Nose

• POST OPERATIVE CARE

  Following surgery, nasal packing may or may not be utilized. This depends upon the actual surgical procedure performed. A splint is applied to the nose. The packing, if used, is removed the next day. I provide a list of important do’s and don’t. While the recommendations vary with each patient, they generally discuss some of the following factor:

  Near the end of the first week, the splint is removed in the office. Most of the swelling and discoloration about the eyes is subsiding. Some slight swelling of the nose (which the patient feels more than anyone sees) is present in diminishing amount for several weeks. The patient is particularly conscious of this in the morning upon arising.

  A noticeable decrease of the swelling occurs throughout the day. A frequent effect is a feeling of numbness at the tip of the nose which may last for a few weeks. When work is done on the nasal septum, that is, the partition in the middle of the nose, there may be varying amounts of nasal blockage for several days after the packing is removed.

  Most type of employment permits the patient to return to work a few weeks after surgery, or even sooner, depending on the individual case and the patient’s type of work.

  Following removal of all dressings, I insist that the patient visit me periodically for checkups over the next year. These are done free of charge. You must be prepared to come in for these

  checkups. During that time you must be very careful that the nose is protected from long exposure to direct sunlight. Eyeglasses must not be worn unless they have been especially altered to avoid pressure on the nose. Individuals wearing contact lenses must consult with me before continuing their use.

  The nose may be gently blown after two weeks. There is no danger in smoking after the first week, in gently cleansing the outside of the nose or in using cosmetics. However, it is not advisable to lift heavy weights for at least two weeks after the operation.

• FACTS THAT SHOULD BE UNDERSTOOD

  When the dressings are first removed, the nose may appear stiff and turned up too much due to the effects of the bandage and the swelling of the tissues. This is only temporary. However, a great deal of swelling disappears within three or four days after removal of the bandage and the nose begin s to approximate its eventual shape. The average acquaintance met on the street would not notice any swelling. It generally takes up to one year for the last one or two percent of the swelling to disappear. This does not usually bother the patient or detract from the appearance of the nose. Rather, the elements of the nose seem to have improved definition as the last bit of swelling subsides.

  In like manner, the tissues within the nose are somewhat swollen after surgery. Therefore, progressively decreasing amounts of nasal blockage should be expected for a time following the average uncomplicated surgery. The thicker the skin, the longer it takes the nose to return to its final shape. It should be noted that the nasal surgery is basically achieved by altering the size and shape of the supporting structure such as cartilage and bone. You cannot change skin that is inherently thick and oily. Such skin limits the amount of correction that can be obtained.

  All the work done is usually on the inside of the nose. There are usually no scars on the outside.

  Finally, again, you should remember the goal is to bring the nose into balance and harmony with the other facial features, not to match an ideal which may be present in one’s mind.

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