Rhinoplasty recovery: what to expect

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 for at least six weeks, because sleeping on your side causes uneven swelling. 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 off at your review, which falls between seven and ten days after surgery. Most patients take ten days to two weeks off work.

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.

Wash three to four times a day and keep going for three weeks. Use boiled water that has been cooled to body temperature rather than water straight from the tap, and wipe the bottle tip with an alcohol wipe afterwards. At first the wash will trickle back out the same nostril. After a few days, as the packing dissolves, it will start to flow up one side and out the other. That is the sign the nose is clearing, and it is worth knowing to look for it.

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 to eight weeks. Contact lenses, or taping them to the forehead, are the usual solutions.

No nose blowing for three weeks, no alcohol for two weeks, no bending forward or straining, nothing over 5 kg, and no strenuous exercise; the table under Returning to exercise shows what you can do and when.

The six-week swell

The six-week swell causes more alarm than anything else in recovery, and it is normal.

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.

Knowing about it in advance makes it far easier to sit through.

How you may feel

It is normal to feel anxious, flat, or even regretful in the first week or two, and it is commonest when the swelling and bruising are at their worst. It has a name, post-operative blues, and it is a recognised part of recovery from this operation rather than a sign you have made a mistake.

What you are looking at in the mirror at that point is not your result. It is a swollen, healing nose with a splint on it.

If the feeling persists beyond a few weeks, tell me or your GP.

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 about twelve months, and later 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.

Ring my rooms about anything that worries you, in every week of this and not only the first, whether or not it turns out to matter.

Taping after the splint comes off

I ask you to tape the nose every night for six to eight weeks after the splint is removed, or for as long as I advise. Taping compresses residual swelling and helps the skin re-drape over the new structure underneath. Use only hypoallergenic tape, and I will show you the technique at your first post-operative visit rather than leaving you to work it out from a diagram.

Returning to exercise

Raising your blood pressure raises the risk of bleeding and swelling, so this is graduated rather than all at once.

When	What is reasonable
Weeks 1 to 2	Gentle walking only. Nothing that lifts your heart rate.
Weeks 2 to 3	Brisk walking. Light stretching with your head upright. No weights, no bending over.
Weeks 3 to 4	Light stationary cycling or elliptical at low resistance. No impact, no heavy lifting.
Weeks 4 to 6	Light lower body work. Nothing above shoulder height, and nothing that reddens your face.
After 6 weeks	Most exercise can resume once I have cleared you at your review.
After 12 weeks	Full return to non-contact sport.
After 6 months	Contact sport and anything with a risk of a blow to the face, once cleared.

Swimming is out for at least six weeks, pools, open water, hot tubs and spas alike, because chlorinated water irritates healing lining and raises the infection risk.

Flying is out for two weeks after surgery. I will confirm you are clear to fly at your review.

Driving is out for twenty four hours after the anaesthetic, and for as long as you are taking any strong pain medication.

Sun, makeup and skincare

Sun protection matters for six to twelve months, which is longer than most people expect. Ultraviolet exposure can permanently darken the small scar between the nostrils and the skin around it. SPF 50+ on the nose every morning, including on cloudy days, and a wide brimmed hat outdoors.

Keep makeup off the nose and the incision for at least two weeks, or until I confirm the wounds are fully healed. When you go back to it, apply gently with a clean brush and take it off with a gentle cleanser rather than scrubbing.

Keep active skincare ingredients, retinoids, acids and exfoliants, away from the nose for about four weeks. A plain fragrance free moisturiser is fine on the rest of the face from day three, avoiding the incisions.

Eating

You can eat normally. Swallowing may feel slightly harder while you are congested, and your sense of smell is usually reduced for the first week and returns as the congestion clears. Avoid very hot food and drinks in that first week, because heat increases swelling. Drink plenty of fluids.

If you are taking strong pain medication, expect it to cause constipation, and deal with it early rather than late. Straining raises pressure in the face and can start a nosebleed. Fluids, fibre, and a stool softener from the first day are the straightforward answer.

Things to avoid

Through the first weeks:

• Blowing your nose (not for three weeks)
• 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 (not for two weeks) 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, a fever above 38 degrees, bleeding that is heavy or does not settle, increasing redness, warmth or swelling of the nasal skin, thick yellow or foul smelling discharge, any sudden change in vision, or difficulty breathing or chest pain.

Difficulty breathing or chest pain, or bleeding you cannot control, means calling 000 or going to your nearest emergency department rather than ringing my rooms.

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

Contact us if anything concerns you at all. A question that turns out to be nothing is always welcome.

If you are travelling home

You cannot fly for two weeks after surgery, and I confirm clearance at your seven to ten day review. Do not book non-refundable return travel before then.

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.

I see you at set points through the first year, because the things that need catching early are not the things patients notice.

The wider picture

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

The full discussion of risks and what can go wrong is in the risks and side effects answers. More about the operation itself is on the rhinoplasty page, and what to do beforehand is on the pre-operative care page. Why early bruising and swelling are often reduced is explained in what makes ultrasonic rhinoplasty different, allergies that slow healing are covered in the impact of allergies on rhinoplasty outcomes, and the cost page covers time off work and fees.