Early postoperative period
During the first two postoperative days, mild bleeding or spotting may occur. This is normal. There remains a risk of bleeding during the first two postoperative weeks. In the event of heavy bleeding, contact the operating surgeon immediately or go to the nearest Emergency Department.
Due to the risk of bleeding, you should not blow your nose too forcefully during the first two postoperative weeks. To make nasal clearing easier, it is recommended to rinse the nose with a seawater nasal spray (e.g. Quixx, Humer), which helps to thin nasal secretions. To soften nasal crusts, a nasal oil may be used (e.g. Coldastop oil).
During the first few postoperative days, nasal swelling develops, which may cause nasal obstruction. Reduction of the swelling takes several weeks. To relieve swelling and improve nasal breathing, topical nasal decongestant sprays (e.g. Xymelin or Otrivin) or appropriate tablets (containing pseudoephedrine) may be used.
After rinsing the nasal cavity, wounds inside and outside the nose must be cleaned with a 3% hydrogen peroxide solution. Use cotton swabs intended for ear cleaning. Apply a small amount of 3% hydrogen peroxide solution to the swab and gently clean the inside of the nostrils using light circular motions. If you also have wounds on the outside, clean them in the same way.
After cleaning, apply an antibiotic ointment to the wounds (e.g. Baneocin). Cleaning the wounds and applying antibiotic ointment is recommended twice daily for up to 14 days. The best results are achieved when the wound is continuously covered with a thin, even layer of ointment. Excessive rubbing of the wounds may cause the sutures to come loose and lead to infection.
Take the antibiotics and painkillers prescribed by your doctor according to the given treatment plan. During the first two postoperative weeks, do not take aspirin or aspirin-containing blood thinners. You may resume taking vitamins and dietary supplements after two weeks.
You may shower already on the day following surgery. Avoid getting water on the wounds and on the nasal splint.
Swelling and bruising of the nose and around the eyes increase during the first 3–4 postoperative days. In very rare cases, the swelling may become so pronounced that it is difficult to open the eyelids. Bruising around the eyes typically resolves within about two weeks.
Approximately 7 days after surgery, the nasal splint is removed. After removal, nasal swelling will persist for several more weeks. Do not remove the splint yourself before one week has passed. The sutures used to close the wounds do not need to be removed, as they are absorbable.
After removal of the splint, continue nasal taping for a few more weeks according to instructions. Taping helps reduce nasal swelling.
Late postoperative period
Light physical activity is allowed during the second postoperative week (e.g. walking, light exercises). Avoid strenuous physical activity for at least two weeks after surgery. You may return to your preoperative level of physical activity after four weeks.
Avoid swimming in pools and natural bodies of water for one month after surgery, as this significantly increases the risk of infection. It is also recommended to avoid hot baths and saunas for one month after surgery, as they may worsen swelling.
Glasses may be worn immediately after removal of the splint. Please note: wearing glasses may be uncomfortable and cause pain. The bone on which the glasses rest may remain tender for up to six months. To reduce pressure from glasses, the skin of the nose may be protected with tape.
Avoid direct sun exposure to the nose for three months after surgery. Direct sunlight may cause pigmentation of bruises. When exposed to the sun, use sunscreen with a protection factor of at least SPF 50.
During the first postoperative month, there remains a risk of infection. Signs of infection include redness of the skin in an area where it had previously subsided, tenderness of the nose on touch, and renewed increase in swelling that had already begun to decrease. If such symptoms occur, contact the operating surgeon immediately, seek urgent consultation with an ear, nose and throat specialist, or go to the nearest Emergency Department.
Swelling subsides gradually. Approximately 60–65% of the swelling resolves during the first 2–3 postoperative months, 70–80% by six months, 90–95% by the end of the first postoperative year, and 100% by the end of the second postoperative year. To speed up reduction of swelling, Arnica gel may be used during the first three months and applied directly to the nose.
Immediately after surgery, the new shape of the nose may initially feel unfamiliar. This feeling is further intensified by swelling. As the swelling subsides, the nose gradually takes on its final shape, and adaptation occurs over time. Generally, the greater the change, the longer the adjustment period. Typically, this takes about 3–4 months. Please be patient during this time.
Very often, the nasal tip initially appears overly upturned, especially in patients whose surgery aimed to significantly elevate the nasal tip. During the first postoperative month, the nasal tip descends slightly and gradually reaches its final position.
From a frontal view, achieving a more aesthetic nasal shape takes approximately 3–4 months in patients with normal or thin skin types and up to one year in patients with thicker skin. Please be patient during this period.
Please remember that formation of the final result takes up to 6 months in patients with thin skin, up to 1 year in patients with normal skin, and up to 2 years in patients with thick skin.
Before 6–12 months have passed since surgery, it is not possible to determine the need for revision surgery. A nose that looks good in the early postoperative period may develop irregularities during later stages of healing. Conversely, a result initially considered unsuccessful may be satisfactory by the end of the healing period. Minor irregularities can occasionally be corrected before final healing. In the case of major deformities, it is always necessary to wait for complete healing before assessing the need for revision surgery.
If have any questions, please send e-mail: priit.kasenomm@gmail.com or call +372 5567 2730