Note: The featured image is an actual patient of Dr. Cason, shown 5 months after revision rhinoplasty. Dr. Cason is pointing out the mild swelling of the nasal tip, which will continue to improve over the next few months. It can take up to 1 year for all swelling to resolve.
Rhinoplasty, or nose job, is a surgery to change either the shape of the nose, improve breathing, or a combination of the two. It is one of the most common surgeries I perform, and is a surgery that I am particularly passionate about. One of the most frequent questions I get during consultations is what the expected recovery looks like after a rhinoplasty. In some cases, patients are wanting to return to their job or school, and may not want their co-workers or peers to know that they had plastic surgery. Whereas other people may be less concerned with this, and want to return to work as soon as possible. Whilst the recovery process in both of these scenarios is identical, there can be variance as to when a patient returns to their normal, day-to-day life.
In all cases, understanding ahead of time what recovery entails helps ensure surgical success and satisfaction. You’ll see me after surgery for follow-up appointments at 7 days, 1 month, 6 months, and 12 months to make sure healing is on track. At each appointment we’ll again review what to expect in the coming weeks, and tailor your recovery process to ensure your results are the best they can possibly be. Listed below are some of the things you can expect after your rhinoplasty, as well as a few of the milestones.
Swelling and Bruising
Swelling and bruising is often patients’ highest concern, mainly because this determines when you can become “passable” in public. Swelling is most prominent during the first 48-72 hours and continues to decrease as time goes on. Bruising can last up to 2 weeks, particularly when surgery involves repositioning the nasal bones, and can be most notable around the eyes. For patients who are hesitant to have their co-workers or peers know they had something done, then waiting at least 2 weeks after surgery to return to work is recommended to ensure that the bruising is minimal. It is important to note that swelling of the nose, particularly of the tip, can last for up to 1 year.
To minimize swelling and bruising, I have patients follow a specific protocol. For the first 2 days, I recommend cool compresses to the face and eyes. This involves soaking gauze pads or washcloths in icy water and applying it to the eyes, and replacing it when the compress becomes warm. Additionally, avoiding excess salty foods, alcohol, bending over, and activities that may raise your blood pressure (including exercise, running, lifting, and sexual activity) for 3 weeks after surgery is recommended. As mentioned, swelling and bruising should continue to improve with time. It’s important to re-emphasize that swelling can take up to 1 year to fully resolve.
What to Expect with Splints
After your rhinoplasty, you will have a splint placed on the outside of your nose to help with healing and support. It is also important in helping minimize swelling on the bridge of the nose. The majority of patients will also have splints place in their nostrils. These splints help support the nasal septum and make sure the nasal airway stays open during the early healing phase. You don’t have to do anything with these splints other than keep them dry. Both the outside and inside splints will be removed in the office 7 days after your surgery.
Pain
Mild pain is to be expected during rhinoplasty recovery. You should take any prescribed pain medications as instructed, and you may switch to Tylenol when pain has lessened. In many patients, Tylenol alone is sufficient to manage pain by the second or third day after surgery. You should also avoid certain medications that can potentially increase bleeding, such as aspirin, NSAIDs (like ibuprofen, Motrin, or Advil), other anti-inflammatory medications, vitamin E, and herbal supplements. If you are taking one of these medications, let us know during the consultation visit so we can plan when to safely resume them. Additionally, cool compresses will help with immediate post-operative pain.
Cleaning and Maintenance
It is very common during the first 48 hours after surgery to have some mild bleeding from your nostrils. These are usually just a few drops of thin blood. You’ll have a small cotton dressing under your nostrils that can help absorb any drainage. We’ll show you how to change this before you leave our facility. After 48 hours you can remove this and can gently start cleaning the inside and outside of your nostrils. This is best done with a Q-tip and a mixture of water and hydrogen peroxide. It is very important to keep the nostrils and incisions clean, as this will help ensure healing occurs as rapidly and efficiently as it can.
After the splint is removed at day 7, you’ll notice some oily build-up on the bridge of the nose. I recommend starting a facial degreaser and a topical retinol on the nose at this point. Keeping the skin healthy during the healing phase is critical in ensuring that it takes on the new shape of the nose naturally.
Long-term Success
Remember, swelling can last up to 1 year, and sometimes longer depending on each patient’s individual case. Other items to help ensure rhinoplasty success include avoiding aggressive exercise for 6 weeks (and contact sports for 6 months). Using sunscreen daily for overall skin health and avoiding excessive sun exposure prior to and 1 month after surgery are essential. My goal for you is to achieve a nose you’re proud of. Following this rhinoplasty recovery plan will help ensure we achieve your goals. I am with you every step of the way and encourage you to call at any time with concerns or questions! Please request a consultation or call us at
(817) 442-1236 to get in touch.