Rhinoplasty Post Operative Care
Dr Jason Roth (MED0001185485) — Specialist Otolaryngologist & Head and Neck Surgeon, specialist registration in Otorhinolaryngology, Head & Neck Surgery.
Cosmetic surgery is a serious decision. Results vary between individuals. If you have any concerns during your recovery, contact the rooms on (02) 9982 3439 or attend your nearest emergency department.
Recovery from rhinoplasty is more prolonged than many patients anticipate, and understanding what to expect at each stage is an important part of preparing for surgery. The information on this page supplements the instructions provided at your pre-operative appointment and is not a substitute for them. If anything on this page is unclear or conflicts with instructions you have been given directly, please contact the rooms.
All surgery carries risks — read the full rhinoplasty risks page →
See also: Rhinoplasty Recovery — Month by Month — a detailed guide to every stage of healing from the night of surgery through to 18 months, including the biology of why recovery takes so long, and what to expect at each phase.
Pre-Operative Preparation
The following must be avoided for at least two weeks before surgery. They increase the risk of bleeding both during and after the procedure:
Cease at least two weeks before surgery:
- Smoking (and all nicotine products)
- Aspirin
- Ibuprofen (Nurofen)
- Naprosyn / Naprogesic
- Excessive alcohol
- Vitamin E supplements
- Garlic tablets
- Ginkgo biloba
- Ginseng
- Horseradish supplements
- Fish oil in high doses
Continue all regular prescribed medications unless specifically instructed otherwise by Dr Roth or your anaesthetist. Do not stop medications for blood pressure, thyroid, diabetes, or other ongoing conditions without guidance.
Post-Operative Instructions
External nasal splint — You will have a splint on the outside of your nose. Keep it completely dry at all times. It will be removed at your first or second post-operative visit (one to two weeks after surgery). The shape of the external splint does not reflect the shape of the nose beneath it.
Nasal congestion — Expect your nose to feel completely blocked, as if you have a severe cold. This is normal post-operative swelling of the nasal passages and can last many weeks. Breathing through your mouth during this period is expected.
Nose blowing — Do not blow your nose for one week after surgery, as this can cause bleeding. After one week, blow gently and one side at a time. If you need to sneeze, open your mouth widely to release the pressure.
Bleeding — Intermittent light bleeding from the nose is normal for the first two weeks. If you experience heavy bleeding that does not settle within fifteen minutes of sitting upright and applying gentle pressure, contact the rooms or attend an emergency department. If your surgery was performed at Castlecrag Private Hospital or North Shore Private Hospital, the ward nursing staff can also be contacted — note that these hospitals do not have an emergency department and cannot provide emergency care once you have been discharged.
Numbness — The tip of the nose and your front two teeth may feel numb for several months after surgery. This is normal and resolves as the small sensory nerves recover.
Internal splints — If internal splints were placed during surgery, they will be removed at your first post-operative appointment (approximately one week). You may notice your ears pop or bubble when swallowing — this is normal and settles when the splints are removed.
Physical activity — Avoid all strenuous activity, heavy lifting (anything over 5 kg), and bending over for at least two weeks. Do not swim for two weeks. Avoid contact sport or any activity with risk of a blow to the nose for at least eight weeks.
Washing and skincare — You may shower but keep your nose dry while external dressings are in place. You can carefully wash your face around the splint — avoid getting the splint wet as it may fall off early. If the splint loosens, apply additional micropore tape to secure it to the cheek skin. Avoid applying makeup directly over the incision lines until they are fully healed.
Sun exposure — Avoid significant sun exposure for at least four weeks. Sun exposure on healing scars causes pigmentation. Apply SPF 50+ sunscreen to the columellar and any external incision lines when outdoors from six weeks onward.
Glasses — If nasal bones were fractured as part of your procedure, glasses must not rest on the nasal bones for four to six weeks. Contact lenses are the most practical solution during this period. A glasses rest device (
nosecomfort.com) can also be helpful.
Swelling and the final result — The shape of the nose will take many months to settle. The final result may not be fully apparent for twelve to twenty-four months, particularly in patients with thicker skin. Do not make judgements about the outcome during the first year. Comparing your appearance at three months with your pre-operative photographs is not a reliable or useful exercise.
Comfort Measures
- Rest as much as possible in the first week. Keep your head elevated on two to three pillows at all times — do not lie flat. Head elevation reduces swelling.
- Apply cold compresses (wrapped ice packs or frozen peas in a cloth) to the cheeks and eye areas to reduce bruising and swelling. Do not apply pressure or cold directly to the nose.
- Avoid spicy foods, large meals, and excessive alcohol for the first two weeks — these can provoke nasal bleeding.
