Expert Insights for Successful Nose Surgery Journey

Discover everything you need to know about rhinoplasty, from initial consultation to full recovery. Dr. Undavia from NJENT shares invaluable insights, covering preoperative prep, surgical details, and post-op care, ensuring a well-informed and confident approach to nose surgery.

What you’ll learn

  • The rhinoplasty consultation process and visualize surgical outcomes using advanced computer imaging technology.
  • Preoperative preparations, including medication management, risk assessment, and scheduling tips for a smooth surgical experience.
  • The rhinoplasty procedure step-by-step, understanding incisions, swelling management, and essential post-operative guidelines for optimal healing.

Listen now for all your facial plastic surgery and ENT questions and get insights from the experts. For professional ENT support, schedule a consultation today at our Marlton, New Jersey location by visiting NJENT.com or call 609-710-NOES (6673).

Listen to the audio version below.

Audio Transcript:

Dr. Undavia
Hey guys, it’s Dr. Undavia from NJENT in facial plastic surgery. And today I wanted to talk to you about what it’s like to have rhinoplasty. So first, just a little brief segment about how we decide we’re doing rhinoplasty. So during our consult, patients will come in and they’ll talk about what they want to have done to their nose. We use a computer imaging program to finalize what we want the nose to look like and whether we think it’s a realistic result and then we can schedule rhinoplasty. Pretty straightforward. Sometimes we have to talk about the septum and other functional related issues to the nose, but from the rhinoplasty perspective, this is kind of how it goes afterwards. So about a week before you have your rhinoplasty scheduled, we have a preoperative exam. We can do that telemed or we can do that in office. It just depends on where you live.

What we do is we go over the things that we’re going to go over right now. We also get medications ready. We also just go over any potential risks. And if you have questions, we go over that. Sometimes patients want to look at their pictures again. They might want to tweak the pictures a little bit. So we do that. But about three days before surgery, you’ll get a phone call from the hospital just asking you what your past medical history is.

And then, one day before surgery, you get a phone call from the hospital to tell you what time to show up. So the night before surgery, after midnight, nothing to eat or drink. That morning, you can shower and brush your teeth, but also nothing to eat or drink. If you do have medications that you need to take in the morning, you take them with a tiny sip of water. Don’t guzzle a whole glass of water. No milk. I had one patient show up who had milk and cookies. Don’t do that.

So when you get to that, so then you go to the hospital or surgery center, when you get there, you just check in and let them know you’re having surgery with us. Then they have you meet the nursing staff, the anesthesiologist, you’ll see me, we’ll do some consents, we’ll just chat a little bit if you have any other questions. We do something called a triple check, which is essentially just making sure you are who we think you are, and we are doing what we think we’re supposed to be doing. Then we head back to the OR.

Most of the times, patients are in the stretcher as we head back to the OR, and you get a little bit of a cocktail through the IV just to relax. It just takes the edge off because you might be anxious about having surgery. When we get into the operating room, it feels like a little bit of chaos, but it is controlled chaos because there’s a lot of things going on all at once. The first thing is somebody’s putting calf compressors on your legs. It prevents a blood clot. Another person is putting on a blood pressure cuff on your arm. It checks your blood pressure. Third person’s putting on EKG electrodes on your chest. It checks your heart rhythm. And then the anesthesiologist gives you an oxygen mask. You know that when you get the oxygen mask, it’s gonna be about 20 to 30 seconds and you’re going to sleep. Once you go to sleep, you get a breathing tube. Once we’re done with surgery, before you wake up, breathing tube comes out. So you never feel it going in or out, but you do have a sore throat for about two to three days.

Sometimes if we have to fix the septum at the same time, or if we have to get grafting from the septum, you have, your upper four teeth on the top here are a little numb or just sensitive. It certainly doesn’t stop you from eating what you want. You’re just aware of it a little bit. So then we get started with your surgery. We sometimes do an open rhinoplasty. We sometimes do a closed rhinoplasty. It really just depends on the nose and the goals for surgery. If you do have an open rhinoplasty, you have one incision right here at the base of the nose. It looks like this. We break it up so that it actually makes it less visible.

If you do a closed rhinoplasty, you don’t have that incision, but you do have incisions on the inside of your nose. The incision here heals great. Within a couple of weeks, it’s just a faint little red line. The incisions on the inside of your nose heal a little lumpier, bumpy, and they take a couple of months to smooth out, and it’s just because you go over hair follicles. So we expose all the parts of the nose that we wanna fix. We fix them. Then we close up incisions. If we have the one incision right here, it gets closed with a blue suture or stitch.

The ones on the inside of your nose get closed with a yellow suture. The blue sutures we take out in a week, the yellow ones dissolve within a few weeks. At the end of your surgery, your nose is already pretty swollen. You put a cast on your nose. Sometimes you get a little mustache dressing so that your clothes don’t get dirty because your nose does drip a little bit for about 48 hours. And then you go to recovery room. I talked to whoever is with you that day. I can show them pictures.

