eat a normal diet after surgery. You may find that swallowing solid food is a bit hard
while your nose is stuffy. Your sense of smell may not be too good for the first week, but will
soon return to even better than before. Drink lots of liquids to help your body recover from
anesthesia and surgery.


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Medicines
 You will be given pain medicine to take as directed.
 You may be given antibiotic pills to take. If you are given these pills, take them as
instructed. They are important for proper healing. Take them until they are completely gone.
 You may be given dexamethasone to take for a week. This helps reduce swelling and
discomfort. Take the dexamethasone exactly as the directions tell you.
 You may be given a packet of Arnica Montana pills to prevent bruising. Take them exactly
as instructed on the package.
 Resume taking all of your normal medicines the day after surgery. It is wise to take a
multivitamin pill during the month after surgery.

Visits to the Clinic
 If you have an ear “bolster” dressing sewn to your ear, you may be scheduled for your first
follow up visit 2 days after surgery.
 7-10 days after your surgery, we will see you in our office. At this time, your outside nose
splint will be removed and your nose will be gently cleaned out.
 Your next visit will be one month after your surgery.
 As a rule, we will then see you at 3, 6, and 12 months after the surgery. There is no charge
for these visits. You may have postoperative pictures taken at these visits.

Long-term Care
 Swelling of your nose and the area around your cheek and upper lip is normal. The swelling
will slowly go down over time. When your plastic splint is removed you will see some
swelling. This swelling at the upper part of your nose between your eyes should be gone by
the end of the second week. The same is true for the minor swelling of your cheeks at the
sides of your nose. You may have some swelling in your upper lip and even on your gums
above your teeth. The mild tenderness and swelling here will be gone within 2 weeks. There
may be minor swelling and a feeling of stiffness in the tip of your nose that goes on beyond
the 2-week period. In many cases, the tip may not appear just as we want it for up to 6
months after surgery. In some cases, we may inject a small amount of cortisone into the tip
to help make the swelling go away.
 Bruising around your nose in your cheeks and lower eyelids is very common after this type
of surgery. It should go away completely in two weeks. If this bruising is a problem related
to your return to work, we can provide you with some cover-up makeup.
 Numbness over your nose is also quite normal. You will slowly regain sensation over the
top of your nose. But you can expect the tip to be slightly numb and “stiff” feeling for up to
three months after surgery.
 Breathing through your nose will slowly improve after we clean your nose out at your first
clinic visit. After a week, your breathing should be much improved. It is vital that you spray
the inside of your nose often with saline spray.
 You may be instructed in a set of nasal exercises. These exercises keep your nose narrow
and straight as the nasal bones heal back to the facial bones. If you are told to do these
exercises, make sure you do them for the first month after surgery. In most cases, they are
not needed beyond that point of time.

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 You must protect your new nose from the sun for 3 months. Sun exposure will cause
swelling in the nose and will slow the healing process. The skin of your nose will be very
likely to burn from sun exposure. Good protection for this 3-month period means both a
brimmed hat and a sun block of at least SPF 15.

For any other questions that may arise, please do not hesitate to contact us at (608) 263-6190.
We would rather answer your questions than to have you worry perhaps needlessly. We very
much hope that you enjoy your new nose both in function and appearance.



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Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor.
This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because
each person’s health needs are different, you should talk with your doctor or others on your health care team
when using this information. If you have an emergency, please call 911. Copyright © 5/2017 University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7087