Jan 20

What can I expect after my Rhinoplasty?

Like any surgery, Rhinoplasty is a little bit different for everybody. That’s why it is useful, and we encourage you, to talk to others who’ve had the procedure to get a sense of their experience. There are some common themes though, as far as recovery goes.

Whatever technique is used (see our Blog on Open vs. Closed Rhinoplasty), you can expect to have some dull aching and headache afterwards for a short time. In the absence of an infection or other problem, severe pain is very uncommon. Most of our patients may take some pain medication for the first day or two after surgery and then are usually feeling well enough to switch to Tylenol or other non-narcotic pain medication.

The most obvious and slightly annoying symptom after rhinoplasty is congestion. Because there is internal swelling in your nose, you will experience some congestion in the first few weeks afterwards until the swelling slowly subsides. This is usually at its worst in the first few days after surgery and then starts to get better. Some patients who had major breathing problems before surgery will notice an improvement immediately after surgery, even with all the swelling. Others may take some more time to start noticing the positive changes. Those of you who did not have breathing problems to begin with will probably notice this congestion more. It can sometimes interfere with sleep in the first few nights after surgery and so, a light sleep aid is often provided. It is helpful in the first weeks after rhinoplasty to avoid dry environments and nasal irritants, and to use a saline (salt water) spray and some ointment in your nose several times a day as necessary to help with dryness and crusting. But, you should avoid blowing your nose until your doctor says it’s OK to do so.

Swelling and bruising on the outside of your nose and cheeks is seen after surgery as well. This can sometimes be severe and sometimes almost non-existent, but usually falls somewhere in the middle of those extremes. The extent of bruising and swelling depends on your body, on what was done, and on how carefully your tissues were handled. If it was necessary to fracture your nasal bones to move them inwards, your chances for bruising are a little higher. Even in the worst cases, bruising is usually mostly gone by 7 days or so after surgery. Your doctor may advise some remedies or herbal medication to help with bruising, but don’t take anything without first consulting him or her.

Most patients plan to take about a week from work and other major activities. You will usually have a cast on your nose and you may have some stitches that need to be removed. This is all usually done about 5 to 7 days after surgery. While you’re probably going to feel well enough to work after a few days, you may not want to be seen with the cast on. Some patients work from home and other brave souls throw caution to the wind and just go in to work with the cast and all. Once the cast is removed, you will look presentable within 1 to 2 weeks after surgery, although it may be on the longer side of that for a revision procedure. You wouldn’t want to have your wedding the next week, but your friends and colleagues shouldn’t be aware of anything. You can wash your face gently and put on a little cover-up makeup or foundation after one week.

By 2 to 3 weeks after surgery, 70 to 80% of the swelling is gone, so you’ll be starting to appreciate some changes. You won’t really see more of the details, though, until about 6 weeks after surgery when 85 to 90% of the swelling has gone down. While you’ll be looking pretty good at 2 weeks, you might still feel a little self-conscious. That’s because your nose (especially your tip) will feel a little (or sometimes a lot) numb after surgery, no matter what technique was used. It can take anywhere from several weeks to 6 or more months for the feeling to return completely. For the first 6 weeks or so, your nose just won’t feel like your own. Things like smiling and animated talking will feel strange. You’ll feel the odd strange pulling or twinge of pain if you make a wrong move like rubbing, bumping your nose gently, or rolling over onto your nose. These are unfriendly reminders that you’ve had surgery, but they are all normal and expected parts of the recovery.

Many patients are very afraid that they will do something to harm their result. While it’s true that a major bump in the nose can cause unwanted healing problems, there aren’t too many things you can do to really harm the result, so don’t be too gun-shy about touching your nose. There are some things you can do, however, to speed up healing and get you back into camera-ready shape more quickly. First is to listen to your doctor and follow all the instructions to the letter. They are usually there for a reason. You will probably receive a list of medications and supplements to avoid before and after surgery, and you should follow this advice to avoid unnecessary anaesthetic problems, bleeding and swelling. Keep your head up after surgery. Keep some cool compresses over your eyes and cheeks in the first 48 hours. For a few weeks, avoid bending, lifting anything over a few pounds, exercise, or anything that gets your blood pressure up. This can increase swelling and cause bleeding. Get a lot of sleep. Get outside and take some light walks. Eat well. Stay attuned to your body and alert your surgeon if your healing seems to be different than expected. In the first weeks, things will not look perfect, so try to avoid staring in the mirror or over-analyzing small changes.

Some other symptoms are common in the months after surgery. Your nose may run more easily, especially when irritated. Nasal allergies can be better or worse for a time. Your nose will tend to swell up a little when you exercise or do anything exertional. The skin over your nose can break out more easily and can be more sensitive to sunburn. While all of these things are irritating, they do get better and your nose will return to a more normal state after the inflammation settles fully. It’s important to remember that with each subsequent revision surgery, this entire process of recovery is slowed down somewhat. So, it’s not uncommon to take up to 2 years or more to see some of the changes you seek if you’ve had a revision procedure.

