Recovery after rhinoplasty - what to expect and when

Preparing for surgery is an important part of ensuring a positive outcome. This is a major undertaking for most patients and understandably, there is a degree of uncertainty about what to expect afterwards. Below is an outline of the different phases of recovery.

On the day of surgery

Patients come in on the morning of surgery. The procedure is performed under general anaesthetic (asleep) but patients are awake within half-an hour of the end, sitting up and talking. There is a splint on the nose and a few sutures under the tip. The majority of my patients go home on the day of surgery (daycase) but can stay the night in hospital should they choose to.

The first week

Patients are able to eat and drink normally, walk to the shops and look after themselves. Most patients worry about pain after surgery but generally, this is not a bit issue an easily controlled with simple regular painkillers (paracetamol, ibuprofen). Some oozing is common from the nostrils in the first 2-3 days and also at the back of the throat. Patients are seen at 1 week to remove the sutures and ensure everything is healing normally. Some bruising under the eyes and cheek is normal at this stage but resolves within 10-14 days.

IMG_7641.jpg


The 2nd week

The swelling and bruising dissipates. Although initially congested, patients usually start to be able to breathe through the nose again. Patients are seen in clinic at 2 weeks and the splint is removed. The change is usually immediately apparent although it will be many months before the final result is achieved. It is often an emotional event - seeing the new nose for the first time. Most patients are thrilled but at the same time, the change can initially feel overwhelming. By this stage, the signs of surgery (bruising etc.) are not usually apparent at conversational distance such that patients can function socially (go out for dinner) or return to work without fear of being noticed.


Immediately after cast removal (in this case at 1 week).

Immediately after cast removal (in this case at 1 week).

2-6 weeks

In the first 6 weeks, the changes are noticeable on a day-to-day basis as the swelling goes down. By 6 weeks, 60-70% of the swelling has resolved. Patients can return to normal exercise (running, lifting weights, gym). Breathing through the nose should return to normal (and often improved) but for sufferers of hayfever, the nose is often more sensitive to allergens in the first season after rhinoplasty.

6 weeks post open rhinoplasty

6 weeks post open rhinoplasty

6 weeks - 1 year

After 6 weeks, changes continue to occur albeit at a much more slow pace - on a week-to-week basis rather than daily. The final result is usually apparent after 1 year although in truth, changes still continue afterwards.

Advanced facial liposcultpure - fine tuning facial appearance with fat grafting

Fat grafting is an increasingly popular plastic surgery technique that allows fine adjustments to facial structure in a completely natural way. It is often used in conjunction with other procedures such as facelift or rhinoplasty but is also has great benefit on its own.

The procedure

IMG_4154.jpg

 

Fat is harvested through a tiny incision in a process similar to liposuction - therefore is an added benefit of removing bits of unwanted fat (e.g. tummy). The fat is purified and then injected with pinpoint accuracy using small cannulas. It is generally performed under general anaesthetic but it is also possible to perform under local anaesthetic. About half the fat is resorbed by the body and about half remains. Being part of your own body, it is more safe and natural than synthetic fillers and also has a much greater scope of effect.

 

Case Example

AC Fat graft.jpg

 

In this case, fat has been injected into the forehead to even out forehead contour and the chin to increase projection. This has been performed at the same time as rhinoplasty to improve the overall side profile. 

 

Preparing for a Rhinoplasty Consultation

rhinoplasty surgery consultation

It is best to be prepared for your consultation to get the most out of it. Here are a few things to think about beforehand:

1. Be clear about what changes you are hoping for - what part of your nose you are unhappy with (tip, side profile, size, crookedness). Goal photos can be helpful as articulating your goals can be difficult as the terminology is often quite confusing.

2. Think about how surgery may impact your life and have a list of questions relating to recovery/ time off work.

3. Be confident in your surgeon. Ask to see a portfolio of before and after photos and make sure this is a routine part of their practice and therefore and area they have genuine expertise in.

4. Consider a follow-up consultation if you are keen to proceed with surgery. It is often helpful to go through the plan again and provides a chance to mop up any unanswered questions.

Rhinoplasty Photos Uploaded

I have just added some examples of rhinoplasty cases to the ‘Before & After’ section.

What is rhinoplasty?

Rhinoplasty is the term used to describe nose-reshaping operations. The aim of rhinoplasty is to improve the appearance of the nose delivering a natural, non-operated look that is well balanced with the rest of the face.

Who would benefit from rhinoplasty?

1.     Cosmetic rhinoplasty. The desired appearance of the nose is very individual and culture-specific. Rhinoplasty can remove bumps, adjust length and width and improve tip definition and projection.

2.     Rhinoplasty after broken nose. Rhinoplasty can straighten crooked noses, remove bumps and adjust abnormalities on the inside of the nose (septoplasty) that are the result of previous trauma, improving appearance and function.

3.     Revision surgery. If you’ve already had a previous rhinoplasty and are unhappy with the result or would like some aspect adjusted, revision surgery may be appropriate.

The operation

Rhinoplasty is carried out under general anaesthesia. Incisions are well concealed on inside the nose and underneath the tip. The procedure takes around 2 hours. It is usual to stay overnight in hospital.

What to expect

A small splint is placed on the outside of the nose for 7 days. Some bruising occurs around the eyes, but usually subsides over 7-10 days. A more in depth discussion of the individual operative plan, risks and expectations will be covered over two pre-operative consultations.

What is liquid rhinoplasty?

Liquid rhinoplasty is a non-surgical treatment that changes the shape of the nose using injectable fillers. It is not as effective or long-lasting as surgical rhinoplasty but may improve the overall appearance of the nose by concealing humps, dips or depressions. This is a simple technique that can be done in outpatients.