Rhinoplasty Aftercare

What to Expect Immediately After Surgery

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No nasal packing: Unlike many surgeons, Mr Biggs does not use any form of nasal packing after rhinoplasty. This means you will be able to breathe through your nose as soon as you wake from the anaesthetic, which makes the immediate recovery period considerably more comfortable.

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Splint and tapes: You will have a small external nasal splint and paper tapes applied across the bridge of the nose before you leave theatre. These stay in place until your first post-operative appointment, usually seven but sometimes upto fourteen days after surgery.

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Dissolvable sutures: All internal sutures are dissolvable. You do not need to have stitches removed from inside the nose. They will break down naturally over the weeks following surgery.

 

Swelling: Noticeable swelling typically begins six to twelve hours after the procedure. It peaks around 48 to 72 hours and then gradually subsides. Some degree of swelling persists for months, particularly at the tip.

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Pain: Discomfort after rhinoplasty is usually mild to moderate rather than severe. You will be sent home with co-codamol, which also contains paracetamol. Use it as required, up to four times in 24 hours. Ibuprofen can be added if additional pain relief is needed. Most patients find they no longer need prescription analgesia by the end of the first week.

 

Your Post-Operative Treatment Routine

You will be sent home with everything you need. The following should all be started the day after surgery:

 

Saline Nasal Rinse (Sterimar & Neilmed)

A salt water nasal rinse helps to flush away dried secretions and blood, keeping the nasal passages clear and reducing the risk of crusting. Begin gently on the day after surgery and use twice daily throughout your recovery. A useful demonstration video is available on YouTube if you search for nasal irrigation technique.

You will be given 2 salt water rinses:

1. Neilmed sinus rinse - start this the day after your surgery, and wash the nose at least twice a day for the first 2 weeks.
The NeilMed Sinus Rinse is one of the most effective and widely used nasal irrigation systems available, and is an excellent choice during your rhinoplasty recovery. To prepare the rinse, fill the squeeze bottle with previously boiled and cooled water, or distilled water, to the fill line marked on the bottle (240ml). Add one sachet of the NeilMed saline mixture, which contains sodium chloride and sodium bicarbonate, and replace the cap securely. Shake gently until the powder has fully dissolved. To use the rinse, stand over a sink and tilt your head forward and to one side at roughly 45 degrees. Place the cap of the bottle against the upper nostril and squeeze the bottle steadily and gently, allowing the solution to flow through the nasal passages and out of the lower nostril. Breathe through your mouth throughout. Do not sniff or swallow the solution. After completing one side, allow any remaining fluid to drain from your nose before tilting to the opposite side and repeating. Once finished, blow your nose very gently, one side at a time, to clear any residual solution. In the first week after surgery, use less pressure than you normally would, and do not be concerned if the flow is partially blocked by swelling. Any solution that does not drain freely will simply run out when you tilt your head back to neutral. Use the rinse twice daily, starting the day after your surgery, always after the steroid drops and before the Clinisept+ spray. Rinse the bottle and cap thoroughly with clean water after every use and leave to air dry.

2. Sterimar - This can be used in addition to the Neilmed, or in rare instances where patients are unable to tolerate the Neilmed sinus rinse.

 

Steroid Nasal Drops

Steroid drops are applied to both nostrils twice daily, immediately after the nasal rinse. Tilt your head back before instilling the drops. They help to reduce internal swelling in the early post-operative period and speed recovery of nasal airflow.

 

Clinisept+ Antiseptic Spray

Clinisept+ is sprayed onto the dissolvable sutures at the base of the nose twice daily, after the nasal rinse and steroid drops. It keeps the suture sites clean and reduces the risk of local infection. Continue until the sutures have fully dissolved, usually two to three weeks after surgery.

 

Oral Antibiotics

A seven-day course of oral antibiotics will be prescribed to prevent post-operative infection. Complete the full course even if you feel well. Mr Biggs usually prescribes penicillin. If you have a known antibiotic allergy or have experienced reactions in the past, please make sure this has been discussed at your pre-operative consultation so that an appropriate alternative can be arranged.

 

Recovery Timeline: Week by Week

Week 1

• Rest at home. Avoid any strenuous activity.

• Sleep on your back with two or three pillows to keep the head elevated above the heart. This reduces swelling.

• Do not blow your nose. If you need to sneeze, try to sneeze through an open mouth to avoid pressure building inside the nose.

• Apply a cold compress or ice pack to the cheeks and forehead (not directly over the nose or splint) to help manage swelling and discomfort in the first 48 hours.

• Some bleeding from the nose in the first day or two is entirely normal. If bleeding is heavy or persistent, contact the clinic.

• Take your medications as instructed.

• Bruising around the eyes and cheeks is common and usually most prominent around days two to four.

 

Weeks 2 to 3

• Your splint and tapes will be removed at your first post-operative appointment, usually between seven and fourteen days after surgery.

• Bruising fades significantly during this period. Most patients feel comfortable in social settings by the end of week two.

• You can return to a desk-based job approximately seven to fourteen days after surgery, depending on how you feel.

• Light walking is fine. Avoid anything that raises your heart rate significantly.

• Flying is permitted from 14 days after surgery.

• Continue your nasal rinse twice daily.

 

Weeks 4 to 6

• Most of the initial swelling has resolved, although the nose will still look and feel different from the final result.

