Rhinoplasty Recovery, Step by Step

Rhinoplasty reshapes the cartilage and bone of the nose. Cartilage and bone can be trimmed, smoothed or removed; grafts can be added to fill depressions; the width and size of the nostrils can be altered; and a deviated septum can be corrected at the same time to improve breathing.

What follows is what the recovery looks like, in the order you will experience it.

Before surgery

The consultation establishes whether you are fit for surgery, assesses the structure and function of the nose, and defines what you want changed. Photographs are taken, a plan is agreed and a date is set. Bring your questions to this appointment — it is the point at which expectations get aligned, and that is the largest single predictor of whether a patient is satisfied afterwards.

The operation

Performed under general anaesthesia, or intravenous sedation with local anaesthesia. Incisions are placed inside the nostrils, or across the columella — the strip of tissue between the nostrils — in an open approach. Where nostril size is being reduced, additional incisions sit in the crease where the nostril meets the cheek.

The mucous membrane is lifted to expose the underlying structure. A deviated or irregular septum is repositioned and reshaped, and bone and cartilage are trimmed or removed as planned. The mucous membrane is replaced and the incisions closed with sutures. An internal splint holds the structures in position, gauze packing may be used to control bleeding, and external dressings are applied.

Day one

Minor swelling, bruising and discomfort around the nose, eyes and cheeks. Mild bloody drainage from the nose, which may require the dressing to be changed several times. Sleep with the head elevated. Cold compresses and prescribed analgesia manage the discomfort.

Days two to four

Bruising and swelling peak around day two and begin to diminish by day four. Cold compresses and analgesia continue. The bloody drainage reduces and stops.

Days five to seven

A follow-up appointment, at which the splints, internal gauze and external dressings are removed, along with any non-dissolving sutures. Bruising is by now largely gone. Stuffiness and drainage into the throat are common up to this point and are relieved by removal of the splints.

Days seven to fourteen

Sense of smell returns. Numbness and tingling in the teeth, cheeks, mouth and nose improve. You can return to a normal sleeping position if it is comfortable. Many patients return to work in this window.

Days fifteen to thirty

Swelling and bruising are substantially reduced and nasal breathing is easier. Air travel is possible.

Months two to eleven

Subtle changes in shape continue and are entirely normal. Most of the residual swelling resolves during this period.

One year

The final shape is settled. Healing after rhinoplasty genuinely takes this long, which is why judgements about the result made at three months are premature.

Restrictions in the first month

• Protect the nose from any impact.
• Do not blow your nose.
• Do not pull clothing on over your head.
• Do not smoke.
• Do not take anti-inflammatory medication unless your surgeon has approved it.
• Avoid dusty and smoky environments.
• Limit exercise to walking. No contact sport, no strenuous activity.
• Avoid wearing glasses, or anything else resting on the bridge.

Contact sport and heavy lifting are avoided for up to six weeks. Most people return to work and normal activity within one to two weeks, depending on the extent of the surgery and the nature of the work.

Risks

Every operation carries risk, and these should be understood before consent, not afterwards.

• Bleeding, during and after surgery.
• Infection. Sterile technique and prophylactic antibiotics reduce but do not eliminate it.
• Adverse reaction to anaesthesia. Rare; the anaesthetist reviews your medical history for this reason.
• Breathing difficulty, from swelling or from structural change during healing. Usually temporary, rarely permanent.
• Numbness. Temporary altered sensation is common; permanent numbness is rare.
• Asymmetry. Perfect symmetry is not achievable in any face, and a degree of residual asymmetry is possible.
• Prolonged pain, swelling or discoloration. Usually settles within weeks; occasionally persists longer.
• Scarring. Incisions are placed inside the nose or in inconspicuous positions, but a small risk of visible scarring exists, more so with an open approach.
• Septal perforation — a hole in the septal wall. Rare, and may require further surgery.
• Change in the sense of smell. Usually temporary.
• A result that does not meet expectations, which may lead to revision surgery.

What helps recovery

Rest, particularly in the first fortnight. Keep the head elevated when sleeping to limit swelling. Do not blow your nose. Keep pressure off the bridge. Avoid strenuous activity for at least two weeks and contact sport for several months.

Do not smoke before or after surgery — it constricts circulation, delays healing and raises the infection risk. Protect the face from strong sun with a wide-brimmed hat and high-SPF sunscreen; UV exposure during healing causes pigmentation change and worsens scarring. Eat well and stay hydrated.

Attend every follow-up appointment. They are how healing is monitored, complications are caught early, and your questions get answered by someone who knows what was done.

Long term

Full healing takes a year, after which the nose holds its shape. Rhinoplasty does not stop the face ageing, and minor changes over the following decades are normal. The improvement itself remains.