Rhinoplasty

What to expect

Your nose will feel congested and there is often a feeling of pressure and possibly headaches as if you have a cold or sinus infection for the first week, and you may have bruising.
Usually you will be provided with a script for antibiotics, Bactroban antibiotic ointment and pain killers. For pain relief it is generally best to take regular paracetamol and an anti-inflammatory such as nurofen, with stronger pain relief used when needed.
You will get some blood and mucus from the nose, particularly while the splints are in place – use a nasal bolster or tape a piece of gauze under the nose with micropore tape if needed rather than constantly wiping the nose.
Decongestant spray (e.g. Flo Rapid Relief) can be used if necessary to reduce bleeding. If you have excessive bleeding, you can use 6-10 sprays if needed.
If you have excessive pain or bleeding, call your surgeon.
Your front teeth and / or top lip may feel unusual - this is normal!
A sore throat is common and should settle once the splints are removed.
Your ears may pop or bubble when you swallow.
There will usually be a moulded plastic splint on the outside, sutures under the nose and silicone splints inside the nose which are removed after 5-6 days in the clinic – if an appointment isn’t made for you from the hospital, please call my rooms to book in.

Keep the nose clear of crusting as much as possible by cleaning it 3 times a day:
- Use Flo Sinus care to flush the nose.
- Then gently clean the nostrils and sutures under the nose with a moist cotton bud, trying to gently lift off crusts or scabs. Hydrogen peroxide can be used to help with this.
- Then apply antibiotic ointment (usually Bactroban, it should be supplied from the hospital or on a script for you) on a cotton bud to the nostrils and the sutures.
After the splints come out, keep doing this for another week then you can stop using the cotton buds and bactroban.
The nasal wash is supposed to flow out of the other nostril, but it may not do this very well while the splints are in place – don’t force it and just let it drip out, the wash will flow through once the splints are out.
The wash should be used for 6 weeks after the surgery – 3 times a day for the first week, twice a day after the splints are removed, then once a day when there is no more blood or mucus coming out in the wash.

During the first week, gentle exercise such as walking is fine but otherwise take it very easy.
Avoid lying flat as this can increase swelling, pain and bleeding – sitting in a chair or recliner is ideal and try to prop yourself up at night.
During the second week you should be feeling a lot better but should still avoid heavy lifting and strenuous exercise as you may trigger bleeding, and contact sports should be avoided for at least 6 weeks.
Most people will take 2 weeks off work.
Generally, avoid blowing the nose while the splints are in place and use the sinus wash instead. Once the splints are out, blowing the nose is fine but keep it straight and don’t wiggle the nose.
If the nasal bones have been affected as part of the surgery, avoid pressure from glasses, especially if they are heavy, for at least 3 weeks.

The nose will still tend to swell, particularly at night. You can reduce this by:
- Taping the nose at night – use strips of thin micropore tape cut to different lengths taped across the nose horizontally before bed, then remove them in the morning
- Or, you can keep the external splint and tape this back on overnight with micropore tape
- Elevating the head of the bed will also help
Gently massaging the nose can help reduce swelling and keep the nose straight. Your surgeon will demonstrate this for you at the first postop visit.