Postoperative instructions

Early postoperative period

  • It is normal to have mild bleeding or smearing during the first 2 postoperative days. During the first 2 postoperative weeks there is a very small risk for severe bleeding that requires intervention. In this case you need to go to the emergency department of the nearest hospital.
  • It is advisable not to blow too strongly your nose for the first 2 weeks after surgery to avoid nose bleeds. You could instead use saline irrigation solutions (Humer, Quixx) to help clearing your nose.
  • You may have blocked nose for a few weeks following surgery due to the swelling. Until the swelling settles, it is advisable to use decongestants (pseudoefedrin tablets or Otrivin/Xymelin nasal spray). If you have nasal splints put into the nose, they also significantly obstruct nasal breathing. However, in most of the patients we do not use intranasal splints. Sometimes we put splints to control excessive bleeding during surgery. In this case, we remove them a day after surgery before your discharge.
  • After washing your nose, you will need to clean your nose with a cotton ear stick soaked with 3% hydrogen peroxide. After careful cleaning using gentle rotating movements, antibiotic cream (Baneocin) is applied with a new cotton ear stick to the nasal entrance and on the wounds outside. You should do cleaning and antibiotic cream applications 2-3 times per day, up to 10 days.
  • Take the antibiotics and the pain killers prescribed for you. Do not take aspirin or its derivates for 2 weeks after the surgery. You can start to take vitamins and food supplements again also 2 weeks after the surgery.
  • It is okay to shower the day after the surgery. However, make sure that the nose cast and/or tapes on the nose remain dry.
  • Swelling of the nose and around the eyes will increase gradually within the first 3-4 postoperative days. Rarely the swelling becomes so intense that the eyes will be completely closed. Applying cold compresses to the nose and face during the first postoperative days helps to control the swelling. You may use crushed ice or commercial cold compress packs. Use them for 20-minute sessions couple of times per day.
  • Usually there is no bruising or limited bruising. Bruises usually appear around the eyes. The swelling and bruises on your face will return to normal after 2 weeks.
  • You will return to your surgeon’s office 7 days after the surgery for removal of the cast and/or tapes. In many patients we use only tapes without the cast. Most sutures we use resorb slowly by themselves. Only sutures that will not dissolve on their own will be removed.
  • Foreign patients can remove the cast and/or tapes by themselves at home after 7 days. We will give detailed instructions how to remove the cast and/or tapes. Do not remove the cast and/or tapes before 7 days!
  • After cast removal thick skin patients are advised to continue nose taping. Taping is not mandatory. It helps to control the swelling. If you practice taping, it is advisable to keep the same tapes on the nose couple of days rather than changing them every day. While the tapes are on your nose, you can wash your face and take a shower. There is no problem in wetting the tapes.
  • Foreign patients need to stay at the clinic 1 night after the operation. In the next morning, we will clean your nose and give final instructions before discharge.

 

Late postoperative period

  • You should restrict your medium and heavy sports activities for the first month. During the second week it is okay to perform non-impact exercise like walking or stationary biking. It is okay to resume low-straining abdominal exercises during the third week and return to your pre-surgical exercise levels during the fourth week.
  • It is forbidden to enter the sea and pool for the first month due to the risk of infection. We do not recommend taking prolonged warm bathing or go to sauna during the 1 postoperative month. These activities increase significantly swelling.
  • You can wear glasses immediately after operation. You can put glasses directly on the tapes covering the nasal bridge. After removal of the cast you can continue to use tapes under the glassess to avoid excessive pressure on the nasal bones.
  • You should protect your face from direct sun for the first 3 months. Temporary bruises on your face may become permanent if exposed to the direct sun. During this period, try to stay out of the direct sun exposure and apply sunscreen on your face (SPF25 or higher) while going out.
  • There is a small risk of infection for the first 3 months. In that period, increasing of the skin redness, which has already been decreased, as well as re-increasing of swelling and pain in your nose, which has already been decreased, may indicate infection. In this case, we recommend you to take contact with any otorhinolaryngology department or clinic in your city. Please contact us as well.
  • Reduction of the swelling and improvement of the shape occurs step-by-step. About 60-65% of the swelling is gone at the end of 2-3 postoperative month, 70-80% at the end of 6th month, 90-95% at the end of 1st year and 100% at the end of the 2nd year. During the first 3 months you can use Arnica gel to help to reduce swelling more quickly. It should be applied onto the nose according to instructions.
  • You can find the change in the shape of the nose and the new look of your face odd in the early postoperative period. It may take up to 4 months psychologically to get used to the new look. Please be patient in this process.
  • The profile view of your nose tip may look too upturned in the early postoperative period. Usually it takes 4 weeks for the nose tip to settle down to its final position.
  • In front view, more pleasing shape of the nose develops within 3-4 months for thin and normal skin patients and up to 1 year for thick skin patients. Please be patient during this process.
  • The final result takes about 6 months for thin skinned patients, about 1 for normal skin and up to 2 years for thick skin patients.
  • Before the first 6-12 months we could not decide whether revision surgery is required. The nose that looks good in early postoperative period may deteriorate at the later stages of the healing. In opposite, the nose that appears to be visually not pleasing within the first 6 months may become aesthetically acceptable at the end of the first year. Please wait patiently for the final healing to complete. At the end of this period, we can plan revisions if needed.

 

If have any questions, please send e-mail: priit.kasenomm@gmail.com or call +372 5567 2730