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Procedure: Rhinoplasty / Revision Rhinoplasty FAQ

Rhinoplasty / Revision Rhinoplasty FAQ

View frequently asked questions from patients considering Rhinosplasty & Revision Rhinoplasty facial procedures.

1. Is nose surgery painful?

No. It is uncomfortable at times because you will not be able to breathe through your nose for a couple of weeks after the surgery.

2. Do you need to break my bones Doctor?

Only if aesthetically advisable. Remember, "breaking the bones" doesn't add any pain to the procedure postoperatively and only augments the result. "Breaking the bones" is, in fact, a very controlled maneuver using delicate instruments; indeed, "controlled infracture" is a more accurate term.

3. Do I need a cast and if so, for how long?

Most rhinoplasty patients will require casting for up to 1 week postoperatively to allow the bones to set. After 1 week the cast is removed.

4. When can I go back to work and see my friends?

Most patients feel confident to see other people at 7-10 days after surgery. 80% of swelling takes 2-3 weeks to resolve while the remaining 10-20% takes 6 months to a year to go away. Bruising takes about 7-10 days to fade away. At 2 weeks postop, I administer a minute shot of cortisone that "turbo-charges" the disappearance of the swelling, so that most feel really great about their result at 3-4 weeks. It is only the very rare patient who experiences prolonged postoperative inflammatory swelling lasting many months.

5. My nose feels hard and stiff and numb. Is this normal?

Yes. These sensations last about 3 months and are par for the course.

6. When can I play sports?

Your nose will be quite fragile for up to 8 weeks after surgery, so it is important to avoid all contact sports for this time. This also includes free bicycle riding (you can fall off), tennis water sports, etc. Murphy's Law dictates that if something bad can happen, it will. Be forewarned.

7. My nose is stuffy. When will I notice an improvement in breathing?

This depends on the individual, the extent of the surgery and how bad your breathing was in the first place. It will take several weeks to notice improvement in nasal inspiration, so before that time, you will be breathing mainly through your mouth. Consequently your mouth can get very dry especially while sleeping. Therefore, it is advisable to utilize a humidifier while sleeping to help alleviate the discomfort associated with a dry mouth. Nasal stuffiness after rhinoplasty results from normal postoperative swelling and obstructing crusts. Occasionally, I will prescribe a nasally inhaled steroid to help reduce the postoperative inflammation and associated blockage. Avoid vasoconstrictors such as Afrin™ after surgery since this may have a deleterious effect upon healing and long term breathing. Nasal saline sprays, such as Ayr™ and Ocean™ are very useful to clean out the nasal passages of crusts as well as the careful use of Q-Tips soaked in hydrogen peroxide. Honey dissolved in a small amount of warm water is quite effective in dissolving crusts, by either carefully sniffing the mixture through the nose or through applying it with Q-Tips. Honey also possesses some antibacterial activity.

8. If I need a minor revision, when can I get it done?

This is infrequent (under 4% with my patients), but if necessary, it is advisable to wait a minimum of 6 months after the original surgery. Very minor asymmetries can be corrected under local anesthesia (like the dentist) utilizing a permanent fat transfer technique, before 6 months.

9. Why do you plastic surgeons recommend chin implants at the same time as rhinoplasties?

We only do if the chin is small in relation to the other facial features. Both the nose and chin are the most prominent features when the face is viewed in profile. Consequently, they should be aesthetically balanced. However, the patient will be the ultimate judge of this.

10. How difficult are chin implants? What is the recovery time?

Chin implant surgery is relatively easy surgery to perform for the surgeon and to recover from for the patient. Swelling is minimal and once the surgical tape is removed after a few days, patients feel comfortable going in public-even making television appearances! The implant will feel like your regular bony chin and should not move or shift. Infection is exceedingly rare. Liposuction under the chin and of the neck to highlight the jawline can be performed at the same time through the small small incision (about 1 cm long).

Randal Haworth, MD
436 North Bedford Drive Suite 105
Beverly Hills, CA 90210
(310) 273-3000 (310) 273-8802 Monday through Friday, 9 a.m. to 5 p.m.