Noone will tell you that recovery was fun. But, most Rhinoplasty patients will tell you that it was very bearable when they knew what to expect. It is the path you have to walk to get to where you want to be. And, hopefully, your surgical team can help make it a little easier for you.

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18 comments

18 Comments so far

  1. Joni April 1st, 2011 5:51 pm

    These blog posts are so informative, and helpful!! Thank you! I had rhinoplasty done over 2 weeks ago, and I am so worried. My main concern is feeling like I won’t be able to treat my nose normally again. I asked my surgeon at my post op visit, and be was very vague.. He just said after 4-6 weeks we let you return to normal. But I want to know if I’ll ever be able to wash my face and nose, or rub it if it itches, and blow It normally, the way I used to before surgery, or will I always have to think about it? Could you please give me a more detailed answer?
    Thanks so much!
    Joni

  2. admin April 3rd, 2011 1:40 pm

    Hi Joni,

    We’re glad you find the blogs helpful. Rest assured, you will absolutely be able to treat your nose normally after surgery. Because your nose is somewhat numb, stiff, and swollen after surgery, it will feel strange. It is not uncommon to have an ‘out of body’ feeling, like you are wearing someone else’s nose. Most of this returns to normal after about 6 weeks, but you will still feel like your nose is overly firm and perhaps a little sensitive for a while after that. It takes a good 6 to 9 months for your to soften and feel much more like your normal nose. Ask your surgeon about when you should resume certain activities such as blowing your nose or exercise as every surgeon prefers a different routine. Good luck with your healing!

  3. Joni April 22nd, 2011 10:52 am

    Thank you so much for your answer. I have a post op appt. With my surgeon in one week. Until then, I would like to know how long does it typically take for the skin to reattach to the bone and cartlidge of the nose? Should I be worried 6 weeks out to rub my nose or use biore strips to clean my pores?
    Thanks again for all this wonderful info!
    Joni

  4. maria May 10th, 2011 3:30 pm

    I would alos like to thanks you for posting this very informative blog. Its feels good to be able to have the information regarding the expected stages to recovery. I too have had rhinoplasty 2 weeks ago, had my cast off one week ago today.Though i am very happy with the overall results and experience with my doctor I am still very numb, all of my brushing is gone which is great, but till feeling very swollen. The tip of my nose seems to be the worst, i feel its very round and rounder then when they removed my cast, is that normal? My other question is regarding Arnica Montana, which i took a week prior to the proceedure and a few days after. I was wondering if i should still be taking it oral, would this help with swelling still? Thank You so much for your answers and insight into the whole process!

    Maria

  5. admin May 12th, 2011 9:41 am

    Hi Maria,

    It is normal for swelling to increase a little after the cast and tape are removed since the skin is now allowed to balloon out somewhat. This should all settle with time. I have not seen a study in which Arnica has shown significant improvement in swelling beyond the immediate post-operative period. Ask your surgeon about what can be done to help swelling settle faster. Best wishes for a great result!

  6. Angelina May 24th, 2011 7:37 pm

    Thank you for taking the time to answer our questions – I had my surgery two weeks ago today and luckly the didn’t have to brake my bone. Most of the work was reshaping the round tip as it was droopy, and making my nostrils smaller. My question is, I have horrible allergies and eventough I’m taking allery medication my nose still runs. As my anxiety grew I started to put q-tips in my nose to get all the gunk out. Can I possibly be moving things around? Could it affect the shape that my doctor was trying to accomplish? Also, I had some dry skin on top of my nose and after a shower I rub off the dead skin as it is soft and moist. I don’t do it hard at all, and I’m VERY gentle and barely touch the surface of my nose with the tip on my skin. Do you think I have possibly damage the end results? Thanks again!

  7. admin May 25th, 2011 12:16 pm

    Hi Angelina,

    It’s important to talk to your surgeon directly after rhinoplasty to discuss any concerns in order to maintain a positive relationship over the course of your healing. In general, it is not uncommon to feel like you have a runny nose for a while after rhinoplasty. Washing your face and touching your nose is unlikely to cause any damage, however, we do not advise our own patients to clean with q-tips beyond the first week and certainly not vigorously. Talk to your surgeon for specific recommendations about how to clean your nose and help it heal as quickly as possible. Best of luck,

  8. Pamela October 19th, 2011 7:29 am

    I had Rhinoplasty and Septoplasty 5 days ago, the swelling has subsided around my eyes, the bruising now is changing from black/dark purple to yellow. I still have the cast on and I am getting it off today but, I just noticed brusing in my lower cheeks and it is swollen, does this mean I may still be bleeding in side my cheeks?

