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• Please also read post-operative septoplasty if this is in combination with the Rhinoplasty (external nose reshaping).
• There will be a mild to moderate amount of pain and discomfort associated with the surgery. This should be easily controlled with oral medications. Tylenol with codeine (or equivalent if allergy to codeine exists) is generally sufficient for pain control. 
• Discomfort and pain should begin to decrease within 72 hours after surgery. A significant increase in pain after this period should prompt you to call the office. 
• Bruising and swelling are not unusual after the surgery. These symptoms often worsen on the second day following surgery, and then steadily improve thereafter. The amount of bruising that occurs varies significantly from one person to the next. Most swelling occurs around the eyes, but some bruising may track down and discolour the cheek area. If only the nasal tip is operated on, only slight bruising is typically expected to occur. 
• Some bloody nasal discharge is to be expected after any nasal surgery. A small "moustache" type gauze dressing will be placed beneath your nose after surgery. During the first 24 to 48 hours, this absorbent dressing often needs to be changed several times a day. 
• At the completion of the surgery, steristrips and a cast are often placed on the outside of the nose, and nasal stents are placed on the inside of the nose (if septoplasty is performed) to improve nasal breathing. If only a septoplasty and/or nasal tip surgery have been performed, the cast may be omitted. The external nasal cast is usually removed 5 to 7 days after surgery along with any external sutures.  An external nasal dressing is re-applied for another week.   The next follow-up appointment (approximately 2 weeks after surgery) is when all external nasal dressings and nasal stents in the nose are removed.
• Nasal stuffiness is most prominent in the first week after surgery. This will significantly improve with daily saline nasal lavage as prescribed and after the internal nasal stents have been removed. Any residual stuffiness can be expected to gradually improve over a period of several weeks thereafter. 
• Numbness in the tip of the nose, upper front teeth, or roof of the mouth is to be expected because nasal surgery typically causes a temporary disruption of some of the nerves in the area. Sensation will generally return slowly over a period of several weeks, and occasionally months. 
• It is very important to be aware that swelling from nasal surgery will temporarily make the nose appear broader and the tip more turned up and less refined than is desirable. The swelling on the bridge of the nose often improves more quickly than swelling on the tip of the nose. This should not be a cause for alarm. This swelling will greatly improve in the first few postoperative weeks. Although much of the swelling will have resolved within a few months, your nose will continue to improve for up to one year after surgery. Patients who have undergone only septal surgery do not normally have any significant swelling on the outside of the nose. 

CALL THE OFFICE PROMPTLY IF YOU NOTICE ANY OF THE FOLLOWING:

• development of a temperature exceeding 38C or 100.4F
• unusual bleeding or discharge from the incision
• unusual bleeding from the nose or any significant re-injury of the nose
• a significant progressive increase in pain which is not easily relieved by taking your prescribed medication

If any of the above should occur after regular office hours, and you cannot reach us at our office, please go to the nearest Emergency department for evaluation.

How do I care for myself after surgery?

• Do not take any aspirin, blood thinners, anti-inflammatory compounds or herbal medication for 2 weeks before and 2 weeks after your surgery unless you first discuss with Dr. Tietze.
• Make arrangements to have someone drive you to and from your surgery.
• Having someone stay with you the first night after your surgery is highly recommended.
• Be sure to fill your prescriptions before your surgery since it means one less thing for you to worry about afterwards.
• Take any antibiotics and any medication only as prescribed by the office.
• Use a saline nasal spray (eg. Salinex, Hydrasense, Simply Saline) and then place a small dab of either vaseline or antibiotic ointment (eg. polytopic or bacitracin) inside your nose 4 to 6 times a day, beginning the first day after surgery. This will minimize nasal crusting and will make you feel more comfortable. Both the saline spray and antibiotic ointment are available at pharmacies without a prescription. A Q-tip moistened with hydrogen peroxide may be swabbed in the nose (be careful not to wet the outside of the nose) 2 to 3 times a day to also help reduce nasal crusting. 
• To minimize swelling, use cool, clean compresses or ice wrapped in a dry cloth. Apply these gently to your closed eyes 4 to 6 times a day for the first 24 to 72  hours after surgery. Do not apply ice or anything to the nose directly. 
• Sleep with the head elevated for the first week after surgery. 
• You should not blow your nose for 3 days after surgery as it can disrupt proper healing and cause bleeding. If you have to sneeze, sneeze with your mouth wide open as this will minimize any disturbance within the nose.  Resume gentle nose blowing after 3 days.
• If an external nasal cast is used, do not allow it to become wet at any time. You may shower or bathe the day after surgery, but do not let the spray strike your nose. Do not rub or massage your nose unless instructed to do.
• Do not travel by plane for 10 to 14 days after nasal surgery in order to avoid any possibility of sinus blockage. 
• You should do no vigorous exercise and should avoid any significant physical exertion, lifting or straining for a minimum of 3 weeks after your surgery, as this activity could disrupt your wound healing and cause bleeding. Plan on taking it easy. Be careful not to bump it or squeeze it. Be aware that the most common sources of inadvertent injury to your nose after surgery are children and pets.