Rhinoplasty is a popular and very successful procedure for reshaping the nose. While many have an interest in such nasal surgery, there is understandable concern about going through a surgery and, in particular, the recovery from it. Because of the very visible location of the surgery (hard to miss the nose in the center of your face!), everyone is very interested in knowing how ‘bad’ one will look after and for how long.
Rhinoplasty is an operation that is a complex series of surgical maneuvers that changes in shape or size the bone and cartilages of the nose. As a result, no rhinoplasty surgery is ever exactly the same in any two patients. (nor should it be) But there are some basic components of the operation that do affect the recovery and how one will temporarily look during the recovery period. In my Indianapolis plastic surgery practice, I like to make sure that patients know what to expect and why.
One of these options that has great impact on whether one will have bruising and how much is the bones of the nose. If they are merely shaved or rasped at the bridge area, one will have no bruising or swelling under the eyes. If these bones are broken, for the sake of narrowing the upper part of the nose and to close an open roof after a significant hump reduction, there will be bruising under the eyes that is typically thought of after rhinoplasty. The nasal bones are cut low at their base where they join the upper jaw bone up to the inside corner of the eye. Cutting these bones with a small chisel causes bone bleeding which oozes into the soft tissue planes of the tissues underneath the lower eyelid. Because this tissue plane stops where it joins the cheek, a very sharp line of demarcation develops between bruised and non-bruised cheek skin. This bruising in many will take up to three weeks to go away completely. Mineral make-up or foundation can be used for camouflage.
Whether one has an open or closed rhinoplasty influences how much and how long swelling of the nasal tip will persist. The vast majority of rhinoplasties today are done open so tip swelling can be expected. The thicker one’s skin is, the more and longer this swelling will persist. This is one of the major benefits to the tapes and splint that patients wear after surgery. Keeping down a large amount of swelling and helping the skin to heal back down are its main objectives. When the splint and tapes are removed after the first week, one should anticipate improvement in the shape of the tip already but there will be some significant swelling and shape changes to occur as this goes down. Patience is the key to seeing the efforts of what was done underneath. In some patients this may take months, but most seen a lot of satisfying improvements by the third week after surgery.
The other issue affecting recovery is whether one has had any internal or functional nasal surgery done at the same time as the rhinoplasty. (septoplasty, turbinate reduction) If so, expect some congestion and nasal stuffiness for several weeks. If not, one’s nasal breathing should be unchanged after surgery.
Understanding what to expect after surgery, before you have it done, can ease one’s concerns as they go through the recovery period. This is particularly true in rhinoplasty surgery where patients are often quite anxious.
Dr. Barry Eppley
Indianapolis, Indiana