Sydney Rhinoplasty Surgery

SAN Hospital, call patient/parent afternoon prior to surgery day and
Hunters Hill Hospital please call nursing staff P 88769387

The best way to prepare for rhinoplasty surgery is to ensure all your questions are answered. If you understand what rhinoplasty involves, your apprehension particularly on the day before rhinoplasty surgery will be less. Often this means arranging another appointment to see your rhinoplasty surgeon to discuss any specific issues about the aims to be achieved for your personal rhinoplasty, or issues regarding medications, sport, work or travel. Please refer to our rhinoplasty website page for medication protocols . This lists the 60 medications which will promote excessive bleeding and increase the risk of revision rhinoplasty. These medications e.g. Nurofen, Aspirin, Codral and Fish Oil should be avoided for two weeks prior to your rhinoplasty. Sport or going to the gym within two weeks after rhinoplasty can cause bleeding. Exercise such as walking in the first two weeks following rhinoplasty is encouraged as it helps reduce swelling for you to be moving around. Contact sports such as soccer or netball are avoided for six weeks after rhinoplasty, to allow for firm bone healing. Travel plans for the period following surgery should be discussed with your rhinoplasty surgeon as you will need regular post op consultations to check on the rhinoplasty wound healing … frequently, for the first six weeks then occasionally for a total of 18 months. As you will be having a general anaesthetic, avoid alcohol for 24 hours prior to your rhinoplasty. Cease smoking as early as possible prior to surgery as your rhinoplasty wound healing will be compromised. Lastly, another tip is to wash your hair the morning of the procedure as hair washing is tricky following surgery as you must keep your rhinoplasty plaster dry.

Rhinoplasty surgery takes 4-5 hours which is followed by an hour in recovery so tell friends and relatives to allow plenty of time before expecting to see you awake. With modern rhinoplasty anaesthetic techniques bruising is minimal but it may increase and move down over the cheeks over the first few post op rhinoplasty days. Most people stay one night in hospital following rhinoplasty though some people are discharged that day. For the first night only you will need to sleep up on 3 pillows. Nurses or your relatives change the small rhinoplasty bandage under the nose. The nasal dressing in only required for the first night. This is not difficult for your family but it does mean getting up in the middle of the night. Before discharge after rhinoplasty your doctor and nurses will show you how to douche the nose with saline. This will need to be done 6 times a day for 6 weeks to prevent crusting and infection in therhinoplasty wound. Antibiotics will also be given to you, for one week. After 5 to 7 days you will see your rhinoplasty surgeon for removal of the rhinoplasty splits both inside and outside the nose. Many people fear this visit but it is usually a great relief to have the plaster off and to breathe freely (and probably better than ever). Having sutures out is fiddly but not a huge discomfort. After 5 days you will no longer be so tired in the afternoons so we encourage you to take up gentle exercise such as walking. By now your rhinoplasty plaster is off and you can wear makeup. By 10 to 14 days post rhinoplasty, you will feel well enough to go to work. Most rhinoplasty patients comment at this stage that there is very little pain following rhinoplasty surgery. They mainly notice post op fatigue and 5 days of nasal blockage. Contact sports or wearing swimming goggles are avoided for 6 weeks following rhinoplasty. Sun or reading glasses also weigh down on the rhinoplasty wound and are best avoided for 3 weeks, more if they are particularly heavy. Your post op rhinoplasty appointments will be made for 1 week, 2 week, 6 week, 3, 12 then 18 months. You will be surprised and pleased to see increasing definition in your post op rhinoplasty nose as healing occurs over this 18 month period. Remember as well the older we are, the longer it takes to heal.

To view a list of medication you can / cannot take pre and post-operation, please CLICK HERE.

Cigarettes and Alcohol

Cigarette smoking is a risk for nose surgery. Smoking interferes with the blood flow so healing is poorer and infection more likely. This can lead to nose scarring and the need for revision rhinoplasty. The oral contraceptive pill is not a problem itself, but if combined with smoking, a rhinoplasty patient could develop leg clots and possibly even death as the clot passes to the lungs. Smoking also causes coughing on waking up after rhinoplasty surgery. Coughing can lead to bleeding which may mean the nose must be packed with ribbon gauze to stem the nasal bleeding. This could distort the rhinoplasty result. Alcohol within 48 hours of an anaesthetic could alter the amount of drug the anaesthetist needs to give. Best avoided! In a special group are Roaccutane and steroids such as Prednisone. Both of these medicines will delay healing to the point where nose surgery is not advisable. Make sure you have been off Roaccutane for six months prior to any nose surgery. Ask your doctor about Prednisone as this varies with the dose. Remember, rhinoplasty surgery is elective surgery. You want the very best result so you will need the very best conditions. For a full list of medications to be avoided before and after rhinoplasty, go to our tool bar, click “Rhinoplasty”, and then click “General Instructions”. If there is any doubt, simply contact us.

• Make sure you douche the nose 6 times a day.It will clear the congestion.
• Dab the nose with a Kleenex as it will dribble blood occasionally for about 3 days. Do not wear the cotton bandage under the nose as you did in hospital. This gives nappy rash after a while.
• You may sleep on one pillow at home.
• Walk for at least 20-30 minutes a day. This will help the swelling drop. It is normalfor some bruising to track down the cheeks.
• Pain relief is rarely required but use Panadol if needed.
• Before your first post op appointment, douche the nose and use Vaseline on a cotton bud to clean the stitches under the nose.

No one can undergo a rhinoplasty without some swelling afterwards. The bulk of the swelling and bruising will be gone 2 weeks after rhinoplasty surgery but it takes 18 months for all the swelling to truly settle. On a positive note, this means your rhinoplasty will look better and better. Certain factors affect the amount of swelling you will experience after rhinoplasty . 1. If you don’t need much done e.g. a small bump, your rhinoplasty will not involve much disturbance to the body, so post op rhinoplasty swelling is small. Conversely if you have a nose which has been traumatised by sporting injuries it may need major rhinoplasty reconstruction. Here obvious post op rhinoplasty swelling may last several weeks, even months. 2. Allow time for your post op rhinoplasty to settle. It is fine to plan to return to work 2 weeks after rhinoplasty surgery but less than this amount of time may mean that your swelling is noticeable. 3. As we age, the collagen and elastic fibres in our skin are less likely to take up the new shape of the nose quickly. This means that after rhinoplasty the skin gradually moulds and the swelling takes longer to subside. 4. If you are not active and simply take to bed following your rhinoplasty, the swelling will be prolonged. Vigorous exertion may create bleeding but walking at least once a day win the first 2 weeks following rhinoplasty surgery is a good way to encourage the rhinoplasty swelling to drop with gravity. Lying horizontal tends to allow it to puff up again. 5. Lastly, if you have a very big nose, or a very big bump, your new rhinoplasty nose may be much smaller. You need to allow time for the rhinoplasty to heal as the skin envelope of the old nose moulds to the new rhinoplasty nose.

Dr Dunlop will confirm this for you if you are unsure please call us on (02) 9487 7877.

To view a complete list of medications you must cease taking prior to surgery please click here.

10 days but you can wear concealer makeup after the fifth day

Five to seven days post-op.

You will be tired – like jetlag for approx. 10 days.

Contact sports should be avoided for 6 weeks to allow time for the bones to knit. The gym is fine after 2 weeks but goggles for swimming should be avoided for 6 weeks as they press on the bones which are still healing. Football players should postpone rhinoplasty surgery until the end of their football career as further trauma may mean further surgery.

Skeletal maturity means revision surgery is less likely. We recommend 16 for females and 17 for males.