Rhinoplasty Post-Operative Instructions

Posted by Anthony Bared, M.D., F.A.C.S.

Rhinoplasty Post-Operative Instructions

Rhinoplasty specialist and board-certified facial plastic surgeon Dr. Anthony Bared performs revision rhinoplasty and nasal surgery in Miami, FL. Dr. Bared personalizes each rhinoplasty surgery to support his patients’ cosmetic and functional goals, and he explains the details of the surgery and recovery during the rhinoplasty consultation

If you are getting ready for your rhinoplasty procedure, it’s important to prepare for your recovery in advance so you can focus on healing and enjoy the best possible results. Here are the steps you should take prior to your surgery. 

Preparing for Rhinoplasty Surgery

Before scheduling rhinoplasty surgery, Dr. Bared reviews the patient’s medical history and medication list. Patients must make the following adjustments to their habits, schedules, exercise routines, medications, and supplement use in the weeks before and after the surgery:

  • Accutane (Acne Medication)

Stop taking Accutane for acne six months before rhinoplasty surgery and discontinue its use for three months after nasal surgery to reduce the risk of low sebaceous gland activity and unsatisfactory healing of the nasal tip.

  • Alcohol

Stop drinking alcohol for three weeks before and three weeks after rhinoplasty surgery. Alcohol can cause thinning of the blood, which promotes bleeding and bruising. 

  • Smoking

Stop smoking four weeks before and at least four weeks after rhinoplasty. Smoking and nicotine affect the body’s natural healing processes and raise the risk of surgical complications, scarring, and infection. 

  • Aspirin and NSAIDS Drugs

Discontinue taking aspirin and drugs containing aspirin, such as Motrin, Aleve, Excedrin, and Advil, two weeks before the surgery. Aspirin, anti-inflammatory drugs (NSAIDs), and aspirin-related products may cause thinning of the blood and increase the risk of bleeding. 

  • Birth Control

Discontinue birth control pills two weeks before the surgery and two weeks after.  

  • Hormone Replacement

Patients taking hormone replacement therapy (HRT) must contact their prescribing physician to discuss stopping HRT two to four weeks before and two weeks after surgery. 

  • Blood-Thinning Medications and Supplements

Avoid taking medications like Viagra, Coumadin, Plavix, drinking herbal tea, and taking herbal supplements like Ginkgo, Vitamin E, Garlic, St. John’s Wort, and Echinacea two weeks before the surgery and two weeks after. Discuss pausing the use of these and similar medicines with your prescribing physician and with Dr. Bared, as they may increase bleeding after rhinoplasty.

  • Ask a Friend or Family Member for Help

Patients must arrange for a friend or family member to bring them home after the surgery, as it is not safe to travel home alone after rhinoplasty. Having help with meals and small tasks during the first days after the surgery may also be beneficial.  

  • Use Pre-Surgical Prescriptions

Dr. Bared may prescribe medications to be used in preparation for the surgery, such as Bactroban ointment in each nostril three to five days before surgery. 

The Day Before Rhinoplasty

The office staff will contact the patient on the day before the surgery to give them an arrival time. Do not drink caffeinated beverages, including coffee and energy drinks, 48 hours before the surgery. Patients should have nothing to eat or drink after midnight on the evening before the surgery. 

The Day of the Procedure

Remove jewelry and leave it at home. Wear cotton underwear (avoid nylon and synthetic fabrics) on the day of the surgery. 

Wear comfortable clothing with a zipper or buttons in the front. Do not wear turtlenecks, pullovers, or tight-fitting clothing. Wear clean cotton socks and slip-on shoes.

You must follow all pre-surgery instructions and arrive at least 15 minutes before the time provided. Take nothing by mouth on the day of surgery, including gum, mints, or candy. Use only a small amount of water for brushing teeth or taking approved medications. 

Post-Rhinoplasty Instructions

Follow these instructions during the first week and until released by the doctor:

  • Some bruising and swelling are normal. Keep the head elevated when lying down to reduce swelling and encourage healing.  
  • Take extra-strength Tylenol for mild discomfort, or take prescription pain medication for more severe pain as prescribed by Dr. Bared.
  • A fever of up to 101.5 is normal the first two days after surgery. In case of temps over 101.5, contact the doctor.
  • Apply ice compresses over the eyes as instructed by Dr. Bared.
  • Initially, a bland diet is recommended, such as clear broth and liquid. Some patients may experience nausea or vomiting for the first 24 hours but should contact the office if they experience severe nausea and cannot keep fluids down. 
  • Apply Vaseline or Chapstick to treat dry lips.
  • Keep the nasal splint dry.
  • Bathe rather than shower until cleared.
  • Some drainage with blood-stained mucus is normal (change drip pad accordingly).
  • Follow instructions, including applying Mupirocin ointment and ice packs.
  • Do not drive or operate a motor vehicle while taking sedatives or pain medication.
  • Avoid exercise, bending, and sun exposure.
  • Avoid nose blowing. 
  • Avoid sexual activity for three weeks.
  • Avoid facials and massages immediately after surgery and for six months after. 

Patients will receive a phone call from the office after the surgery but may call 305-912-9646 at any time if they have concerns. 

One Week Post-Surgery

Dr. Bared will perform an examination and remove the splint, dressing, and sutures one week after the rhinoplasty surgery. After the examination, patients should stick to the following instructions:

  • Apply Bactroban using a Q-tip just inside the nostril, twice daily, for four days. 
  • Two sprays of saline spray may be recommended 2 to 3 times a day in each nostril over the next four weeks to assist in the healing process and clean out any crusting from the inside of the nose. 
  • Begin to blow the nose gently after approximately one week. After two weeks, patients can usually blow their noses normally.  
  • Refrain from strenuous activity, which will elevate the blood pressure and heart rate, for two weeks after removing the splint. Three weeks after surgery, the patient can resume physical activities and standard workouts while avoiding contact sports. 
  • Patients may wear contact lenses without restrictions after one week. Wear a nasal splint under glasses. 
  • Medication with aspirin or ibuprofen, like Advil or Motrin, must be avoided for an additional two weeks after the one-week follow-up and splint removal. 
  • After the one-week visit, the patient can get their face and nose wet while showering. However, they cannot submerge their heads completely underwater for two weeks. 
  • The doctor may recommend a mild astringent to clean the nasal skin because it tends to be oilier for a brief time after surgery. After two weeks, the patient may resume their regular skincare regimen.
  • Avoid any sun exposure for the first three months after the surgery because the skin will be more susceptible to sunburn and swelling. Patients must also practice caution throughout the first year. 

Contact Rhinoplasty Specialist in Miami, FL

Following Dr. Bared’s preoperative and postoperative rhinoplasty instructions will significantly reduce surgical risks and encourage optimal results. Patients should call 305-912-9646 or contact facial plastic surgeon Dr. Anthony Bared and his staff in Miami with questions or concerns during the healing process.