Rhinoplasty is a permanent surgical procedure, so the results should last your lifetime. The most important aspect of your rhinoplasty is choosing an experienced and skilled rhinoplasty specialist whom you can trust with your nose. Rhinoplasty is considered the most difficult of all facial plastic surgical procedures.
Everything about your proposed surgery should be explained to you by your surgeon at your consultation and again at your pre-operative appointment. You should have pre-operative lab work and surgical clearance from an internist if indicated.
On the day of surgery at our office, your anesthesiologist and nurse will ask you a few questions before taking you into the operating room suite. Once you lay down on the bed, you are made comfortable by the nursing staff with pillows and warm blankets. Once the monitors for your heart, blood pressure, and oxygen level are in place, the only uncomfortable thing that you feel is the small amount of numbing medicine that the anesthesiologist injects next to a vein in you hand. The I.V. is then placed painlessly. At this point the anesthesiologist gives a little medicine in the IV that makes you feel very good ("Just Say NO to Drugs, except in the operating room), then we ask that you think of your favorite place with your favorite person, and you are off to pleasant dreams and a restful sleep. Our anesthetists usually use a medication called Diprovin (made famous by Michael Jackson, but in our center only board certified anesthesiologists administer the medication with proper monitoring) and once you are asleep they then place a laryngeal mask (LMA) to facilitate administraton of oxygen. The LMA also protects the airway and stomach from any fluid. Depending on what needed to be done to your nose, your operation may last anywhere from 1 to 3 1/2 hours. I prefer to not use post-operative "packing" into the nose. If you ask patients who have had rhinoplasty,"What was the worst thing about your rhinoplasty?", if they had packing in their nose for a few days, they will say, "The packing!"
Next thing you know, you are waking up in the recovery room with tape and splint on your nose. After about one hour, once you are fully awake, you are allowed to go home. Once you are home, we recommend that patients get into bed with there head elevated up on 3 to 4 pillows so that their nose is elevated well above their heart. Baggies of frozen peas are kept on the bridge of the nose as tolerated. Surprisingly, our patients seldom complain of pain, but rather a stuffy nose or sinus headache type of pressure that is usually relieved with Tylenol.
Patients return to the office two days after surgery to have their nose cleaned of any mucus or dried blood, the nasal passages are suctioned so that breathing is a little better. The nose will become congested again for a few days. On the fifth day, my favorite, the tape and splint are removed and the new nose is unveiled.
Swelling and bruising continue to resolve over the next few days so that patients are quite presentable between 7 to 14 days after surgery. Physical activity is limited for the first two to three weeks after surgery. The appearance of the nose should continue to improve over the next 6 to 12 months. We then see our patients at one week, one month, three months, six months, one year, and then once a year as needed.
All patients should be aware that there is usually between a 3% to 10% chance of revision surgery after initial rhinoplasty.
Good luck and be well.
Dr. P
A patient recently asked about her nose 6 days after her rhinoplasty by another surgeon, "Why is my post-op profile identical to my pre-op profile?" Here is my answer:
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