November 27, 2015
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Rhinoplasty (cont.)

What happens the day of Rhinoplasty Surgery?

It is important to check in with the surgical facility on time. Bring all papers and forms including any preoperative orders and history sheets. Wear comfortable loose fitting clothes that do not have to be pulled over the head. Leave all jewelry and valuables at home. Remove all make-up with a cleansing cream. Thoroughly wash the face with soap and water and do not apply make-up or creams.

Do not take any medication unless instructed to do so. Usually a nurse will start an intravenous infusion line (IV) in the pre-operative holding room and a medication may be given for relaxation.

What happens during rhinoplasty surgery?

In the operating room, the anesthesiologist will usually use a mixture of a gas and an intravenous medication. Continuous monitoring during the procedure usually includes a pulse oximeter (oxygen saturation) and EKG (cardiac rhythm). The surgical team is prepared for any emergency. In addition to the surgeon and the anesthesiologist, there will be a nurse and a surgical technician in the room. Depending on what is required and what additional procedures are performed, the surgery may take one to several hours. The surgeon normally talks with any family or friends once the patient is safely in the recovery room.

What happens after rhinoplasty surgery?

Patients are monitored after surgery in the recovery room by a nurse. A patient is able to go home the same day as the surgery once fully recovered from the anesthetic. This usually takes several hours. Transportation home will need to be arranged. A responsible adult should be in the same residence overnight for help on short notice.

At home the patient should have bed rest with the head elevated on 2-3 pillows. Edema and swelling are minimized by keeping the head elevated above the heart. An assistant should be available for out of bed excursions to the bathroom. Straining should be avoided. If constipated, take a stool softener or a gentle laxative.

Swelling and bruising of the nose, upper lip, cheeks, or around the eyes for several days after surgery is a normal occurrence. This will gradually go away over the next 7 to 10 days. Ice on the face, bridge of the nose, and eyes as much as tolerated will help to minimize these problems. This will also help with postoperative edema and pain. Some patients have found frozen vegetables in packages (for example, bags of frozen peas) to be a convenient ice pack which conforms to the face.

A nasal splint or cast will cover the outside of the nose, and will usually be removed one week following surgery. As swelling subsides, the splint tends to fit less tightly. If the cast gets wet it may come off prematurely; this is usually not a problem and does not affect the outcome of the procedure.

Moderate bleeding from the nose is normal, and will gradually decrease. The gauze dressing ("mustache dressing") will collect blood and should be changed only when saturated. It is not unusual to change these dressing every hour during the first 24 hours after surgery. This dressing will usually not be needed after a few days. Do not take aspirin, aspirin-containing medications, or non-steroidal anti-inflammatory medications (such as Advil) for 3 weeks following surgery.

Picture of Mustache Dressing
Picture of Mustache Dressing

It is best to eat a light, soft, and cool diet as tolerated after recovery from the anesthetic. Avoid hot liquids for several days. It is best to go slowly with food immediately after the procedure to prevent postoperative nausea and vomiting. Patients occasionally vomit one or two times immediately after surgery; if it persists, medication to settle the stomach may be prescribed. It is important to remember that a good overall diet with ample rest promotes healing.

Antibiotics are prescribed after surgery. It is important to finish all the pills that have been ordered. Some form of a narcotic will also be prescribed (usually vicodin) which is to be taken as needed. If narcotics are taken, it is important not to drive or engage in activities where impaired judgment could cause injury. In some situations steroids may be prescribed to be taken either preoperatively and/or postoperatively. It is very important to take this medication as prescribed, and not discontinue it prematurely. An anti-emesis medication such as phenergan may be prescribed for nausea or vomiting postoperatively. Possible drug reactions to any of these medications, such as a rash, should be reported to the doctor as soon as noticed. No other medications, either prescribed or over-the- counter, should be taken without the knowledge of your doctor.

Medically Reviewed by a Doctor on 4/14/2015


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