Post-Rhinoplasty (Nose Job) Care

Immediately After Surgery (First Few Hours)

• Due to receiving sedative medications, do not eat or drink anything for at least one hour after entering the ward.
• After one hour, if there is no nausea, you may slowly sip sweet liquids like fruit juice with the nurse's permission.
• If you experience nausea, stop drinking and inform the nurse immediately.
• To prevent nausea and vomiting, avoid drinking large amounts of fluids for the first 8 hours after surgery.
• To start eating, begin with packaged fruit juice (Sandis) and then use compote (stewed fruits).
• Patients with thick, oily skin or those prone to acne are advised to use natural juice instead of packaged juice.

Body Position and Swelling Control

• Adjust the upper part of the bed to a 30-degree angle to reduce congestion and swelling in the head and face.
• Blood and serous fluid discharge from around the front nose bandage for several hours (up to 48 hours) is normal (this condition is more severe in men).
• Use ice packs and cold water compresses on the eyes and nose for at least 48 hours (except during sleep); this does not cause sinusitis.
• Discharge time is approximately 3 hours after surgery (if there is no dizziness or nausea), but it depends on the patient's general condition.
• For the first 24 hours after surgery, you must always have assistance when using the restroom.

Home Care (Days 1 to 8)

Rest and Sleep

• Rest in a semi-sitting position (e.g., in front of the TV) during the day to reduce swelling.
• Use an extra pillow under your head while sleeping.
• Sleep on your back (supine position) for the first two nights, after which you can also sleep on your sides.

Nutrition

• 8 hours after surgery (if there is no nausea), you can consume light, low-fat soup.
• After 24 to 36 hours, gradually start consuming soft foods like stew.

Prescribed Medications

Start taking medications from the moment you arrive home. Common medications include:

• Cephalexin: 20 capsules (1 capsule every 6 hours).
• Prednisolone Forte 50mg: 10 tablets (half a tablet daily for 3 days).
• Acetaminophen with Codeine: 10 tablets (1 tablet every 6 hours as needed).
• Saline Irrigation Solution: Half a liter (for internal nasal irrigation).
• Vitamin A Eye Ointment: For lubricating inside the nostrils.
• Phenylephrine Drops: To open nasal passages.

Note: In case of pain, use only plain acetaminophen or acetaminophen with codeine. The use of other painkillers is not allowed due to the risk of bleeding.

Nose and Bandage Care

• In most patients, internal nasal tampons are removed before discharge from the hospital, but in some cases, they will be removed in the clinic a few days later.
• After removing the tampons, wash your nose with saline solution (at least 4 to 6 times a day using a 10cc syringe) and expel secretions through the mouth.
• Avoid blowing your nose forcefully for two weeks.
• After tampon removal, breathing may be noisy and difficult, but it will gradually improve.
• In case of congestion, use phenylephrine drops for a maximum of 7 days (4 drops in each nostril, morning and evening).
• Lubricate inside the nostrils twice a day using a cotton swab dipped in Vitamin A ointment.
• If one or both nostrils are blocked due to swelling, do not worry and there is no need to continue washing.
• If the front nose bandage gets stained with blood, replace it with gauze (sterile or non-sterile) and M3 hypoallergenic tape.

Sneezing, Runny Nose, and Bruising

• Sneezing and runny nose are common and often do not indicate a cold.
• When sneezing, keep your mouth open to avoid pressure on the nose.
• If sneezing is bothersome, you can use an antihistamine-decongestant tablet (one tablet every 12 hours).
• Swelling and bruising around the eyes start a few hours after surgery, peak on the second and third days, and then subside.
• Bruising and swelling may be asymmetrical, but they resolve spontaneously.

Cast (Splint) and Suture Care

• Wearing glasses on the nose cast is permitted until the eighth day; consult the doctor regarding glass use after the eighth day.
• Using contact lenses is permitted from the fourth day.
• If there are sutures in the nasal alae (wings), starting from the fifth day, you can gently wipe blood clots with a cotton pad soaked in alcohol.
• The nose cast must not get wet under any circumstances; for showering, wash your body and hair separately.
• The nose cast is usually removed in the clinic 5 to 9 days after surgery. Take a full shower (including wetting the cast) one hour before the appointment to facilitate cast removal.
• If the cast becomes loose (especially in oily skin), inform the doctor or assistants immediately.
• If additional septal cartilages are handed to you, keep them away from light and heat.

Additional Recommendations

• Laughing or talking extensively causes no harm.
• Using wound healing ointments (such as Cicalfate, Rejuderm, or Stratamed) on the alar sutures is effective.
• Internal nasal sutures are absorbable and come out gradually.
• In patients with thick skin, avoid consuming "hot natured foods" (such as honey, dates, walnuts, molasses, and sweets) as much as possible.
• The occurrence of acne around the nose and face is somewhat normal; if it intensifies, inform the doctor.
• In patients with thick skin, avoid sun exposure or tanning beds (solariums) for at least 6 months.

Psychological Recommendations: Others' Opinions and Mirror Gazing

Regarding Friends' and Relatives' Opinions

Unfortunately, many patients immediately after surgery (even with the cast on) face varied and sometimes biased opinions from friends and relatives, leading to decreased self-confidence and anxiety. Always remember:

• Aesthetic standards vary from person to person; it is impossible to satisfy everyone.
• The best people to give opinions are father, mother, sister, brother, and spouse.
• The final result of the surgery can only be evaluated after 6 months to one year.

Regarding Mirror Gazing After Surgery

Many patients constantly look at their noses in the mirror just a few hours after surgery or immediately after cast removal. This behavior, due to existing swelling, results in nothing but stress, anxiety, and sometimes depression. Please be patient and remember that the final shape of the nose requires complete subsidence of swelling, which takes months.

Final Note: The above information has been prepared based on Dr. Hadi Amali's years of experience in rhinoplasty surgery. Strict adherence to these points will bring you a more comfortable recovery period.

Be happy and proud
Dr. Hadi Amali