Post Operative Advice Sheet - Rhinoplasty

1. You should arrange for someone to drive you home from hospital and to stay with you for the first night following your discharge from hospital.
2. You will experience mild to moderate discomfort after your surgery and it is recommended that you take one or two pain relieving tablets (such as Paracetamol) on a regular basis for the first week or so.  DO NOT TAKE ASPIRIN OR ANY PRODUCTS CONTAINING ASPIRIN as this may prolong or cause bleeding in the early post operative period.
3. There maybe considerable swelling and bruising following surgery, though this should settle over the first two or three weeks.  Although most of the swelling has settled by two weeks, there will be some degree of residual swelling which can take up to nine months to resolve. You will notice some firmness of the tissues around the operative site and this can be alleviated and softened by regular moisturisation and massage of this area from week six onwards. To minimise swelling and bruising around your eyelids you are advised to sit up right throughout the day and prop yourself up with several extra pillows at night for the first two weeks post operatively.  For the first 48 hours after removal of your nasal pack, you may experience some oozing from your nostrils which should simply be dabbed with a soft tissue.  Bleeding from the nose is rare, which can be stopped or reduced by keeping your head elevated and applying icepacks on the side of the bleeding.  Do not sneeze for at least two weeks after surgery.  If you feel a sneeze coming on try to turn it into a cough.
4. Do not do anything that would raise the blood pressure in your head, eg bending forward, straining, heaving lifting etc.
5. It is important to rest as much as possible for the first 48 hours after surgery, after which you can recommence gentle activities and household chores, but should refrain from exercising for at least two weeks. You will be expected to move around the home as much as possible and not lie in bed for protracted periods.
6. You should avoid getting the wounds or dressings wet for the first week.
7. About a week after the operation you will be seen in the Dressing Clinic by a nurse who will remove the external splint from your nose and if you have stitches just underneath your nose, these will be removed at this time.  Any tiny sutures inside your nostril be dissolvable and you should avoid picking at these or inserting anything into your nostril for at least three weeks post operatively.  You may may start using make up again as soon as the splint has been removed from your nose.Once the wounds have healed and they have been inspected by the nurse you will be advised that you may recommence bathing and washing of the scars.  Until this point, you should avoid getting your wounds wet.  You should avoid using make up for at least one week post operatively.
8. For the first week post operatively you should avoid doing any household chores and the second post operative week you may recommence light household chores.  You may return to swimming two weeks post operatively and can recommence exercises and gentle gym work one month post operatively.
9. I would have advised that it is important to stop smoking prior to your operation in order to reduce the risks of complications.  Once your wound has healed it is safe to recommence smoking if you wish to do so.  You should however, avoid smoking for the first two weeks post operatively.
10. You may commence driving 72 hours after your operation.  After this you may recommence driving once you feel confident to undertake an emergency stop, until you feel confident to do this you should refrain from driving.
11. Following surgery, the type of job that you do determines when you can return to work.  If you mainly confined to deskwork, you may feel able to return to work after two weeks.  More physical occupations may require four to six weeks of recuperation before you feel able to return to work.
12. Massage and moisturise the external scars from six weeks with E45 cream. The scar will take time to mature.  Over the first six weeks your scar will become stronger and stronger and by week six it will be as strong as it will ever be.    The delicate scar tissue is at greater risk of sunburn if exposed to the sun, therefore, you are advised to avoid sun exposure to any scar tissue for the first six weeks of healing, after this if the area is to be exposed to sunlight you should apply sun protection factor 15 or greater sun block to exposed scar tissue.
13. Though most people experience uneventful post operative recovery, if you develop any of the following you should contact the ward on the telephone number printed below:
• Temperature greater than 38.5°
• Severe pain not alleviated by simple painkillers
• Fresh bleeding from the wound, other than a minor ooze
• Any wound discharge after 48 hours