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Rhinoplasty

AMBULATORY CARE:

What you need to know about a rhinoplasty:

Rhinoplasty is surgery to repair or reshape your nose.

How to prepare for a rhinoplasty:

  • Your surgeon will tell you about how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight before your procedure. Arrange to have someone drive you home when you are discharged.
  • You may need to stop taking any medicines that thin your blood 1 week or more before your procedure. These medicines include aspirin, ibuprofen, and anticoagulants.
  • Your surgeon will tell you which medicines to take or not take on the day of your procedure.

What will happen during a rhinoplasty:

  • You may be given general anesthesia to keep you asleep during surgery. You may instead be given medicine to keep you relaxed and pain free during surgery.
  • Incisions may be made on your nose and around your nostrils (open procedure). You may instead have incisions inside your nose (closed procedure). You may also have incisions through your septum. The septum is the wall of tissue inside your nose that separates your nostrils.
  • Your surgeon may file or shave the bone to straighten or reshape your nose. He or she may need to break your nose bones to reshape your nose. Your septum may be straightened during surgery. Swollen tissues in your nose called turbinates may be trimmed or partially removed.
  • Any incisions will be closed with stitches. Gauze may be placed in your nose to help stop bleeding.

What to expect after a rhinoplasty:

  • You will have swelling, pain, and bruising for 2 to 3 weeks.
  • You may have a splint on your nose to protect it.
  • You may have numbness for several weeks to months.
  • It may take up to 1 year to see final results.

Risks of rhinoplasty:

You may bleed more than expected or get an infection. Your nose may not look the way you expected it to. You may have trouble breathing because of swelling in your nose. You may have skin irritation or a visible scar. Blood or fluid may enter your lungs when you inhale. Rarely, the tissues in your nose may start to die from the pressure of gauze packing. Your eyes may be damaged and cause blindness. The fluid around your spinal cord may leak from your nose.

Call your local emergency number (911 in the US) if:

  • You have trouble breathing.
  • Clear fluid comes out of your nose when you bend your head forward.

Seek care immediately if:

  • Your heart is beating fast or has an irregular rhythm.
  • You have severe pain.
  • You have red streaks on the skin around your nose.
  • Your nose or the roof of your mouth is pale or starting to turn black.

Call your doctor if:

  • Your splint is loose or comes off.
  • You feel blood draining down your throat.
  • You have a fever above 101°F (38°C).
  • Your nose is red, swollen, and draining pus.
  • You have a bad smell or taste in your mouth.
  • You have a change in your vision.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Antibiotics help prevent or treat a bacterial infection.
  • Decongestants help reduce congestion and help you breathe more easily. If you take decongestant pills, they may make you feel restless or cause problems with your sleep. Do not use decongestant sprays for longer than a few days.
  • Steroids help reduce redness and swelling.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Care for your nose:

  • Rinse your nose with saline 1 or 2 times a day, or as directed. Mix ½ teaspoon of salt and ¼ teaspoon of baking soda with 1 cup of warm distilled water. Nose rinses help remove crusts and prevent infection. Apply petroleum jelly to your nostrils after you rinse your nose. You may have gauze taped under your nostrils. Change the gauze if it gets wet or dirty. If you have a splint, do not get it wet or try to remove it.
  • Apply ice on your nose for 15 to 20 minutes every hour for 24 hours. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
  • Elevate your head and upper back. Keep your head and upper back elevated day and night to decrease swelling and pain. Prop your upper body on 3 to 4 pillows or sit in a recliner.
  • Protect your nose. Do not bump your nose or allow anyone to touch your nose. Avoid heavy activity or exercise.
  • Do not blow your nose. The increase in pressure can cause bruising, swelling, and bleeding. Try not to sneeze. If you have to sneeze, keep your mouth open to decrease pressure in your nose.
  • Use a cool mist humidifier. A cool mist humidifier will increase air moisture in your home. This will help keep your nose and throat moist and prevent irritation.
  • Avoid sun for 1 year. Sun exposure can discolor your nose or cause a sunburn. Use at least an SPF 30 sunscreen. Wear a hat to limit sun exposure on your nose.

Follow up with your doctor as directed:

You will need to return to have the stitches, gauze packing, or splint removed. You may also need frequent visits to monitor how well your nose heals. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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