- Most patients require ten to fourteen days away from work. Those in public-facing roles or with physically demanding jobs may need longer.
- Do not rub the nose or apply pressure to it.
Post-Operative Medications
Important: Purchase all post-operative medications well in advance of your surgery date. Do not attempt to fill prescriptions on the day of or after surgery.
Cephalexin or Amoxicillin (or alternative if allergic)
Oral antibiotic to reduce infection risk. Start the day after surgery and use as directed.
Antibiotic ointment (chlorsig eye ointment)
Apply with a cotton bud gently inside the nostrils and over external stitch lines. Three times daily (every eight hours).
Meloxicam or Celecoxib
Anti-inflammatory for pain relief. Do not take ibuprofen at the same time as either of these. Use as directed.
Paracetamol
Safe to take alongside all prescribed medications for additional pain relief. Up to 4 g per day.
Endone (oxycodone) — if prescribed
Stronger pain relief for use in the first few days only, as needed. One tablet every six hours as required. Paracetamol can be taken in addition. Do not drive while taking oxycodone.
Drixine (oxymetazoline) — as needed
Decongestant nasal spray that also helps control bleeding if it becomes troublesome. Three sprays in each nostril every eight hours as needed. Not always required.
FESS saline spray / sinus rinse (Flo or NeilMed)
Sterile saline nasal rinse to moisten the nasal passages and clear crusts and dried blood. Start with the gentle saline spray for the first day or two, then progress to a high-volume sinus rinse. Use liberally and frequently — the more often the better. Always rinse gently — high volume but low pressure. Excessive pressure will force fluid into the ears.
Prednisone (if prescribed)
Corticosteroid to reduce facial and nasal swelling. Take in the morning. Common side effects include increased appetite, sleep disturbance, mood changes, and agitation. In patients with diabetes, blood glucose levels should be monitored more closely. Contact Dr Roth if side effects are concerning.
Recovery Timeline
Night of surgery
Overnight hospital stay. Head elevated. Splint and dressings in place. Nasal congestion is marked. Pain is generally mild.
Days 1–3
Bruising and swelling peak — most pronounced under the eyes. Fatigue is common. Rest at home with head elevated. Cold compresses to cheeks.
Days 7–10
First or second post-operative appointment. Splint and external sutures removed. Internal splints removed if present. Bruising beginning to fade. Most patients are socially presentable by 10–14 days.
Weeks 2–4
Bruising resolved. Swelling improving significantly. Return to normal social and work activities for most patients. Avoid strenuous exercise and contact sport.
Months 1–3
Approximately 70–80% of swelling resolved. The nose is taking shape. Tip swelling remains prominent. The result at this stage is not final — do not make assessments yet.
Months 6–12
Continued refinement. The nose is approaching its final appearance. Tip definition improving. In patients with thicker skin, residual tip swelling may still be noticeable.
12–24 months
Final result. All residual swelling resolved. Skin fully re-draped. Only at this point can the outcome be properly and fairly assessed. Patients with very thick skin may take longer.
Post-Operative Appointments
Post-operative appointments are scheduled at approximately one week, two to three weeks, and then at intervals of three, six, and twelve months. You can drive yourself to these appointments once you have ceased oxycodone. You do not need to take pain relief before attending.
The first one or two post-operative appointments are clinical review sessions — they are not the time to bring family members or friends to view the result, and the appearances at these early appointments are not representative of the final outcome. You may not film the splint being removed or photograph the nose at these visits without prior discussion.
Flying After Rhinoplasty
There is no absolute medical contraindication to flying after rhinoplasty, but it is advisable to wait at least seven days before travelling by air. Moving around in airports and on planes increases the risk of a nosebleed in the immediate post-operative period. If travel is unavoidable, carry Drixine spray and nasal saline, remain well hydrated, and avoid carrying heavy luggage.
When to Seek Urgent Review
Contact Dr Roth or attend your nearest emergency department immediately if you experience:
- Fever above 38.5°C
- Heavy bleeding from the nose that does not settle
- Severe or rapidly worsening pain
- Increasing redness or warmth around the incisions or nose
- Significant swelling that appears suddenly rather than gradually resolving
- Any other concern that cannot wait until your next scheduled appointment
Dr Roth’s rooms: (02) 9982 3439 | Out of hours: attend the nearest emergency department.
Rhinoplasty Pre-Operative Information → | Rhinoplasty Anaesthesia → | Rhinoplasty Risks → | Rhinoplasty Surgery Overview →
Dr Jason Roth | MBBS, FRACS (ORL-HNS) | MED0001185485
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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