Are you thinking about getting a rhinoplasty, but you’re just not sure how the recovery is going to work out with work and with life?
I’m Dr. Dominic Castellano from Elite Facial Plastic Surgery, and I’m going to break down post-rhinoplasty care, what you can expect, and some recovery timelines.
I’ve helped hundreds of patients reshape their noses, correct structural issues, and feel more confident with rhinoplasty.
Ready to get the nose you’ve always wanted? Schedule your consultation today.
Want to know more about nose reshaping? Check out my full rhinoplasty video playlist.
Immediately After Surgery: What To Expect
You will leave your procedure having a splint on the nose. Normally that splint is covering the upper one-half, and you’ll have tape as well.
That splint, in most surgical practices, is going to stay on anywhere from 5 to 7 days.
Icing Instructions
During that time period, I recommend my patients to:
- Put some ice over one eye and then over the other eye.
- Not on the nose, but resting on the eye and the cheekbone.
- This helps with swelling and reduces bruising.
I normally recommend patients do that 20 minutes on, 20 minutes off for the first 4 hours.
After that point, there’s really not much more you need to do from an icing standpoint.
Activity Restrictions
I also tell patients:
- Avoid blowing your nose
- Don’t do any heavy lifting
- Avoid strenuous activity
- Just take it easy
Incision Care (Open Rhinoplasty)
If you have what we call an open approach rhinoplasty, there’ll be a small incision going across the part of the nose called the columella (sometimes mispronounced as “Cella”).
You’ll want to:
- Clean that area with a very small amount of hydrogen peroxide.
- Dab it, don’t rub it.
- Apply a little bit of either:
- Aquaphor, or
- An antibiotic ointment like Bacitracin.
Just keep it clean. It doesn’t have to stay gooped on.
Most patients don’t like the swelling inside the nose, and I totally understand. But you’ve got to abstain from blowing your nose to let the incisions in the area heal.
5–7 Day Follow-Up Appointment
After surgery, you’ll follow up with your surgeon 5 to 7 days later.
At this appointment, the splint comes off. I’m sure you’re thinking it’s painful, but it’s not. The only time it’s normally painful is when somebody’s rushed and takes it off.
In my practice:
- We take our time.
- We soften up the tape.
- The splint comes off very gently.
- The five little sutures at the base of the nose come off as well.
After that:
- I’ll put on some adhesive material.
- I’ll put tape back on.
- I normally have you keep that tape on for about another 2 to 3 days.
Removing the Tape at Home
At the 2–3 day mark:
- Take a shower and get your nose wet.
- Put alcohol on your nose.
- The tape usually comes off at that point in time.
From there, you’ll leave the nose alone and let it heal.
Follow-Up Appointment Schedule
I typically like to see my patients:
- At 2 weeks
- At 1 month
- At 3 months
- At 6 months
- At 9 months, if needed
That way, I can make sure things are healing up well and answer any questions you may have.
Rhinoplasty Swelling Timeline
If you do any reading about rhinoplasty online, you’ll see that most surgeons consistently say that with a primary rhinoplasty, you need to give your nose about a good 9 to 12 months to let the swelling settle.
What I like to tell patients is that swelling occurs in stages.
It’s not like you wake up one morning and — bang — it’s all gone.
How Swelling Changes Over Time
- Initially, the whole nose is swollen.
- When the cast (overlying the bone and cartilage) comes off, some swelling reflexively comes back.
- The skin and tissue absorb some of that swelling.
Once the splint comes off, the clock starts.
From that point:
- Swelling goes down in monthly intervals.
- I like to tell patients that the last area to settle is usually the nasal tip.
The nasal tip:
- Is the lowest portion of the surgical field.
- Is where the lymphatics reconnect to drain excess fluid.
- Is mainly cartilage and soft tissue, which tends to take the longest to heal.
I’m often counseling patients and just telling them to hang in there. You’ll be amazed at how much your nose changes from the point of surgery to when you’re at least 9 to 12 months out.
Is Rhinoplasty Painful?
One of the big things patients often inquire about is: Is it painful?
I’d say 90–95% of the rhinoplasties that I do are not painful.
Now, there is soreness. There’s a difference between being sore and having pain.
- Soreness is usually controlled by anti-inflammatories like:
- Motrin (ibuprofen)
- Advil
- You can add Tylenol (acetaminophen) as well
Pain, if present:
- May require short-term pain medication.
- Usually improves after about a day.
- Should be manageable within a couple of days.
After a few days, you really shouldn’t need anything.
Everybody has a different pain tolerance, but for the most part, recovery discomfort is very manageable.
What About Internal Nasal Splints?
I’m sure you’re wondering about the dreaded internal nasal splints.
For rhinoplasties that are just changing the outside of the nose, you normally don’t need internal splints. For my patients, I normally don’t use them at all.
So, the only thing coming out when you follow up is the five little sutures at the base of your nose.
Will the Incision Be Visible?
I know a lot of patients are concerned about having an incision.
- The small incision across the nose heals beautifully.
- When it heals, it is not perceptible.
- The remainder of the incisions are inside the nose.
- Those use absorbable sutures, so you don’t have to do anything.
It’s the beauty of the technique that I use—you don’t have to do anything to it.
The hardest part for you as the patient is just being just that: the patient. Give your nose time to heal.
If you have any questions or concerns, call your surgeon. That’s why I see you so often, just to make sure things are healing up well.
Will I Need Steroid Injections?
There are some instances where something may need to be done.
For example, a steroid injection in the supratip area (just above the nasal tip).
This is normally reserved for:
- Patients with a very large amount of swelling that’s not going down.
- Patients with thicker skin envelopes.
Again, I can’t tell you for sure—everybody is different. But those are the times when something may need to be done.
Should I Keep Retaping My Nose?
Another common thing I hear is patients wanting to keep retaping their nose.
I normally don’t encourage that because you can irritate the skin, and you can become obsessive about it.
I just tell patients:
- Leave your nose alone.
- Let it heal.
- Let me (or whomever your surgeon is) guide you through the process.
Get The Nose You’ve Always Wanted with Dr. Dominic
Don’t let your nose control your confidence any longer. With expert rhinoplasty techniques and aftercare, Dr. Dominic will shape the nose you’ve always wanted.
Book your consultation today. Let’s start planning your transformation.
