Rhinoplasty recovery: what to expect

Recovery from rhinoplasty is longer than most patients expect and less painful than most patients fear. This is what actually happens.

If you are my patient, the written instructions you were given take precedence over anything here. This page is general guidance for people deciding whether to have surgery, or trying to work out whether what they are experiencing is normal.

The first three days

Significant swelling and bruising around the eyes and nose. Nasal congestion, so you will be breathing through your mouth. Blood-stained mucus drainage is normal and expected.

A splint sits on the outside of the nose holding the cartilage and bone in position while they heal, and it must be kept completely dry.

Sleep on your back with your head elevated on two pillows. Ice packs on the cheeks help for the first two days.

Most patients describe the pain as moderate and manageable. Pain that worsens after the first few days should be reported rather than tolerated.

Days four to ten

Bruising peaks and then begins fading to yellow and green. The dissolvable packing inside the nose clears with nasal washes.

The splint comes out at the seven to ten day appointment. Most patients feel well enough to return to desk work at that point.

Nasal washes from day two onwards matter more than most patients expect. They are the main thing keeping the inside of the nose clear while it heals.

Weeks two to six

Most bruising has resolved by week two or three.

The tip may feel firm or numb. That is normal and it settles over months rather than weeks.

Glasses must not rest on the bridge of the nose for the first six weeks. Contact lenses, or taping them to the forehead, are the usual solutions.

No nose blowing, no bending forward or straining, nothing over 5 kg, and no exercise that raises your heart rate.

The six-week swell

This is the part nobody warns patients about, and it causes more alarm than anything else in recovery.

Nasal swelling can temporarily increase at around four to six weeks after surgery, before it begins to clearly improve. Your nose may look worse at six weeks than it did at three.

It does not mean anything has gone wrong. It is a normal part of healing as the deeper tissues reorganise.

If you are not expecting it, it is frightening. If you are, it is a stage.

Months two to twelve

Gradual refinement continues throughout. Tip definition improves as the deeper swelling resolves, and the tip is the last part of the nose to settle.

Most activities are resumed by six weeks.

The final result is typically visible at nine to twelve months, and longer in patients with thicker skin.

This is why the photographs in my gallery state how long after surgery each was taken. A nose at six weeks and the same nose at a year are visibly different, and comparing yourself at three months against someone else’s twelve month result is not a fair comparison.

Things to avoid

Through the first weeks:

• Blowing your nose
• Getting the splint wet
• Removing or touching the splint
• Picking at scabs or touching inside the nose
• Bending forward or straining
• Lifting anything over 5 kg
• Exercise that raises your heart rate
• Alcohol and smoking
• Ibuprofen, aspirin and other non-selective anti-inflammatories, which affect bleeding
• Glasses resting on the bridge

Sneeze with your mouth open. Walk gently as tolerated. Drink plenty of fluids.

What to contact us about

Rather than waiting: worsening pain after the first week, fever, bleeding that does not settle, increasing redness or swelling of the nasal skin, or any sudden change in vision.

These are uncommon and they need assessing rather than monitoring at home.

Contact us if anything concerns you at all. I would rather answer a question that turns out to be nothing than have you sit at home worrying about it.

If you are travelling home

Clearance to fly is given at the day seven review and depends on how you have healed, not on a fixed timetable. Do not book non-refundable return travel before that appointment.

Follow-up at three, six and twelve months can be done by video with photographs, so you do not need to travel back to Brisbane for a short review.

The wider picture

Recovery varies between patients and the timeline above is typical rather than guaranteed.

The full discussion of risks and what can go wrong is on our risks page. More about the operation itself is on the rhinoplasty page.