The Road To Recovery: What to Expect


There will be bruising and swelling as well as a "stuffed up" feeling. You may or may not have nasal packing. The swelling and pressure may be relieved by "icing" and many surgeons strongly recommend this. Some patients report that the best thing to ice it down with is a bag of frozen peas or raspberries. Although, the moisture content is higher in raspberries so that they remain frozen for longer periods of time, thus less trips to the freezer. However, some patients find that they can better "mold" the peas to their face. Just be careful you don't puncture the bag from freezing and thawing. It can be a real mess. 

Some surgeons do not recommend cold compresses so check with your surgeon first. Remember you WILL be bruised so do not become frightened. The bruises increase or darken as they heal, just like any other bruise. By the way, not everyone will get a yellow cast, that was a "in-operative joke" - I didn't mind at all. I went out out the mall, shopping, a few days later with the bruises and neon cast and all! (this is my primary, my revision photos are coming soon!)

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4 hours post 5 days post

You ingest a bit of blood during the procedure and it can make you sick later. patients report minor nausea and advise they only may vomit once or twice (unrelated to anesthesia). 

Unfortunately, many patients report a major dislike of the act of breathing through the mouth and feeling 'stuffed up'. This may be probably be more psychological than anything but can prove quite frustrating to some. Your packing, if you have it,  will be removed in a few days at your first post-operative consult.

You should stay sleeping in a 30 degree angle or at least 2 fluffy pillows worth. This helps keep the swelling and bruising to a minimum as when the head is lower than the heart it can dilate the capillaries and blood vessels more than is recommended. Also, the throbbing and swelling is increased when the patient is not elevated. it can also help ward off post-operative bleeding or hematoma.

Please refrain from taking any of the aspirin containing medications and most surgeons do advise to continue taking Vitamin C daily to help with healing. although with patients who tend to form excessive scar tissue advise your surgeon of this factor. Some surgeons believe that taking large amounts of Vitamin C post-operatively increases your risk of over0pcollagenation or excess scar tissue. If you are taking SinEcch as well, you should continue taking this as well until your last prescribed does. Remember that it is best not to drink alcohol for at least 3 weeks post-operatively as well.

The cast is removed in approximately 7 days. This may hurt just a little bit if your surgeon is not careful and many will use a cotton swab saturated in alcohol to remove and adhesive residue around the nose. If your sutures are being removed this may be slightly uncomfortable if they were tied very tightly or if the surgeon accidentally snips the tender skin around the sutures. 

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day after cast was removed
(attractive, huh?)

After removal the swelling "moves down" and patients report actually feeling it throb and move downwards until the area between your top lip and nose is slightly swollen and feels stiff. It may feel this way for several hours. Be very careful not to accidentally strike your nose  because it will hurt very badly and you don't want to traumatize the tissues more than they are or risk moving your nose out of alignment. Although your bone is pretty much well into fusing back together by now - it is still weakened until fully healed. Most sutures are of the dissolving kind but may appear as black or dark blue "hairs" sticking out of your nose so you may want to have them trimmed so you don't fell uncomfortable in public. It usually takes about 10 days for the bruising to disappear completely. However, in smokers it can take up to 3 weeks or more. So, Quit smoking now for a better chance at a smoother and faster recovery. 

Taping To Control Swelling & Promote Faster Healing
Although not all surgeons will have you do this as many surgeons and many different ideas of what does and does not work. It is important top get the approval of your own surgeon before starting any type of post-operative edema compression exercises.  PLEASE check with your surgeon before trying anything that he did not specifically instruct you to perform.

The below information has been provided for your convenience from Dr. James J. Romano of San Francisco, California and is in no way to be construed as medical advice but more of an informational guide for your research. 

Nasal Taping Instructions

The gentle application of tape to your nose postoperatively will help to reduce swelling quicker, speed healing, and obtain a better and a more predictable result. The pressure from the tape "splints" the new nasal structure in place to better control healing. The pressure of the tape also "presses out" the swelling and tissue edema.

Some patients patients can tolerate taping very well for long periods, others can not. Let your nose and your anatomy give you that message. If you cannot tolerate taping, the signs are usually irritation, redness, and bumps from the tape. Stop taping if this case or try interrupting the process for several days until the irritation clears, then try again.

Taping can be safely performed at any times and as often as you like. I recommend this schedule at a minimum:

  • Begin immediately after the splint is removed. Do this for at least six (6) weeks, at least at night.

  • If you don't mind taping during the day, it is fine to do so.

  • After six (6) weeks taping can be discontinued. If you notice some return of swelling then it is okay to resume taping if you wish.

Instructions: 

  • Wash your nose with mild soap and water and blot dry. Wait 5-10 minutes.

  • Cut three 1-1/12 to 2 inch strips of paper tape 1/2 inch wide

  • Apply the first strip across the top of the nose just behind the tip and press down onto the sides and cheek as you apply the tape.

  • Apply the second strip under the tip and press up onto the sides of the nose to support the tip. Pinch the edges together at the tip to apply gentle pressure and support.

  • Apply the third strip of tape over the first

  • Repeat this daily, or twice daily, as your nasal tissues tolerate.

Diagrams & Photos:

Copyright Dr. James J. Romano - used with permission. This information can not be copied, duplicated or posted without express permission from the author unless it is for personal use by Dr. Romano's patients or the visitors of the RevisionRhinoplasty.net website. This information may not be reproduced for used on other websites unless permission is granted from the author.

It takes about a year for the swelling to completely subside but it starts looking good in a few weeks. But! Just when you think it is looking great - it defines and looks even better!

 


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