Christopher Thomson F.R.A.C.S
Ear, Nose and Throat & Facial Plastic Surgery
Phone: +64 (03) 356 0274
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Patient Information on Surgery of the Nose - Rhinoplasty

Modern rhinoplasty is a very popular procedure. It involves a change of shape to the appearance of the nose. There is no "standard nose" - exactly what can be accomplished varies with every case. Changes can be made to the bridge of the nose, the tip or the nostrils. These can be done together, but the more complex the procedure, the less predictable the result.

After surgery a plaster will cover the nose to hold it in its new shape. This is removed after about 1 week. Nasal packing is sometimes required and usually removed the day after surgery. Many patients develop bruising around the eyes, all patients develop swelling around the nose. There is wide variation in the amount from patient to patient. Bruising usually settles over 1 to 2 weeks, but rarely may persist longer, Although the nose usually looks acceptable by 1 to 2 weeks, a few patients may have persistent swelling, especially in the lower half of the nose.

It is important not to over exert during the healing period or troublesome bleeding may occasionally occur and require repacking of the nose. Eyeglasses should not be worn for 5 weeks after surgery and prolonged sun exposure to the skin of the nose should be avoided for 3 months after surgery.

Swelling of the lining of the nose occurs along with the general swelling of the region and produces a mild obstruction of the nasal air passage. The tip of the nose often feels numb for some months but this is quite normal and usually recovers completely.

Minor irregularities along the bridge line may be felt by a discerning finger. These should not be regarded as serious because they are seldom visible. However, persistent irregularities of contour in the bridge line do occasionally follow this reconstructive surgery even in expert hands due to the vagaries of healing. If still present one year after the operation they may be enhanced by a further operation but this is rarely necessary.

In the first few weeks there may be a feeling of stiffness or numbness in the upper lip. This is because swelling in the nose can affect the movement of the lip. As with all other changes due to this swelling process, it is usually quite transient. The lip or a front tooth may become numb, usually a temporary problem.

Finally, obviously there can be no guarantees with any surgery. Remember improvement not perfection is the realistic aim. A further operation may occasionally be helpful to improve the result.

Should there still be any question regarding this surgery, be sure to get them answered in advance by myself. Well meaning friends are not a good source of information! Find out everything you want to know before the operation - a well informed patient is a happy one!

Postoperative Instructions after Rhinoplasty

Be patient. Swelling will persist for 2 to 3 weeks.

Regular Postoperative Care

Apply antibiotic ointment to the inside of the nostrils 3 to 4 times per day for 2 weeks.
Antibiotic tablets are continued for 1 week.
Keep the plaster case dry until it is removed (generally at 1 week).
Keep your head elevated, do not bend over or strain excessively for a week.

Pain

Paracetamol, codeine combinations may be used e.g. panadeine. DO NOT USE ASPIRIN or products CONTAINING ASPIRIN as they may produce a nose bleed.

Nose blowing

Gently only for the first 10 days. The nasal congestion usually resolves after 7 to 14 days. If you feel a sneeze coming on, do it through an open mouth.

Bloody discharge

Expect decreasing amounts over 7 to 14 days depending upon the exact type of surgery performed. Please report frank nose bleeding to me.

Nasal and Facial Appearance

In the first few weeks, the nostrils will be asymmetric and the tip of the nose may seem raised. The shape of the nose takes many weeks to settle. There will be swelling in areas of the nose and cheeks. Be patient. The final result may take 6 to 12 months to appear.

Events after Rhinoplasty

Eye Glasses The weight of glasses may deform the nasal bridge for 4-5 weeks. Until then, suspend from forehead using tape.
Makeup May be used at any time.
Bruising Variable - Usually resolved at 1-2 weeks.
Return to work Usually at 1 to 2 weeks.
Strenuous exercise 3 weeks.
Contact Sport After 2-3 months, but ideally avoided after rhinoplasty.
Bathing, washing hair At any time, provided the nasal plaster cast is not wet.
Sun protection Direct sunlight may cause skin markings. Use sunscreen regularly for 3 months.

The above table serves only as a guide. Feel free to discuss specific problems with me.

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