Nose Job Surgery (Rhinoplasty) Pre & Post-Operative Instructions

Nose Job Surgery (Rhinoplasty)

Pre-Operative Instructions

  • Please advise the doctor if you are taking any blood thinning medication (e.g. Warfarin, Disprin, Aspirin, etc.)
  • This will need to be discontinued prior to surgery as per doctor’s instructions.
  • Uncontrolled high blood pressure raises the risk of bleeding complications in all forms of surgery – please ensure your blood pressure is well controlled prior to your surgical date.
  • DO NOT take any of the following medications prior to surgery:

– Anti-inflammatories (e.g. Brufen, Ibuprofen, Myprodol, Voltaren, etc.)

– Homeopathic medications (e.g. Arnica, Rescue Remedy, St John’s Wort)

– Vitamin E (oral or topical)

  • Prepare your skin for 3 weeks before surgery with Alpha Hydroxy Acid Cream (e.g. Environ Alpha Range/Neostrata).
  • Take a bath or shower with antibacterial soap (or Bioscrub) on the morning of your admission.
  • Hair should be washed the night before or morning of your admission to hospital.
  • Wash your face thoroughly with antibacterial soap on the morning of your admission to hospital.
  • Do not apply day cream or make-up.
  • Regardless of whether you are having a general anesthetic or conscious sedation – you should not eat or drink anything for 6 hours prior to surgery.
  • If you are a smoker – NO SMOKING for 1 month prior to surgery and 2 weeks after.
  • Bring comfortable cotton underwear.

Post-Operative Instructions

  • You will stay in the hospital overnight (Christiaan Barnard, Cape Town)
  • You will need someone to drive you home after your surgery and help you for 1 to 2 days.
  • You will need plenty of rest.
  • Decreased activity and pain medication may promote constipation, so you may want to add more fruit and fiber to your diet.
  • Be sure to increase your fluid intake.
  • Take pain medication as prescribed. Do not take aspirin or any products containing aspirin.
  • Do not drink alcohol when taking pain medications.
  • If you are taking vitamins with iron, resume these as tolerated.
  • Do not smoke, as smoking delays healing and increase the risk of complications.
  • Do not drink alcohol when taking pain medications.
  • If you are taking vitamins with iron, resume these as tolerated.
  • Do not smoke, as smoking delays healing and increase the risk of complications.


  • Start walking as soon as possible – this helps to reduce swelling and lowers the chance of blood clots.
  • Do not drive until you are no longer taking any pain medications.
  • You may tire easily. Plan on taking it easy for the first week.
  • No strenuous activities, including sex and heavy housework, or any activity that increases your blood pressure for at least 2 to 3 weeks (walking and mild stretching are fine).
  • You can return to work within 1 to 2 weeks.

Incision Care

  • You may shower only after your post-operative appointment (usually 4 days post-operatively).
  • You may shower 48 hours after removal of the nasal plugs.
  • Avoid steam baths and saunas for several months.
  • Avoid exposing your scars to the sun for at least 12 months.
  • Always use sunblock – regardless of the weather – if you plan to go outdoors or not.
  • Keep incisions clean and inspect through Micropore daily for signs of infection or oozing.
  • Keep Steri-Strips on (until your doctor says they are no longer necessary).
  • Stay in bed with your head elevated for the first day. Sleep with it propped up.
  • You may use cold compresses for comfort and to help decrease the swelling.
  • Do not wash your hair until the nose splint is removed or ask for special instructions.
  • Avoid blowing your nose for 1 week.
  • Be gentle when washing your face and hair or using cosmetics.
  • Do not use make-up on external incisions until advised by your doctor. It is important to gently remove all make-up with recommended facial cleanser – splashed off with warm water.
  • You may follow your usual skincare routine – taking care to avoid applying any creams containing Vitamin E on the incision areas.
  • Incision areas may be massaged with aqueous cream for the first 3 months.
  • Contact lenses can be worn as soon as you wish, but glasses cannot be worn until your nose is completely healed (approximately 2 months). After your nose splint is removed, tape your glasses to your forehead or prop them on your cheeks until completely healed.

What To Expect

  • You will be up and about in 2 days, but it may be several weeks before you are back to your normal full capacity.
  • After surgery, particularly during the first 24 hours, your face will be swollen.
  • A small amount of bleeding is common during the first few days.
  • A splint is applied immediately after surgery for 7 days. Nasal packs may also be used.
  • Minimal post-operative pain will be experienced.
  • Your nose may ache and you may have a dull headache.
  • You will have black eyes and a swollen nose and eyelids for 7 to 14 days.
  • Most swelling and bruising should disappear within 2 weeks. Some subtle swelling (noticeable only to you) will remain for several months.
  • Healing is a slow and gradual process.
  • Some numbness may be present around the operative areas.
  • You may experience some obstruction to air-flow through the nose for 2 weeks after the operation.
  • Swollen nasal tissues may cause the nose to seem blocked up for several weeks.


  • The improvement will be visible after 2 to 3 weeks when most of the swelling has subsided and usually continues to improve for many months.
  • Final results may not be apparent for a year or more.

Follow Up Care

  • If you have nasal packing, it will be removed after a few days.
  • Sutures are removed in 5 days. All internal sutures will dissolve.
  • Frequent follow-up visits should be scheduled.

When To Call

  • If you have increased swelling or bruising beyond 72 hours post-operatively.
  • If you have increased redness of the nose.
  • If you have severe or increased pain not relieved by medication.
  • If you have any side effects to medications, such as rash, nausea, headache, and vomiting.
  • If you have an oral temperature over 37°C.
  • If you have any drainage from the incisions or notice a foul odor.
  • If you have bleeding from the incisions that does not stop with light pressure.

Emergency Contact: 078 867 61372