Patient Instructions for Rhinoplasty (Nose Surgery)

Reading the below tips and instructions for Rhinoplasty (Nose Surgery) which are written by Dr. Shahriyar Yahyavi, will help you to have a better preparation before nose surgery and better recovery after nose surgery. 

1) Because of taking hypnotic drugs, patients shouldn’t eat or drink at least an hour after entering the sector. After about an hour, and in the absence of nausea, the patient (after getting permission from the nurse) can drink sweet liquids like fruit juice or water slowly.

2) Nausea after surgery may occur because of anesthetic drugs. If you have nausea, please stop drinking and inform the nurse. Rarely, due to hypersensitivity to anesthetics, severe nausea and vomiting (which usually contains blood) will occur. Fortunately, this situation will be temporary. It is better to stop eating and drinking till the nausea is over.

3) Patients are advised to eat soft foods like soup and stews for first two days after the surgery.

4) For patients with thick skin, or patients who have acne on their skin, it is recommended that they take natural juices.

5) If possible, adjust the bed level and put the upper body of the patient in a state of 30 degrees to have less congestion and swelling in his head and face.

6) Having blood and plasma in the patient’s nose bandage for several hours (sometimes up to 2 days) is normal and is not a sign of bleeding. Of course, this case is more severe in men.

7) Intermittent use of ice and cold compress on the eyes and nose for 48 hours is recommended (when sleeping, do not use ice compress). It is mentioned that ice compress will not cause or aggravate sinusitis.

8) Prediction of discharge time is approximate and depends on the patient’s general condition, but in most cases, if the patient does not have vertigo and nausea (for about 3 hours after surgery) he can go home with nurse’s permission.

9) Since many patients are weak and lethargic after nose surgery (for 24 hours), the use of toilet should be made with caution and with hands holding the walls.

10) At home, it is recommended that the patient rests (during the day) in a semi-upright position. For example, like the position when a person usually sits in front of the TV, then the patient will have less swelling.

11) When sleeping, using an extra pillow under the head helps to reduce swelling of the face.

12) Preferably for 4 nights, it is better that the patient sleeps in a supine position and after that the patient can sleep in any form.

13) If there is no vomiting, the patient can eat low-fat soup 8 hours after nose surgery.

14) Patients are advised to eat soft foods like soup and stews for first two days after the surgery.

15) Please start taking prescribed medications from the moment of arriving to hotel. Generally, medicines contain 20 capsules cephalexin (every 6 hours – 1 capsule) and 10 tablets of acetaminophen with codeine (every 4 hours – 1 capsule) and a half liter of serum washing salt and eye vitamin A ointment and phenylephrine drops.

(Some of the patients feel pressure in their nose but fortunately most of the patients won’t have a lot of pain after nose surgery.)

16) In case of pain, just use acetaminophen or acetaminophen with codeine. Taking any other medication (due to the risk of bleeding) is not allowed.

17) In most of the patients, a special kind of nasal tampons (called Silicone Tampons) is used, which has airways for an easier breathing. They will be removed from the nose, at the time of cast removal.

18) After removing the nasal tampons, start washing your nose regularly with saline solution. At least 4 to 6 times a day (using a 5ml syringe) pour saline into your nose and lead nasal discharge upward and spit them (slowly) out of your mouth or let them come of your nose.

19) Note that you should not clean your nose for 2 weeks by snorting.

20) After removal of nasal tampons, usually because of swelling inside the nose, your breathing will be accompanied by some sounds and it will be difficult, but these problems will be solved gradually.

21) If you have nasal congestion, you can use phenylephrine for maximum 5 to 7 days to improve breathing. (3 drops in each nostril, in the morning and at night).

22) It is recommended to keep inside of your nostrils greasy, so please use Vitamin A Ointment 2 times a day.

23) It is possible that because of swelling inside your nose, one side or both sides are blocked, in that case, do not worry.

24) Having blood or plasma, the patient’s nose bandage will be bloody. Therefore, for the convenience of the patient, try to replace it every 8 or 10 hours, if necessary.

25) For changing the bandage under the nose, use a gauze (sterile) and a roll of tape, for holding the bandage.

26) Sneezing and a runny nose are common, and often not a sign of a cold. Please keep your mouth open when you sneeze to avoid applying pressure to your nose. If the number of sneezing is annoying, taking the pills of Antihistamines Decongestants (one tablet every 12 hours or every 24 hours), can partly control it.

27) Swelling and bruising around the face and eyes depends on the type of operation, operation’s duration, patient’s skin, the thickness of the nasal bones, type of anesthesia and the patient’s age. Bruises usually begin a few hours after the surgery.

(Bruising and swelling in the second and third days reach its climax and then gradually will be removed.)

28) Rarely bruising and swelling of the face and eyes may be non-symmetrical. In one side it might have greater intensity. This issue will be resolved spontaneously.

29) Sometimes asymmetrical swelling leads to tilt of the cast (plaster) of the nose, which is not worrying. With the removal of the cast (plaster), this feeling will be relieved.

30) Wearing glasses is not permitted for 8 days after the surgery. After 8 days you can wear glasses.

31) Using contact lenses from the fourth day onward is allowed.

32) Patients who have stitches on their nostrils can dislodge blood clots on the fifth day. To remove blood clots, use a cotton soaked in alcohol/water and rub it on the stitches. Usually from the fourth day onward, some of stitches will fall-off spontaneously.

33) Cast (plaster) on your nose must not get wet. If you want to take a shower, please only wash your body. If you want to wash your hair, it’s recommended to go to saloons, in order to avoid the cast getting wet.

34) Usually, 5 to 7 days after nose surgery, cast (plaster) on your nose will be removed by my assistant. One hour before coming to the office for removing the cast, take a complete shower with lukewarm water, and make your nose cast thoroughly wet.

35) If your nostrils are stitched, the stitches will be removed at the same day of cast removal.

36) Sometimes for patients with thick skin (oily skin), cast (plaster) on their nose will become loose sooner than the expected. In this case, inform me or my assistant at the earliest.

37) If you are given additional cartilage, please keep them in a cool and dark place.

38) Laughing or talking too much is not harmful to the nose and is allowed.

39) If your nostrils are cut, you can use scar repair creams (Stratamed, etc.) on the cuts. Please use it 7 days after the surgery, and use it for 2 weeks. Apply twice a day.

40) All stitches inside of the nose are absorbable and will fall off or absorb by themselves.

41) It is recommended to the patients with thick skin not to eat honey, dates, walnuts, wine, chocolate and sweets for 2 to 4 weeks after the surgery.

42) After the surgery, the incidence of discoloration around the nose and face and having red acnes in some patients is normal.

43) The patients with thick-skin and oily noses, should avoid solarium for 6 months after surgery.

44) Having normal breathing after the surgery can take up to 2 months. Breathing difficulties are usually normal after the surgery and it’s not worrying. 

45) Snoring after the surgery in patients who have snoring background, or are over-weighted is normal. These patients should avoid gaining weight.

46) Having some asymmetries in the first few months after the surgery is normal. As the swelling is reduced, most of the asymmetries will go away.

47) Two months after the surgery, usually the patient might smell stench inside the nose which is due to the stitches falling off. By washing inside the nose using saline wash, the bad smell will fade away.