After Rhinoplasty (Nose Surgery)

1. No lying flat.  Sit up or lie with head of bed elevated 30-45 degrees.  This is necessary to decrease edema (which will cause difficulty with breathing).
2. No nasal breathing.  Mouth breathing instead.  Good oral hygiene will be necessary as mouth will become dry.  Also increase fluid intake for same reason.
3. Use air humidifier in immediate postoperative phase to keep nasal passages moist.
4. Sense of smell may be diminished.  Nasal numbness sensation may also occur.  These generally resolve with time.  Avoid nasal irritants like smoke and fumes due to potential discomfort they may cause.
5. Ice may be used topically on face to decrease edema (most benefit in first 72 hours) and minimize bruising.  Ice must not be placed directly on face.  Place facecloth between ice and face (burning).  Apply 15-20 minutes at a time and remove for same.
6. Due to risk of prolonged bleeding, avoid Aspirin, Ibuprofen, and other NSAID (Non steroidal anti-inflammatory drugs) medications.  For bleeding, apply firm, direct, pressure with finger to nostril until bleeding stops.  Head remains forward.  Do not tilt head back.
7. Sneezing – Do not close mouth when sneezing.  Mouth must remain open.  Closing of mouth causes an increase in surgical site strain and potentially can cause nasal sutures to move.
8. No heavy lifting or straining.  This causes surgical site strain as well as increases chance of nasal bleeding.
9. If nasal packing is used, there may be some difficulty with swallowing.  A sucking action will occur in the throat because packing doesn’t allow air to pass through the nose thereby creating a partial vacuum.  Small sips are preferred.
10. A mustache dressing may be used.  This is a folded 2×2 gauze placed below nares and secured with tape as a drip pad for bleeding.  Change as needed.
11. Nasal/facial edema may interfere with field of vision if swelling reaches to eye region.  Use caution with depth perception, operating vehicles or machinery, etc.  There is no permissible machinery operation postoperative for 12-16 hours until the effects of the anesthesia have worn off.
12. Keep nostrils clean with Hydrogen Peroxide dipped Q-tips applied topically to nostril.  Cleaning required more frequently first 3 days postoperative. 
13. No glasses on nose for first 10 days postoperative.
14. Nasal numbness (especially tip of nose) is common for the first several weeks as nerves re-grow, it will return.
15. Physical activity should be limited to that which does not increase pulse above 90 or cause increase blood pressure for 4-6 weeks postoperative.
16. Patients who received general anesthesia should return home from our office immediately upon discharge and lie down with the head elevated until all the effects of the anesthesia have disappeared.  Anesthesia effects vary by individual, and you may feel drowsy for a short period of time or for several hours.  You should not operate any mechanical equipment or drive a motor vehicle (including ATV’s, dirt bikes, etc.) for at least 24 hours or longer if you feel any residual effects from the anesthesia.  Do not use appliances or equipment that could be dangerous such as power tools, stoves, burners or lawn mowers.  Watch out for dizziness.  Walk slowly and take your time.  Sudden changes of position can also cause nausea, dizziness or even fainting.  Do not drink any alcoholic beverages.  The drugs in your body may increase your reaction to alcohol and could be dangerous.