Rhinoplasty, sometimes referred to as a “nose job,” has many benefits for patients, cosmetic reasons being one. However, your nose could also be affecting how you’re breathing and sleeping! While not all cosmetic facial surgeons offer nose surgery, Dr. Agnihotri has a passion for them. He can perform surgery on anything from a minor hump removal to detailed nasal tip refinement.
What is It?
A cosmetic reshaping of the nose.
1-2 weeks depending on initial healing. 6 weeks of full healing.
Anesthesia: IV sedation / General anesthesia
Who is it for?
Anyone that would like to have a more, symmetrical, aligned, smooth, beautiful nose. Can also help with breathing.
One Week Before Surgery:
Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently. PLEASE DO NOT SMOKE for at least 2 weeks, since this is very detrimental to healing and may cause failure of the implants.
Day Before Surgery:
- The Surgery Center will call you the day prior to surgery to inform you of your arrival time for surgery.
- DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT (including water and gum chewing). SURGERY MAY BE CANCELLED IF THIS IS NOT FOLLOWED. A fasting state is required in order to receive sedation for surgery. The only exception is medication, which we will instruct you to take the day of surgery with a sip of water.
Day of Surgery:
- You may shower and shampoo the morning of surgery. Do not wear makeup, hair sprays or gels, or nail polish. You may leave acrylic nails on.
- Avoid clothing that must be pulled over the head. Please wear loose fitting clothing.
- Do not wear jewelry of any sort or bring valuables to surgery. If you are unable to remove your rings, please see your jeweler to have them removed prior to surgery.
- Dentures, if worn, should be left in place.
These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care.
- Limit your activity sharply over the first week following surgery.
- You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from develop in the legs. Move/ pump your legs frequently while lying down. This also helps in preventing blood clots from developing.
- When you rest or sleep, keep your head elevated 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result.
- Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.
- Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional outbursts will only add to the swelling or increase the likelihood of bleeding.
- Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks.
- You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery.
- It takes 6 weeks for the nasal bones to fully heal. Slowly resume your activity.
- Contact and semi-contact activities are to be avoided for 4-6 months. Full swimming is allowed after 6 weeks.
- Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.
- Drink plenty of fluids following surgery, as dehydration can contribute to nausea.
- Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea.
- If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes.
- Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.
- Keep your cast dry. It will be removed on postoperative day 7.
- Change drip pad under nose as needed. Up to a dozen times in the first 24 hours is normal.
- After packing is removed use nasal saline mist every 1-2 hours while awake for approximately 2-3 weeks. You may purchase this over the counter. This prevents dryness and crusting on the inside of the nose.
- Clean your incision with peroxide, and then apply Neosporin ointment to the sutures twice a day.
- When the cast is removed, the nose will be quite swollen and the nasal tip will be turned up slightly. This will settle down over the next 3-4 days, then more gradually thereafter
- Nasal exercises may be given to you at the appropriate time. These are to keep the sides of the nose narrow and in proper alignment, along with decreasing scar tissue formation.
Pain, Swelling, Bruising, and Infection:
- Most patients complain more of discomfort from nasal and sinus congestion than from pain. Any pain should be controlled via the prescribed medication. After the first day the pain may subside enough so that Tylenol may be sufficient.
- Swelling and bruising about the eyes and cheeks is variable. Swelling and bruising maximizes at about two days then subsides over the next 5-7 days. You will be instructed on the use of Arnica, an herb with no known side effects, to minimize bruising.
- Do not worry if you have excess swelling around the eyes and cheeks. This will clear and not affect the final result. Bruising may persist a few days longer.
- Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated.
- Your final results will occur between 6-12 months.
- You may bathe but not shower while the cast is in place. The cast must remain dry.
- You may carefully wash your face with mild soap and clean washcloth or cotton balls, but make sure the cast remains dry.
Other Common Instructions After Surgery:
- Do not blow your nose or sniff excessively as this will only irritate the healing tissues. If you must sneeze, open your mouth.
- DO NOT PLACE Q-TIP OR KLEENEX IN YOUR NOSE IN AN ATTEMPT TO CLEAN YOUR NOSE.
- Expect your nasal passages to be obstructed by swelling for at least two weeks. A humidifier may help you sleep by allowing you to breathe through your mouth more comfortably.
- It is normal to have some nasal bleeding over the first twelve hours after surgery. It may be necessary to change the gauze drip-pad a dozen or so times over that period.
- It is normal to have a pinkish-reddish discharge from your nose and your throat for the first three to four days. This will gradually subside.
- If you have any profuse nasal bleeding after this time, immediately lie down with you head elevated on 3-4 pillows. Iced wash cloths on the back of the neck and over the eyes may help. Please call if these measures do not suffice.
- You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications.
- Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery.
- Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing.
- Take all medications as instructed postoperatively.
- Avoid excess sunlight to the nose for at least a year. Do not let your nose become sunburned. Even mild sunburn may cause prolonged swelling or redness. Use sunscreen with zinc oxide and SPF 20 or greater if you will be in the sun.
- Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.
Call Dr. Agnihotri if you Develop any of the Following:
- Fever of 101 degrees F or greater.
- Pain not relieved with pain medication.
- Swelling, redness, bleeding, and/or foul drainage from incision area.
- Persistent nausea and/or vomiting.
- Any other concerns.