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Rhinoplasty facts
These procedures are done to change, correct, or repair the nose.
A thorough discussion of the patient's goals, anticipated results, and possible surgical limitations is an essential part of pre-surgical planning.
Surgery is usually done in an outpatient surgicenter facility under anesthesia.
Assistance is required for the first day after surgery.
Several office visits for nose care and optimal results will be necessary following surgery.

What is rhinoplasty?
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Rhinoplasty is a facial cosmetic procedure, usually performed to enhance the appearance or reconstruct the nose. During rhinoplasty, the nasal cartilages and bones are modified, or tissue is added, to improve the visual appeal of the nose. When rhinoplasty is used to repair nasal fractures, the goal is to restore pre-injury appearance of the nose.

Initial evaluation for rhinoplasty
Cosmetic concerns and expectations should be fully discussed prior to surgery. The surgeon's recommendations and any particular limitations set forth by the structure of your face, skin, and nose are important to have and understand explained. Photographs (without make-up) are usually obtained before surgery to help with preoperative planning and after surgery to document postoperative results.

Quick Guide
Cosmetic Surgery: Before and After Photos of Cosmetic Surgeries
Cosmetic Surgery: Before and After Photos of Cosmetic Surgeries

What happens before rhinoplasty surgery?
In most situations, the surgery is performed as an outpatient at either the surgicenter or the hospital. Usually, the anesthesiologist will call the night before surgery to review the medical history. Preoperative laboratory studies will need to be done several days in advance.

Aspirin, or any product containing aspirin, should not be taken within 10 days of the date of surgery. Non-steroidal anti- inflammatory medications (such as Advil, Motrin, Naprosyn) should not be taken within 7 days of the date of surgery. Prescriptions for pain medications are usually written prior to the date of surgery and should be filled in advance.

No food or liquids should be consumed within 6 hours prior to the time of surgery. This will help to reduce postoperative bleeding and coughing. Difficulty with tissue healing has also been noted in smokers during the postoperative period.

Any illness prior to the day of surgery should be reported to the surgeon's office as soon as possible. , if illness occurs the day of surgery it is best to proceed to the surgical facility as planned and be evaluated to decide if surgery is safe.

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What happens the day of Rhinoplasty Surgery?
It is important to check in with the surgical facility on time. Wear comfortable loose fitting clothes that do not have to be pulled over the head. Remove all make-up with a cleansing cream.

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). Depending on what is required and what additional procedures are performed, the surgery may take one to several hours.

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.

At home the patient should have bed rest with the head elevated on 2-3 pillows. 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. Ice on the face, bridge of the nose, and eyes as much as tolerated will help to minimize these problems.

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.

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It is not unusual to change these dressing every hour during the first 24 hours after surgery. 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
Avoid hot liquids for several days. Patients occasionally vomit one or two times immediately after surgery; if it persists, medication to settle the stomach may be prescribed.

Antibiotics are prescribed after surgery. It is very important to take this medication as prescribed, and not discontinue it prematurely. No other medications, either prescribed or over-the- counter, should be taken without the knowledge of your doctor.

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What is the post-operative care for rhinoplasty?
In most situations, packs will have been placed in the nose to control postoperative bleeding. Immediately after the nasal packs are removed, a saline nasal spray such as "Ocean Spray" is used several times per day to prevent crusts from forming in the nose. The nose is usually tender after surgery, so a spray of special numbing medication is used before removing crusts.

After the packing has been removed, breathing through the nose is acceptable, but do not sneeze or blow through it for 7-10 days. Expect some light blood-tinged drainage from the nose for several days.

Rest for the first week following surgery. Facial tanning is discouraged for 6 months after surgery. Make-up may be worn anytime after surgery.

After several days a few of the absorbable sutures may become noticeable. They will often be tender for several weeks, and there may some numbness of the teeth and palate for several months.

If there are no bleeding problems, exercise and swimming may be resumed after 3 weeks. Diving should be postponed for two months. It is advisable not to schedule travel for three weeks following surgery to allow for proper postoperative recovery and healing.

Notify Your Doctor If You Have:
A sudden increase in the amount of bleeding from the nose unrelieved by head, ice, and pressure elevation.
A fever greater than 101.5 degrees F which persists despite increasing the amount of fluid intake and Tylenol. A person with a fever should try to drink approximately one cup of fluid each waking hour.
Persistent sharp pains or headache that is not relieved by the prescribed pain medication.
Increased swelling or redness of the nose or eyes.
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What are the risks and complications of rhinoplasty?
This surgery, as any surgery, may involve risks of unsuccessful results, complications, or injury from both unforeseen and known causes. Because individuals differ in their response to surgery, their anesthetic reactions, and their healing outcomes, ultimately there can be no guarantee made as to the results or potential complications.

The following complications have been reported in the medical literature. This list is not meant to be inclusive of every possible complication. Many of these complications are rare, all have occurred at one time or another in the hands of experienced surgeons practicing the standard of community care.

Nasal obstruction due to failure to straighten the septum or later re-deviation of the septum, collapse of the nasal cartilage, or the re-growth or swelling of the turbinates.
Failure to resolve coexisting sinus infections, or recurrence of coexisting sinus problems and/or polyps, or the need for further or more aggressive surgery.
In rare situations, bleeding can lead to a need for blood products or a blood transfusion. Autologous (self-donated) or designated donor blood may be arranged in advance in case an emergency transfusion is necessary.
Chronic nasal drainage or excessive dryness or crusting of the nose or sinuses.
Need for allergy evaluation, treatments, or environmental controls. Surgery is not a cure for or a substitute for good allergy control or treatment.
A cosmetic result that does not meet expectations; possible need for revision surgery.
Failure to resolve associated "sinus or nasal" headaches. The exact cause of headaches can be difficult to be or determine from many different causes. A consultation with another specialist such as a neurologist may be necessary.
Damage to the eye and associated structures (rare).
Permanent numbness of the upper teeth, palate, or face.
Prolonged pain, impaired healing, and the need for hospitalization.
Septal perforation (a permanent hole inside the nose between the two sides).
Failure to restore or worsening of the sense of smell or taste, or failure to relieve nosebleeds.

Photographs (without make-up) are usually obtained before surgery to help with preoperative planning and after surgery to document postoperative results.

Non-steroidal anti- inflammatory medications (such as Advil, Motrin, Naprosyn) should not be taken within 7 days of the date of surgery. Swelling and bruising of the nose, upper lip, cheeks, or around the eyes for several days after surgery is a normal occurrence. A nasal splint or cast will cover the outside of the nose, and will usually be removed one week following surgery. The nose is usually tender after surgery, so a spray of special numbing medication is used before removing crusts.
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Bellingham Rhinoplasty Experts

2418 Alabama St
Bellingham, WA 98229

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P: 877-011-2345

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