Archive for the 'Rhinoplasty Recovery' Category

Should you massage your nose after rhinoplasty?

In general, it is best not to massage your nose after rhinoplasty as it is possible, although unlikely, that vigorous rubbing or manipulation in the first few weeks could pop a delicate stitch and disturb the corrections made or affect the cosmetic result. Some people habitually rub the tips of their noses. Recognize that this will not likely ruin the result but may cause more irritation and swelling.

That being said, your nose is not glass after surgery. In fact, it can often feel quite stiff and wooden for a period of several months after surgery. Rolling over onto your nose during sleep or lightly bumping your nose will not make it end up on the side of your head. So, you don’t have to walk around in a bubble after surgery.

After about a month, the skin starts to wrap around the cartilage, and the bone is pretty much set, so contact to your nose is less likely to cause any shift or problems with healing. Likewise, a small rind of fibrous tissue or scar has started to form that will likely hold the cartilage in place even if a stitch were to loosen at this stage.

Some surgeons recommend ‘nasal exercises’ which essentially amount to light lymphatic drainage. These will not be harmful but may not do much either. Instead, we ask patients to tape the nose at night for the first month to help skin contract and push out swelling. If you have any questions about nasal massage, ask your surgeon for his or her preferred routine after surgery.

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Steroids and Rhinoplasty

Please note: We are happy to see that our blog is of some help to many of you who are considering or recovering from rhinoplasty. While we would like to address your concerns directly, we are not able to dispense medical advice over the internet. Your own surgeon is your best resource in the first weeks and months after surgery. If, after 5-6 months, you continue to feel unhappy with your result, feel free to contact us via our practice site and we can arrange time to discuss your concerns. All the best for a happy outcome.

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Narrowing a bulbous tip

A bulbous nasal tip is one of the most common reasons for patients to seek rhinoplasty. A bulbous tip, often called a boxy tip, refers to a tip that is too wide and prominent in proportion to the rest of the nose and other facial features. The key focus in our approach to bulbous tips is in emphasizing creation of a sense of tip refinement and definition rather than excessive narrowing.

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Swelling after Rhinoplasty

April 28th, 2010 | Category: Rhinoplasty Philosophy,Rhinoplasty Recovery

You often hear that it can take a year or longer after a nose job before you’ll see the final result. Many of you may be skeptical and a small number of you probably roll your eyes when you hear a statement like this. Does it really take that long to see results or are surgeons just telling you that so they can buy time in case you’re not seeing what you want to see after surgery?

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How long does it take to heal after rhinoplasty

June 22nd, 2009 | Category: Rhinoplasty Recovery

We are often asked how long it takes to heal after a nose job. Patients are suitably concerned about when they can show up back to work, go on a date, see friends, or worse, go to a family wedding or reunion, without looking alien.

We often tell people that within two to three weeks after surgery, no one but themselves and any one else in on the truth should know that anything happened at all. Most patients are comfortable returning to work even after one week. Bruising and swelling should be minimal if present at all. Read more

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Lines and gaps at the sides of the nasal bridge after rhinoplasty

February 26th, 2009 | Category: Rhinoplasty Recovery,Rhinoplasty Techniques

Here is another one from the Q&A file that can be a source of concern for people soon after a rhinoplasty. We were recently asked about vertical lines/shadows showing up after rhinoplasty on either side of the bridge. What was more worrisome for this person was the fact that she was able to feel small gaps when she pressed on the area. Read more

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Is fluctuating swelling, redness, or bluish discoloration normal a year after Revision Rhinoplasty? Will it go away?

February 25th, 2009 | Category: Revision Rhinoplasty,Rhinoplasty Recovery

We were recently asked this question by someone who was understandably worried about these persistent symptoms about one year after a revision rhinoplasty. She wondered whether steroid injection would still work at this stage.

