Post Procedure Care
POST PROCEDURE INSTRUCTIONS FOR YOUR RHINOPLASTY AND WOUND CARE
Congratulations on completing your Rhinoplasty procedure! Below is a list of instructions designed to help you through the recovery process. After you have read these instructions and you still have questions (especially if you think there is an emergency) please call the office at 425-990-3223.
Please make sure to come in to see us the day after surgery for your post-op appointment. For your privacy we have a back entrance to be used for follow up appointments, there is a doorbell at this entrance. Please ring the bell upon your arrival and we will greet you at the door. We ask that you use this entrance for all follow up appointments for the first month after your procedure.
Things You Will Need:
- Distilled Water
- White Vinegar
- Nasal Saline Rinses
- Blue Bulb for Nasal Rinses
- Silicone Scar Healing Gel
Please visit our Patient Care Page to find out where to purchase specialized ice packs here: http://www.drphilipyoung.com/patient-care/ If you can’t afford these you can always use an ace bandage to wrap the areas and frozen peas for icing.
- You can start rinsing your nose with cool saline rinses once the packing in your nose is removed, if you have packing. The mixture is a quart of distilled water with 2-3 teaspoons of salt, and 1 teaspoon of baking soda.
- You can use a blue bulb that is found in drug stores, in the baby care section to help you with this nasal irrigation.
- When you rinse the nose you should feel the salt water go all the way into your nose and come out the other nostril. This helps to cleanse your nasal passages and can be done 2-3 times a day.
- Cool compresses (ice pack or bag of frozen peas) are essential for the first 7 days (or longer if needed) 15-20 minutes each hour. Popsicles, and cool foods and liquids can also keep things cool in the nasal area as well.
- You should go to the pharmacy and consider purchasing some gauze and tape so that you can change the moustache dressing as needed for any oozing.
- Afrin nasal spray can be used starting right after your procedure and should only be used for a total of 3-5 days. This could help clear your nasal passages and prevent bleeding.
Cleaning Your Incisions:
- You should clean your incision 2-3 times a day or more for the first two weeks with 1 part vinegar and 3-4 parts distilled water mixture. This will help to avoid scabbing/crusting around the wound. You should clean more frequently if there is crusting. The goal is to have a very small | closely opposed incision line with no crusting for the best healing.
- You should keep Vaseline on the incision at all times for the first 10-14 days or until further notified. This will allow your incision to heal faster. A light coat is suggested to help with cleaning.
- After two weeks you can consider Kelocote or other products containing silicone gel on the healed incisions. Apply the silicone gel for 12 hours a day on and 12 hours a day off for the next 3 months. The silicone gel only applies if you have an external incision. The other 12 hours that the silicone gel is off, you should apply spf 45 or greater sunscreen on your incisions (during the day)
- More information on wound care can be found on this link: http://www.drphilipyoung.com/patient-care/procedure-process/wound-care-scarprevention/
- You should avoid hot (temperature) and spicy liquids and foods for the first 2 weeks. Drink plenty of fluids to make sure that your urine is not too dark. It should be a light yellow to clear in color. Eating helps you to absorb your medication and also prevent nausea with your pain medication. However, early on after surgery too much food can cause nausea.
- We recommend that you start taking your nausea and pain medications as soon as possible. Start with the nausea medication as soon as you can after surgery followed by the pain medication (1/2 tablet to one tablet) ½ hour later. You should only have a maximum of 12 tablets of Percocet (5/325) over 24 hours and no more. The pain medication takes an hour or so to take effect and during the start up time you will have pain. The nausea medication also takes about an hour to take effect. But depending on what pain medications you have, you need to follow the directions on the bottle that contains the specific medication.
- Always try to remember not to take too much pain medication. Pain medications can slow your breathing, which can be dangerous. Also you can only have 4 grams of Tylenol in 24 hours; over this amount can lead to irreversible liver damage. So never combine regular Tylenol with your Pain medication.