Every patient of mine gets my cell phone, so I text them pictures also of their nose. And then you stay in recovery room for about an hour, then you go home. Most patients, even if they have a three or four hour trip back home, can drive home, well, they get driven home. They can go home that day. Some of our patients come from farther and they stay in an Airbnb or a hotel. Also very easy, they just need to have somebody with them to take them to the hotel.

When you get home, what you’re gonna see is that you have a lot of swelling, your cheeks, your nose, and your eyes. For your eyes, they typically peak in bruising and swelling around day three, and then it comes down quite quickly. I typically will see patients at one week to remove cast and suction, which we’ll talk about in a second, but by that time, most of the bruising and swelling around the eyes is already gone. You might have a faint little red or a green or yellowish area right here, but that’s about it.

The cheeks and the nose are still quite swollen. And so this is what I tell patients all the time about swelling. Your nose, when we take off your cast at one week, well, it’s actually back up. For that first week, what you feel like is a bad cold. Most patients don’t have a whole lot of pain. We give them pain medication with a narcotic, but they rarely need it. Most of our patients have told us that they just use it for sleeping at night, for the first night or two. Tylenol is more than enough for most patients.

But the cold feeling is really just about being heavy on your face and feeling super stuffy. We don’t use packing, but it still gets swollen and you still have a lot of mucus and old blood in your nose. So we have patients use a sinus rinse or saline in the nose and it helps them remove some of this stuff. I don’t want you to blow your nose for the first three weeks because there’s a risk of a nosebleed afterwards. It’s about one to two percent.

And if you blow your nose, that risk goes up a little higher. So we have patients not blow their nose, but instead use saline to wash stuff out. You can breathe a little bit through your nose, but when I see you at one week, what we first do is we first take off sutures, second, we vacuum out the nose. This gets patients breathing so much better afterwards. And then finally we take the cast off. And the cast reveal is something that everybody knows about, but what they don’t know is that the side view looks awesome. It always looks on point. Sometimes there’s a little, like, you know, if there was a big hump and the skin hasn’t really shrunk down onto the nose, sometimes there’s a little bit of a fullness in where the hump used to be, but that’s about it. In general, it looks great. From the front, it looks pretty swollen. And here’s how it goes for the most part, over the course of a year or two or three, technically.

If your nose was gonna be about this big when all the swelling is gone, it’s about this big when we take your cast off. And as it comes down, it comes down about 50% over two months. So it doesn’t just do this though, it does this. So there’ll be days where your nose might look a little bit this way or this way. It’s just all part of the process. It’s easier said than done, but it is part of the process and you just have to trust the process a little bit.

A lot of things can affect that variability in swelling, sun exposure, salt intake, exercise, temperature. I’m sure other foods can also affect that. But those are things that on a day-to-day basis you might notice. Even from midday to afternoon and morning, your nose might look slightly different. Not massive changes that other people around you are going to notice, but you’ll notice them for sure. So about 50% at two months, 60% at three months, 80% at six months, and 90% at a year.

So, the swelling comes down much faster in the beginning and it really slows down at the end. And what we tell patients is that they’re not done at the end of the year, but for most patients, we don’t need to see them after that. On occasion, we see patients for after a year if it feels like there’s areas of the nose that are being stubborn. The most stubborn areas of the nose for our patients or for any rhinoplasty patient is the tip and super tip. So this is a tip, this is a super tip.

So swelling typically resides right here and it just takes time for that to come down. So often we either have patients tape their nose or we use steroid injections, which for a moment it pinches, but then it’s easy and the swelling goes away within an hour or two from the injection. The effects of the injection can sometimes take four to six weeks and even longer. So we space them out a little bit so we don’t over inject.

But that’s the main thing that we deal with post-operative recovery with rhinoplasty is this swelling issue and you’d be surprised but even at a year at 90% swelling, me and the patient will definitely recognize that there’s little bits of swelling right here The tip definition really does get better over two to three years, but that is the last thing to come down It’s not major, but it’s just it’s noticeable to us.

When it comes to rhinoplasty recovery with restrictions, here are the restrictions that we have. Three weeks for blowing your nose, three weeks for lifting weights, four weeks for running, and four weeks for glasses. Now if you needed to wear glasses because you wear glasses daily, you can get something called the Rhino Shield. It’s a thin little silastic or plastic thing that you put on the nose and it just helps you rest the glasses evenly on the nose.

Those are the main things we deal with. Sometimes patients take medications that can thin the blood. I usually have them stop them seven to 10 days before and then resume them seven to 10 days afterwards. That’s it for rhinoplasty recovery. So if you have any questions, email us at info@njent.com or follow us on Instagram and message us. Take care.

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