Rhinoplasty is a facial surgery procedure for reconstructing the nose. This may be for aesthetic purposes to alter the appearance, size, shape or proportions of the nose, improve breathing, or repair injuries and defects.

As with all surgery that requires anaesthetic, postoperative aftercare and a lengthy recovery, the rhinoplasty procedure can cause swelling in the tissues of the nose and face, which may take some time to reduce.

The amount of swelling may vary between different rhinoplasty surgeries depending on the individual and the type of procedure performed. If nasal bones are fractured, you will experience more swelling around the cheeks and eye area as part of the surgery.

There are several postoperative care measures that patients are required to follow closely to aid recovery and reduce the risk of bleeding and swelling. These include:

Keep Your Head Elevated

Rhinoplasty surgery involves the manipulation of soft tissue, cartilage and bone within the nasal region. As a result, patients commonly experience postoperative oedema (swelling). Keeping your head higher than the rest of your body and avoiding lying down flat will help the drainage of lymphatic and venous fluids, aiding in minimising the extent and duration of postoperative swelling. Elevating your head may also reduce the potential for postoperative headaches and provide a more comfortable experience for patients.

Use a number of pillows when you lie down, and try to sleep in a semi-reclined position to avoid liquid pooling around the surgery site overnight. You should also avoid bending over or any strenuous exercise that will increase your blood pressure.

Apply Cold Compresses

Cold compresses placed on the face after rhinoplasty surgery will help reduce swelling, manage pain and enhance overall comfort during the early stages of recovery. As they numb the area slightly and slow blood flow, applying a cold compress will also help to minimise the severity of bruising. To make a cold compress, dampen a clean towel with water and seal it in a plastic bag before putting it in the freezer for 15 minutes.

You can place the compress on your skin for up to 20 minutes; however, do not put it directly on the nose area, as it may put too much pressure on your nose and will dampen the cast. Instead, place the cold compress on your forehead or cheeks. Ensure the cloth is not too wet so that water doesn’t run onto the cast.

Cold compresses are most effective in the first 48 hours following rhinoplasty surgery. A standard regimen involves applying the compress for approximately 20 minutes, followed by a 20-minute break without the compress. Ice should never be applied directly to your skin, as this can affect blood flow and cause tissue damage.

Stay Hydrated

Drinking plenty of fluids is crucial for postoperative healing. It will help flush out toxins from your body and reduce swelling more effectively. Drink lots of water and ensure you monitor your urine colour — clear or pale-yellow urine indicates proper hydration, while dark yellow urine can suggest you’re dehydrated and need to up your fluid intake.

Patients should also avoid caffeinated drinks such as coffee and tea, as these can contribute to dehydration, inhibiting the normal healing process. You should also keep an eye on your sodium intake, as a high-sodium diet can lead to fluid retention. Don’t add salt to your food, avoid salty snacks and maintain a healthy, balanced diet rich in vitamins, minerals and protein. High-protein foods are especially important for tissue repair, so include lean meats, fish and dairy in your meals or if this is uncomfortable protein shakes or nutritional supplement shakes are a great alternative.

Rest is critical

In the two weeks following rhinoplasty surgery, rest is paramount. Beyond this timeframe, a significant reduction in swelling and bruising is expected, so you can slowly begin to resume social activities. Don’t schedule surgery too close to a special event such as a holiday or wedding — your surgeon will advise you to allow several months for the complete resolution of swelling, ensuring an optimal aesthetic outcome.

Avoid Alcohol, Drugs and Supplements

Stop taking any supplements or other drugs and medications in the two weeks prior to your rhinoplasty surgery, as well as post-surgery, as they may affect your blood pressure, circulation and healing. We always advise to let your surgeon know of any medications or supplements you are taking so your surgeon can advise you specifically.

Avoid consuming anti-inflammatory drugs such as Ibuprofen for pain or to reduce swelling. While these medications generally assist with discomfort, they can elicit adverse effects in the context of rhinoplasty recovery. Anti-inflammatory drugs contain properties that can hinder the normal clotting process of blood, which can increase the risk of postoperative bleeding and lead to further inflammation. Avoiding these medications will also help minimise the potential for haemorrhage at the surgical site. Anti-inflammatory medications must be avoided for at least two weeks prior and post surgery.

Always follow your surgeon’s prescribed pain management plan to ensure a smooth and complication-free recovery. If you have concerns or questions about medications used during the recovery period, seek professional guidance from your anaesthetist.

Alcohol is a diuretic and can cause dehydration, which may exacerbate the risk of swelling. The consumption of alcohol should be avoided until you fully recover and the swelling after rhinoplasty has gone down. If you’re unsure, refer to your surgeon’s postoperative instructions and consult with them regarding the appropriate time to resume consuming alcohol.

Follow Your Surgeon’s Nasal Taping Guidelines

After your rhinoplasty procedure, Dr Shahidi — who is a fellow of the Royal Australian College of Surgeons (FRACS) and has undertaken a fellowship of Australasia Academy of Facila Plastic Surgery (AAFPS) — will place a cast, splints and surgical tape across the nasal bridge and nasal tip. This will help minimise swelling, maintain airway integrity, ensure unobstructed airflow, and optimise healing. Dr Shahidi will remove these splints at your postoperative check-up. This step is critical for ensuring that the surgical site is healing well and that any necessary adjustments can be made. Dr Shahidi then asks his patients to wear the cast to bed every night or as much as possible for the next 4-6 weeks.

After about 4-6 weeks, you’ll only have to wear the tape at night. This transition is part of the gradual healing process and is designed to align with the changing needs of the nose as it progresses towards its final shape. Make sure to apply the tape as directed for at least 6 months after the rhinoplasty procedure, although you may be recommended to use the tape for longer.

While nightly taping of your nose for a long period may seem like a burden, it contributes to minimising visible scarring and optimising the long-term aesthetic result of the rhinoplasty procedure.

Ahead of your procedure, Dr Shahidi will clearly outline the steps needed for nasal taping, so you should adhere to those guidelines to achieve the safest results.

Avoid Sneezing, Coughing, Nose Blowing and Crying

Sneezing, coughing, nose blowing and crying can cause swelling in the nose and irritate the stitches, increasing the potential for bleeding or bursting. Using a humidifier can help to keep the air in your room moist to avoid coughing, and you should stay away from cigarette smoke and other pollution.