Rhinoplasty - Facial Rejuvenation Centre

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Rhinoplasty - Facial Rejuvenation Centre

Facial Rejuvenation Centre Surgery

Anesthesia Operation Room Suite

Deirdre Leake, M.D.

BEFORE AND AFTER SURGERY INSTRUCTIONS

RHINOPLASTY(NOSE RESHAPING)

Rhinplasty, nasal cosmetic surgery, is performed to improve the nose aesthetically-making it harmonizes

better with the other facial features-while maintaing or improving function. Because it is the most defining

feature of the face, the size and shape of the nose has a significant impact on a person’s appearance.

Some patients want their nose to be straight; others want the nostrils narrowed, while others say their nose

sticks out to far from their face. Because the nasal tip loses support as we age, some patients are surprised

to realize how significantly rhinoplasty contributes to a more youthful appearance.

BEFORE SURGERY

At your preoperative appointment our nurse will provide all the instructions for you to follow before and

after surgery. We will call the day before surgery to confirm your time to arrive. Upon arrival for your

surgery, you will talk with a nurse (who will start an IV), discuss anesthesia (local anesthesia with IV

sedation keeps you asleep and comfortable and meet with your doctor before going into surgery.

Rhinoplasty surgery takes about an hour or two depending on the structure and amount of change you are

seeking. Revision rhinoplasty usually takes longer, especially if you need grafts as we previously discussed.

Also if you are having a combination of procedures your surgery will take longer. Recovery time takes

about an hour and we will call your ride thirty minutes before your ready to leave.

PREOPERATIVE INSTRUCTIONS

1. Please avoid any aspirin, aspirin-containing products, or ibuprofen (Advil, Aleve, etc.) for one

week prior to and two weeks following your surgery. See our “Medication List” for products to

avoid prior to surgery. If you are on any medications that affect bleeding (such as coumadin or

warfarin) please notify the office immediately.

2. Please refrain from tobacco products and alcohol for two weeks prior and three weeks following

surgery. Along with delayed would healing, persistent skin redness and other complications may

persist when tobacco and alcohol are not discontinued.

3. Please notify us of all routine medications and significant health history. We ask that you remain

on your daily medications unless instructed otherwise. At the preoperative appointment, our nurse

will tell you which daily medications to take the morning of surgery.

4. At your preoperative appointment you will be given prescriptions for use before and after surgery

including an oral antibiotic and pain medications. Please obtain these prescription medications

before your surgery and bring them with you the day of surgery.

5. We will ask you to take Arnica, a nature herb that significantly decreases bruising, before and after

surgery. We will also ask you to take 1500 mg of Vitamin C (ascorbic acid), which helps promote

healing, before and after surgery.

6. You may not eat or drink after midnight the evening before the procedure unless instructed

otherwise. You may brush your teeth. Your procedure will be cancelled if you do not follow the

instructions.

7. It is not required that a family member or friend stay at the surgical center during your surgery, we

will need a number where they can be reached when you are ready to leave. Someone will need to

drive you home after your surgery and stay with you that evening. Transportation to the office the

day following surgery is also required.

The Facial Rejuvenation Centre

1750 Tree Blvd., Suite 10, St. Augustine, FL 32084 (904)810-5434 www.frcentre.com


AFTER SURGERY

After surgery your nose will be packed with soft nasal packing. There will be soft silastic splints along each

side of your septum (divider of the inside of the nose). Splints reinforce the newly shaped cartilage. You

may notice that tears run down your cheeks. This is due to swelling and will subside during the first week

following surgery.

The nasal packing will prevent breathing through your nose so you will have to breathe through your

mouth. Your mouth will become very dry. Please drink as much fluid as you can which will prevent you

from becoming dehydrated. Drinks at the bedside along with a humidifier (cool or warm) may help.

Following nasal surgery, mucous membranes can produce extra mucous. Draining of red-tinged mucous

through your packs onto your drip pad is normal. Many people ask “How much drainage is too much?” If

you are completely saturating the drip pad with bright red blood every five minutes around the clock for an

hour, notify us at the numbers listed below. This is uncommon and can routinely be treated over the phone

or with an office visit to our office. You will also have a splint or “cast” on your nose to protect its new

shape as it heals. This will stay on your nose for 7-10 days and will be removed in our office at your

postoperative appointment.

Following your procedure the nurses will ask you to meet the discharge criteria: to drink liquids, walk with

a steady gait, void, manage your discomfort, and to have your nasal drainage under control. The nurses will

teach you how to change the drip pad under your nose, which you will need for about 24-48 hours.

You will be asked to come to our office the following day for packing removal. Although removal of nasal

packing has been described by most patients as discomfort rather than pain, you are encouraged to take

your pain medicine about an hour prior to packing removal. Packing removal will help relieve some of the

pressure. However, due to swelling, you will not be able to breathe well through your nose for one week.

POSTOPERATIVE INSTRUCTIONS

FIRST 24 HOURS

1. Keep ice-water soaked pads on eyes until bedtime, changing pads every 20-30 minutes. Pads

should be soaking wet-do not wring out completely.

2. Keep head elevated.

3. Reduce activity to decrease chance of bleeding or wound opening, swelling and nausea. You

may get out of bed to use the bathroom.