While discoloration is admittedly unusual at this stage, the key to this question is fluctuation. If swelling and redness were persistent and not getting better, we would be concerned about a possible low grade infection or chronic inflammatory condition, especially if there were a graft of foreign material placed in the nose. When swelling or discoloration fluctuates between being present and then going away, we are not nearly as concerned. Read more

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Rhinoplasty Mistake #2: The Pollybeak Deformity

So, what is a pollybeak deformity? Well, that’s the unpleasant and unkind name we give to a nose in which the area just above the tip is too full. Normally, there should be a little dip or depression just above your nasal tip that defines the transition from your bridge to your tip on profile. When that area is high or filled in, we call it a pollybeak.

When it is very full, it can even make the nose look down-turned like a parrot’s beak, thus the name. The reason for this is that the area above the tip often becomes the part of your nose that sticks out or projects the most from your face. This is not the way it should be. Your tip should be the most projecting point of your nose.

Check out the photo below to see a pollybeak deformity indicated by the arrows.

nose pollybeak deformity photo

OK, what causes a pollybeak deformity? Read more

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Why don’t you use nasal packing after Rhinoplasty?

March 02nd, 2008 | Category: Rhinoplasty Recovery,Rhinoplasty Techniques

Want to know the most significant complaint we hear about after Rhinoplasty surgery?

It’s not pain, pressure, headache, or even discomfort. In fact, rhinoplasty is rarely very painful.

The symptom we hear about most is nasal congestion.

nasal packing after Rhinoplasty photo

The picture above shows one technique that some surgeons still use to pack the nose. Most surgeons still use some form of packing or splint, which can either be merocel, gauze, xeroform or a variety of other forms. The end result unfortunately is more discomfort for the patient.

While not being able to breathe through your nose is not earth-shattering, it is extremely annoying. Think of it like a bad head cold that lasts. So, anything we can do to prevent this symptom is meaningful to you, and therefore important to us. And the biggest thing we can do to help, is to avoid nasal packing.

Packing is routinely used by some to help prevent excessive bleeding or dripping. We find we almost never need it. By handling tissues exceedingly carefully and gently, we find that we can generally keep bleeding, bruising, and swelling to an absolute minimum…and the benefit to you is an earlier return to breathing through your nose, less blockage from the beginning, and no painful removal of crusted packing.

We really have a passion for rhinoplasty, and we do all we can to help make your experience with us the best it can be… so we encourage you to come in and experience the difference.

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I read your recent blog about rhinoplasty in African American patients but I have a problem with keloids and was wondering how big of a problem this will be if I do have rhinoplasty.

Your concerns are valid and it is important to discuss your history of poor scarring whenever you undergo any type of surgery. You should note however that different parts of the body will heal differently. The simple answer is that keloids rarely develop in the central face and we here at Profiles have never seen a keloid develop after we have done rhinoplasty.

A more in depth explanation begins with an explanation of scarring. First, we need to help you in understanding the difference between a hypertrophic scar and a keloid. Clinically, hypertrophic scars are enlarged scars that stabilize or shrink with time. Keloids, however, initially develop as hypertrophic scars but later extend beyond the original injury area. They rarely regress on their own and have a propensity for recurrence after excision.

Keloids may affect virtually any surface on the body with the central chest, deltoid/shoulder region, and back having the highest frequency. And this has led some doctors to speculate that motion and tension play a large role in causing keloids to develop. While this may be true to some extent, the earlobes, which are one of the most frequent sites affected, are obviously subject to minimal motion or tension forces.

photos Before and After Earlobe Keloid Scar Excision

photo Before and After Earlobe Keloid Scar Excision

This African American patient demonstrates a typical example of a large keloid scar of the earlobe that was removed in one session with flap reconstruction of the back of the ear. The After photo to the right shows her postoperative result over 6 months after the procedure.

All this being said, while you should explore this issue with your doctor before surgery, you should feel some comfort in knowing that the nose is rarely a site for keloid development after rhinoplasty or nasal surgery. In fact, we did a literature review to check on your answer and were unable to find any papers which could point to a case of a keloid after rhinoplasty.


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