Marisa Marques

Rhinoplasty

(usually a day of hospitalization)

Rhinoplasty is one of the most challenging procedures in plastic surgery.
Type of Approach: 1) Open approach; or 2) Endonasal (closed) approach.

Nasal deformity

- Nose not harmoniously with the rest of the face
- Airway resistance

Postoperative care
During the first 48 to 72 hours, the patient is instructed to keep the head of bed elevated at 45 degrees and use a chilled gel eye mask to help minimize postoperative swelling. The drip pad under the nose is changed as often as necessary until the drainage stops, at which time it can be discontinued. Any manipulation of the nose, including rubbing, blotting, or blowing, is discouraged for the first 4 weeks postoperatively.
We prefer to keep our patients on a liquid diet in the day of surgery and then advance them to a soft regular diet the following day. Any foods that require excessive lip movements, such as eating apples or corn on the cob, should be avoided for 2 weeks after surgery.
The sutures and nasal splints are removed at the initial visit on postoperative day 5 to 7. The nose (especially the tip) may appear swollen and turned up and the tip may feel numb, but the patient is reassured that both are expected and that both will resolve with time. Normal sensation usually returns within 3 to 6 months. The patient is instructed to avoid letting anything, including eyeglasses, rest on the nose for at least 4 weeks.
The patient is also instructed to avoid direct sunlight and to wear sun protection factor 50+ to prevent possible hyperpigmentation of the incision.
We restrict the patient’s activity for 3 weeks postoperatively, after which the patient can gradually resume normal activity.
Any contact sports or activities that may cause direct trauma to the nose are prohibited for at least 8 weeks after surgery.
Although some noses look excellent within 6 to 8 weeks, some may remain swollen for up to 1 year, but after 3 to 4 weeks, it will generally not be obvious to anyone but the patient.
After the first postoperative visit, have the patient return to the clinic at 3 and 8 weeks after the operation. We continue to follow the patient at postoperative months 3, 6, and 12, and annually thereafter.
 
Complications
Infection, hemorrhage, excessive narrowing or convexity, redundant soft tissue, stair-step deformity, nasal bone asymmetry.
Approximately 1 in 25 primary rhinoplasty patients require revision.
 
 
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