- Do not use high dose vitamin E, herbal medications or supplements, aspirin, Aleve, Ibuprofen or other anti-inflammatories for two weeks before and after your surgery. These medications and agents all cause bleeding. Here is a link to all the medications to avoid http://www.drphilipyoung.com/wpcontent/uploads/2012/11/Medications-to-Avoid.pdf
- You should start your antibiotics and Clonidine (if you have this medication) as soon as possible after your surgery as well. The antibiotics and Clonidine are to be taken regularly and finished completely. The nausea and pain medications are taken on an as needed basis.
- Some of your stitches will need to be removed 6-7 days following your surgery; others may be removed a month later.
- Sometimes stitches can break because we use very delicate stitches to get a good result. If this happens schedule an appointment as soon as possible for us to restitch the area.
- You will have some mild bleeding from your incisions. This is normal when the local anesthesia wears off. The first 24 hours is the most common time period for severe bleeding. The other time point is at 7 days when the clots get dissolved. Hence the first two weeks are crucial and you should be careful.
- We usually see you the next day after your procedure. This is when we determine if you have swelling that we should worry about.
- Your swelling may increase over the next 3-4 days. Sometimes swelling lasts well over a week in a small population of patients. It all is dependent on the amount of surgery that you have.
- Try to avoid sleeping on the sides of your face. This can lead to asymmetry and lead to a distorted look. Give yourself some time for the swelling to go down. All lumps and bumps eventually resolve.
- Sleeping at a 30-45 degree angle, on your back can help the swelling for the first week.
- Cool compresses (ice pack or bag of frozen peas) are essential for the first 7 days (or longer if needed) 15-20 minutes each hour. No warm compresses are recommended nor Massage unless directed by the Doctor.
- 15-20 minute walks twice a day will also resolve residual bruising and swelling (start these 3 days after your surgery if you would like).
- If you notice redness spreading, skin hot to the touch, white/yellow discharge from the incisions, or increased pain to one particular area, please set up an appointment to be seen this could be an infection that is easily treatable if caught early.
- Sun avoidance is crucial to avoid having your wound turn dark from hyperpigmentation.
- You must stay out of the sun or minimize your exposure for the next 6 months. If you do go out in the sun you must wear sunscreen SPF 45 and reapply every 30 minutes to an hour. You should try to avoid putting on sunscreen for the first two weeks.
- No strenuous activity, straining, bending over, lifting greater than 5 pounds, drinking alcohol or hot oral fluids, eating spicy foods, strenous exercise, very hot showers and hot baths, aspirin, anti inflammatories, high dose vitamin E, herbal medications, smoking, for 2 weeks after surgery. It’s okay to take a light walk for about 15-20 minutes once or twice a day after the first three days and increase your activity slowly after two weeks.
- Light walks also sometimes help with resolving residual bruising and swelling.
- You can bathe/shower after the first 72 hours, just as long as you don’t use very warm water. The water should be lukewarm just warm enough not to cause discomfort from being too cold.
- If you are straining going to the bathroom, in order to avoid pressure along your incision lines and to avoid bleeding, our Doctors usually suggest drinking a lot of fluids to help your bowel movements (to the point where your urine is clear), Metamucil daily, and / or Colace 100mg orally twice a day. Our Doctors also suggest using over the counter suppositories or enema’s as needed.
- Your healing, swelling and recovery will be 60% at 6 weeks and 80% at 6months. You should gauge your activity based on this. We generally advise starting regular activity slowly 2 weeks after your procedure.
- Make up can usually be worn after 7 days depending on how your incisions heal. No makeup should be applied over raw areas.
- Do not use age defying make-up around your incisions or on your eyes as it contains
retinol and may cause an allergic reaction for up to one month after your procedure.
- We typically have most of our patients come back the next day.
- You will then return in another 6-7 days after your surgery for suture removal unless otherwise directed.
If there any questions that are not being cleared up please call the office or set up an appointment immediately if you have concerns.