  9. admin October 19th, 2011 9:22 am

    Hi Pamela,

    As bruising and swelling subside, they usually descend down via gravity through the normal tissue planes. So, it is fairly common to see some swelling and discoloration go down the cheeks before it goes away completely. Hope you have a great result.

  10. sam March 24th, 2012 1:05 am

    I have to say, i had my op done in Europe but i stumbled across your blog today and have found it immeasurably useful and insightful.

  11. Aaron September 6th, 2013 12:32 pm

    Hello,

    This Blog has been very informative. I was hoping to have a question answered. My nose was broken twice over 10 years ago which left me with a severeley deviated septum and hump on the bridge. I will be under going a rhino/septo and my surgeon informed me that he will be using cartlige from my ear to repair the damage. He informed me that after 6 weeks i should be able to return to my regular workouts. he informed me that my nose will never be as strong as it was prior to the surgery. that concerns me as I practice jiu jitsu and sometimes receive rubbing and pressure on the nose. how does the nose hold up 2 months after surgery with moderate rubbing/pressure? Will the nose ever develop good resiliance to rubbing and pressure? thank you for your time.

  12. developer September 16th, 2013 9:30 am

    Hi Aaron,

    I would say that your nose will never be as strong as it was before you broke it. Surgery should not make your nose a lot weaker. After about 6 weeks, your nose should be almost as strong as it was before surgery, strong enough for normal physical activities. That being said, I have done Jiu Jitsu and had my face planted into the mat more times than I care to remember. That is one sport wherein repeated injury or an errant elbow or foot can put you at higher risk for re-breaking your nose. If you can live with that risk, then roll on.

  13. May December 1st, 2013 6:36 pm

    Hello,
    This blog has been very informative. I had my op done 20 days ago. My nose looks uglier now and bigger than before I had it done. This is sad because I have been wanting to do this for over 20 years and finally got enough courage to do it. I am trying to be patient because i know results vary and can take up to a year. My question is that I feel like I have soars in my nose that are obstructing my breathing. I also caught a cold right before the cast came off which has forced me to blow my nose a little. another concern is that the packing would not come out on the docs first try. He attempted to remove the packing for about 20 minutes before he gave up and had me return the next day to the surgery center. With better tools and another 10 minutes of poking around in my nose the packing finally came out. I am so worried that all that trauma negatively effected the surgery. Any feedback from your experiences would be greatly appreciated. I will be seeing my doctor this week for preop visit.

  14. developer December 2nd, 2013 10:00 am

    Hi May,

    We’re sorry that you’ve had a difficult time with your early recovery. In general, the packing issue and swelling from a cold should not have a long term effect on your result. You may notice a temporary increase in swelling though. If you feel there are sores in your nose or you are having ongoing concerns that healing is not progressing appropriately, you should raise these issues with your surgeon when you see him this week. We wish you the best for a great outcome.

  15. Hollie December 4th, 2013 11:29 am

    Hello,

    Thanks for the helpful info, reassuring to know all of this is normal! I had a closed rhinoplasty 19 days ago and so far my recovery is going well. I hoped you would be able to help me with a couple of queries please? My two questions are about my smile – I am aware that this is normal to be affected, my consultant tells me it usually starts to normalise after 6 weeks, sometimes longer, and I wondered if this was the time frame in most cases or is it usually longer? Secondly I was wondering if there was anything I could do to try and help speed up getting my smile back? Should I be trying not to smile or should I be acting normally etc…? Many thanks for your help!

    Hollie

  16. developer December 4th, 2013 12:11 pm

    Hi Hollie,

    Congratulations on your new nose. We typically find that patients’ smiles tend to feel more normal around 4 to 6 weeks after surgery. Your smile may be affected by some swelling of the upper lip and cheek area. But, most of the issue patients have with their smiles after surgery is that smiling feels strange because there is some numbness of the nose and tip, even if your smile looks normal to others. There is nothing for you to do other than things that will help recovery in general, such as getting good sleep, nutrition, avoiding salt, etc. Our advice to patients after one week is that they should return to activities, work, social interaction, and act normally. Don’t avoid smiling or making eye contact. Don’t behave differently. You’ll be surprised that few, if any, people notice any difference in you. All the best!

  17. maria June 15th, 2014 11:25 am

    Hi, Doctors, I was on a wait list for getting a rhinoplasty, and was just notified that there was a cancellation. The trouble is that my appointment for surgery would be two weeks before I am slated to drive half way across the country and move into a new apartment. Would it be safe for me to do this, or should I wait until next summer, when I can stay at home for 6 weeks? I want to get this done sooner rather than later, bit I do not want to incur unneccessary risk. Thank you.

  18. developer June 16th, 2014 8:10 am

    Hello Maria,

    We don’t have any issues with our patients traveling long distances either by car or by air at least one week after surgery. In fact, many patients come to us from out of state and even out of country and return home after one week. That being said, it is always best to check with your operating surgeon as each surgeon will have his or her own preferred post-operative routine. All the best on your many impending changes!

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