4. You will have a gauze drip pad placed under you nose. Change this as needed for the first 24

hours following surgery. It is not uncommon to change this every 15 minutes for the first several

hours following rhinoplasty. If you completely saturate the pad with bright red blood every 5

minutes for one hour around the clock, please call your surgeon. Take medications as prescribed.

Do not swallow any drainage from your nose as it may make you nauseated. Cough it up and spit

it out.

5. No nose blowing.

Next day after surgery

1. You will be asked to come to our office the following day for packing removal. Although

removal of nasal packing. You are encouraged to take pain medicine 1 hour prior to office visit.

Wound Care

*Keep ice-water soaked pads on eyes until bedtime, changing pads every 20-30 minutes. Pads

should be soaking wet, do not wring out completely. It is the weight of water as well as the temperature that

helps minimize bruising. A small bag of frozen peas or corn may also be used. Make sure the bag is not

placed directly on the skin. Use a washcloth or towel between the bag and your skin.

*Following the removal of the packing, the drainage will eventually subside and the drip pad will no

longer be required. Do not use saline nasal spray until the night following packing removal.

The Facial Rejuvenation Centre

1750 Tree Blvd., Suite 10, St. Augustine, FL 32084 (904)810-5434 www.frcentre.com


*The cast remains on your nose for one week. It must be kept dry or it could become loose. Notify

your surgeon immediately if the cast falls off.

*Clean incisions with a Q-tip soaked in peroxide twice a day to prevent scabbing.

*The evening following packing removal, start using the ointment (polysporin/bacitracin) two times

a day (morning and evening) inside the base of each nostril. Insert only the cotton part of the Q-tip into

your nose. Ointment is applied after the morning and evening saline rinses.

Salt water rinse and ointment

*Following nasal packing removal, start your saltwater rinses in the evening. Salt water rinsing is

very important for your postoperative healing. The salt water moisturizes, cleanses and facilitates healing.

*You can make your own salt water by mixing one tablespoon of sea salt (not table salt) and 12-16

oz of lukewarm water in a small plant mister bottle. Place the tip of the mister gently near the opening of

the nose and spray your nose. If you prefer you can purchase saline spray in your drugstore with a

prescription. Please rinse your nose with salt water five to six times a day until your splints are removed.

You may then decrease your rinsing to three times per day.

Medications

• Most patients complain of discomfort more than pain. Use pain medication as directed/ as needed.

• Do not drive or drink alcohol while taking pain medication.

• Taking pain medication with food helps minimize nausea sometimes associated with pain

medications.

• Start antibiotic ____________________ when you get home. It is not uncommon to have a low-

grade fever for 24 hours following surgery.

• Take Vitamin C (ascorbic acid) that helps promote healing, for two weeks following surgery.

• Take Arnica, a natural herb that significantly decreases bruising for one week following surgery.

Bleeding

A small amount of bleeding on the dressing is normal. If you have persistent bleeding relax and reduce

activity. If bleeding persists call our office (904) 810-5434.

Healing Care

• Rest (both physical and mental) and adequate nutrition is important factors in healing, so eat well

and take it easy for a few weeks.

• Numbness, tingling, swelling, itching, discoloration, bumpiness, hardness, crusting, tightness, and

redness around the incisions are normal and should go away with full healing.

• Avoid sun exposure as much as possible for three months, as it can cause swelling or uneven

change in pigmentation. Wear a hat and sun block (UVA and UVB). Full healing takes two to

three months.

Diet

Avoid dairy products for five days following surgery. Dairy products have bacteria that are harmful if the

integrity of the oral mucosa has been broken. To protect the incisions from infection, avoid dairy products

for five days. Advance diet from liquids to soft food (oatmeal, French toast, yogurt, soup, and pasta) to

your regular diet as tolerated. Avoid food with sharp edges such as tortilla chips for ten days following

cheek implants.

Activity

Rest for the entire day after surgery. Sleep with head elevated or use two to three pillows for one week

after surgery. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or

sir on the floor and let them climb on to your lap. No driving for one week following surgery. Two weeks

off work is recommended.

Always protect your face from the sun. At this point, a hat and sunglasses are a good idea. Following

surgery, our staff will tell you when it is ok to apply sunscreen, cosmetics for facial creams.

The Facial Rejuvenation Centre

1750 Tree Blvd., Suite 10, St. Augustine, FL 32084 (904)810-5434 www.frcentre.com


Please notify the office 904-810-5434 and ask for our nurse for any concerns or if there is an

emergency.

Please Remember

Swelling, bruising and disrupted sleep are very normal postoperative symptoms and will decrease as the

healing process occurs. Assistance with daily activities the first two to three days after surgery is

recommended.

Final Result

Following a chin implant, it takes time for the swelling to subside and for the skin to heal. Most patients

return to work one week following surgery; however two weeks is ideal, depending on the degree of

privacy one is trying to maintain. At two weeks postoperatively, swelling and bruising may be apparent to

you but not to many of your coworkers and closest friends.

The Facial Rejuvenation Centre

1750 Tree Blvd., Suite 10, St. Augustine, FL 32084 (904)810-5434 www.frcentre.com

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