• You may gradually return to normal activities, including light gym work, from around 2-3 weeks. Build up slowly.

• Avoid any contact that could result in a knock to the nose during this period.

 

Months 3 to 6

• You will be reviewed in clinic at approximately three months. This is an important milestone appointment to assess your early result and address any questions.

• Contact sports, including football, rugby, and martial arts, should be avoided for three months after surgery.

• The nose continues to refine during this period. Residual stiffness and subtle swelling, particularly at the tip, are normal and expected.

 

6 to 12 Months

• The final result becomes progressively clearer as the last of the swelling resolves and the skin contracts to the new underlying structure.

• Tip refinement, in particular, can take a full twelve months to reach its final appearance. This is a normal aspect of rhinoplasty healing and not a cause for concern.

• For patients who have had piezoelectric (Piezo) rhinoplasty or dorsal preservation rhinoplasty, the healing trajectory tends to be smoother and the nasal bridge more stable throughout this period, as these techniques preserve rather than remove the native tissue architecture.

 

Recovery After Piezo and Dorsal Preservation Rhinoplasty

Mr Biggs uses ultrasonic Piezo instrumentation for all bony work and is one of the only surgeons in Hampshire performing dorsal preservation rhinoplasty (DPR). Patients undergoing these techniques often notice some differences in their recovery compared to conventional structural rhinoplasty:

• Reduced bruising. Piezo technology cuts bone with precision and without the vibration associated with osteotomes. This typically results in less periosteal disruption, less bruising, and a faster resolution of the periorbital (around the eye) discolouration that many patients dread.

• Bridge stability. In dorsal preservation rhinoplasty, the dorsal roof is preserved rather than resected and rebuilt. This means the bridge of the nose maintains a more natural integrity during healing and is less prone to the step changes in swelling that can occur with conventional hump removal.

• Tip swelling still takes time. Whether Piezo or DPR is used, the nasal tip behaves in the same way as in any rhinoplasty. The skin envelope at the tip is thick and relatively inelastic, and full tip definition continues to develop for twelve months or more.

 

When to Contact the Clinic

Most recovery is straightforward and follows the pattern described above. However, please contact Tasha at the clinic immediately if you experience any of the following:

• Bleeding from the nose that is heavy, does not settle with gentle pressure, or recurs repeatedly after the first 48-72 hours

• A persistent temperature above 38 degrees Celsius

• Increasing pain rather than gradually improving pain, especially from day three onwards

• Rapidly worsening swelling or redness around the nose or eyes

• Any concerns that something does not seem right

 

For out-of-hours emergencies, you will be given a direct contact number at the time of your discharge. Do not hesitate to use it.

Clinic contact: Tasha (Natasha Read), timbiggssec@adnovaclinic.com, 01489 663273.

 

Frequently Asked Questions About Rhinoplasty Recovery

Will I have nasal packing after my rhinoplasty?

No. Mr Biggs does not use nasal packing. You will be able to breathe through your nose from the moment you wake up. This is one of the most common anxieties patients have before surgery, and it is worth emphasising that the packing-free approach makes the immediate post-operative experience considerably more comfortable.

 

How much bruising should I expect?

Very little with Piezo! This varies between patients. Most people experience some bruising around the eyes and cheeks, which peaks at 48 to 72 hours and fades significantly by the end of the second week. Patients who undergo Piezo rhinoplasty typically experience less bruising than those undergoing conventional osteotomies, due to the precision of the ultrasonic technique.

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When will I see my result?

Around 70 to 80 percent of the result is visible by six weeks. The remaining refinement, particularly at the tip, takes between six and twelve months. It is important not to judge the final outcome too early. Swelling is uneven and does not resolve in a straight line, so there will be days where the nose looks better or worse than the day before. This is entirely normal. Sometimes swelling can be uneven - worse on one side than the other.

 

When can I wear glasses after rhinoplasty?

You should avoid resting glasses on the bridge of the nose for at least six weeks after surgery. In the early weeks the bones are still consolidating and pressure from glasses can affect the final position. Contact lenses are the easiest solution during this period. Alternatives include taping glasses to the forehead or using a glasses stand. Mr Biggs will advise you specifically at your post-operative appointments.

 

When can I exercise after rhinoplasty?

Light walking is fine from the first week. You can gradually return to light gym work from approximately 2-3 weeks. Contact sports and activities with a risk of impact to the nose should be avoided for three months. If you are a keen swimmer or cyclist, discuss your specific activities at your pre-operative consultation and a personalised plan can be agreed.

 

Will I need a revision?

Mr Biggs has a revision rate of under five percent. In the event that a revision is required following surgery at Adnova Clinic, it is performed free of charge. Any decision about revision is made no earlier than twelve months after the primary procedure, once healing is complete and the final result is established.

 

Can I fly after rhinoplasty?

Flying is permitted from 14 days after surgery. There is no evidence that flying damages the surgical result, though the change in cabin pressure can temporarily increase nasal congestion. If you have a trip planned shortly after surgery, please discuss timing with Mr Biggs at your consultation.

 

Contact

For all rhinoplasty enquiries, pre- and post-operative questions, and appointment bookings:

 

Adnova Clinic, Fareham (rhinoplasty and septorhinoplasty)

Eagle Point, 1 Little Park Farm Road, Fareham PO15 5TD

Secretary: Natasha Read

Email: timbiggssec@adnovaclinic.com

Tel: 01489 663273