How to prepare:
It is important that you are not taking any medications that thin the blood prior to your surgery. You will be provided with a list of medications and the time period in which they need to be stopped before having your surgery. If you are a smoker, you must not smoke for 4 weeks prior to surgery and for 8 weeks after. Arrange for a friend or family member to escort you home from surgery and to remain with you for 24 hours following your surgery.
What will happen during a rhinoplasty:
Once in the operating room, you will receive anesthesia to keep you asleep during your surgery. The incisions created depend on the type of rhinoplasty you are having. During an open rhinoplasty you will an incision on the underside of nose between the nostrils and inside your nostrils. For a closed rhinoplasty, incisions are only made inside the nose. Some surgeries also require additional incisions, either behind the ears or on the chest if cartilage from a different area of the body is needed to provide greater support to your nose. Your surgeon will discuss with you prior to your surgery if this may be needed. Special tools may also be used to remove bone and cartilage from the bridge of the nose or to fracture your nasal bones to reshape the nose. Patients who also have difficulties breathing may also undergo a septoplasty, or removal of a portion of the nasal septum to remove tissue which obstructs the movement of air through the nose. A splint is usually placed on the nose once the surgery is completed. It is generally worn for 1 week and removed at your post-operative visit.
What are the risks:
Rhinoplasty carries the risk of bleeding and infection. You also may not look exactly as you wished or expected to look after the surgery. Revisional surgery to correct or improve an outcome may be necessary. After surgery most patients have a difficult time breathing through the nose due to swelling and possibly the presence of nasal packing. Other risks include the poor appearance of the scar, and very rarely the leakage of spinal fluid from your nose or damage the eyes causing decreased vision.
What to expect after surgery:
You will need to take antibiotics to prevent infection and will also be given pain medication to take if needed. It is important that you keep your head elevated at all times to prevent swelling and reduce pain. You must sleep on 3-4 pillows or in a recliner for the first week. Applying ice to your nose for 15-20 minutes every hour for the first 24 hours will help reduce swelling and pain. Be sure to wrap a towel around your ice pack and not apply it directly to your skin. It is important you do not blow your nose and you must sneeze with your mouth open to reduce pressure in the nose. You will be required to return for post-operative visits to check your wounds, remove any sutures or splints, and check for any other post-operative problems. It is very important your protect your nose from any trauma for several weeks after your surgery.
Contact your surgeon if:
- Your splint comes off
- You feel blood draining down your throat
- You have a fever over 101 deg F
- Your nose is red or draining pus
- Your upper teeth, gums, or nose is numb
- You have a change in vision
- You have severe pain
Seek care immediately or call 911 if:
- You have trouble breathing
- Clear, thin fluid is draining from your nose when you bend forward