Many of my Orange County rhinoplasty patients are concerned about post-op recovery.
In majority of my cases, a full rhinoplasty is required. This means the hump is reduced, the tip is refined, the septum and the inside of the nose are addressed, and the bones are narrowed.
For such cases, I have been using the open rhinoplasty technique for over 10 years, since it allows better visualization of the entire nasal anatomy, thus resulting in a more predictable result. The trade-off is slightly more swelling, especially in the tip area, which may take longer to resolve.
After surgery, the patient will have a splint on the nose for protection and nasal packing. Some surgeons prefer to use internal splints rather than packing. This is a personal preference. In my hand, I have had better consistency with packing as I can modify the amount on each side. The patient breathes through his/her mouth until the packing is removed. It is critical for the patient to keep the head elevated to minimize swelling, and to avoid sneezing or blowing the nose.
The patient is seen 24-48 hours after surgery. Most patients are surprised the amount of pain is less than expected. I have had a few patients who have had breast augmentation and rhinoplasty. All agree the pain of breast augmentation was worse than rhinoplasty. At this time, the splint and packing are inspected to make sure every thing is in place, and the patient has no bleeding. The patient should not wear any glasses.
The next follow-up visit is 7-8 days after surgery. At this time, the splint and packing are removed. For open rhinoplasty, I use absorbable sutures at the base of the columella, and no removal is required. I always warn the patient although the nose has improved, there may be significant swelling at this time. The patient should avoid blowing the nose or sneeze forcefully. No glasses are to be worn unless they can be fitted so there is no pressure on the bridge of the nose. If the patient has dry nose, over the counter salt water sprays can be used as often as needed. No exercise or heavy activity is permitted.
The patient returns for their one month visit. The patient is concerned about the swelling, especially in the tip area. Although the swelling has improved, it is still present. I remind patient the swelling usually starts improving at 3 months. However, the final shape of the nose may take 6-12 months. During the first three months, it is common for the nose to go through cycles of less and more swelling. The patient may start exercising and wearing glasses. Obviously, I do not recommend contact sports at this time!
The three month follow-up has arrived. The nose is beginning to take its shape and the patient is happier. I have noticed a metamorphosis in many of my patients at this 3 month follow-up. At the time of consultation, most patients are somewhat shy. At this follow-up, they walk and act more confidently. Many of my female patients have make-up on with nice clothes. It is a joy to see this change!
At the six month follow-up, the swelling in the nose is minimal to none. The patient is pleased with the result. They still walk and act confidently!
One year follow-up has arrived. The nose has achieved its final shape. However, over the coming years, minor changes will occur in the shape of the nose, which are detectable only by comparing photos.
This is a typical recovery for a rhinoplasty patient. Not everyone will have the same experience and, rarely, complications do occur.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call (714) 834-0101.
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