The nature of every recovery differs on many factors including your healthiness, psychological frame of mind, type and extent of rhinoplasty undertaken, and a little bit of good fortune. For example, someone undergoing a difficult revision rhinoplasty procedure may have some underlying swelling that may even be less than acceptable even at 2 weeks, whereas someone undergoing a primary rhinoplasty may not have much swelling even at a week. A patient who needs to reduce a hump may have slightly more bruising than someone who needs to have the bridge raised upward since in the latter situation the bones do not need to be narrowed (in most cases but not all). Of course, someone may have more bruising or swelling than someone else just by random fortune or lack thereof. Psychologically speaking, someone who has more swelling may actually think the swelling is minimal compared with someone who has more swelling but feels as if the swelling is only minor in his or her own mind.
Despite all of these variables, Dr. Lam’s patients typically go through significantly less recovery than patients who have procedures performed elsewhere. Even though his patients may in certain cases have some bruising, it is not that common and when bruising occurs is rarely as significant as elsewhere. The reason for this more limited recovery time is that Dr. Lam is incredibly skilled at performing nose surgeries using only the finest instruments that cause significantly less bruising not to mention that he is a very gentle surgeon with delicate hands and a delicate touch. In those patients who qualify (no autoimmune, no cardiac issues, no hormone replacement therapy, no coagulations issues, no oral contraceptive therapy like birth control, etc.), he also uses tranexamic acid (TXA) that further limits and can in many cases virtually eliminate bruising.
The recovery will now be described in components: how you look, how you feel, and when can you get back to social, professional, and sporting activities. For the first week, you will have a splint and tape on your nose, so how you look will be obvious that you have had a rhinoplasty. At a week, that splint and tape are removed and in many cases despite mild swelling you may be able to return to social interaction. Of course, there is still swelling externally on the nose but in many cases individuals are able to return to social and professional activities. For those individuals who are particularly worried or have more swelling or bruising than anticipated, then 10-14 days may be a safer bet. Rarely do individuals need more than that timeframe. In major revision rhinoplasty cases, as mentioned, there could be a higher baseline swelling that may be socially unacceptable in some cases for 2 to 3 weeks but that is uncommon.
In terms of how you feel, most individuals do not experience significant discomfort. Dr. Lam does use very tiny nasal packs for one night in those individuals who have a hump reduced and need to have osteotomies (bone cuts) but unlike what is experienced elsewhere the packing should not hurt and you should be able to breathe around these packs. You simply remove it the following morning very easily with a simple pull, and in those rare cases where you may be uncomfortable to do so, Dr. Lam is more than happy to help you do that in the office. There will be some nasal dripping that may be initially bloody for the first night and become pink then clear over the first 1 to 3 days but this dripping usually stops by days 3 to 4. In rare cases, it may continue for a few more days but doubtfully beyond that period of time. Rhinoplasty cases should not be painful following surgery and is very different from the experience of many patients who have had their nose surgery initially performed elsewhere. In rare cases, you may experience a sinus headache, that can usually be quickly alleviated with some Afrin spray (which Dr. Lam would only like you to use if you are experiencing this kind of headache.) At times, the nose can be very congested feeling and this should dissipate by itself over 1 to 2 weeks. If Dr. Lam sees a lot of clotting in the nose, he may remove some of these clots at a week but will most likely have you use gentle saline spray to remove the residual over the following week’s time, but absolutely no picking of your nose with your fingers, Q-tips, or other devices. In short, rhinoplasty for most patients is not a painful experience in Dr. Lam’s hands.
In terms of sports activities, Dr. Lam would like you to take a week off from any kind of activity that would elevate your heart rate. After a week you may begin light cardio and gently return back to a full program listening to your body to ensure that you do not accidentally fall and hurt your nose and your body. As far as weight lifting, after a week, you may return to doing so but you should avoid free weights that would be held up over your head to avoid accidentally hurting your nose for the first 6 weeks. In addition, Dr. Lam would like you to avoid swimming for 6 weeks and contact sports for 3 months following nose surgery.
Ideally, you should be wearing contacts for the first 6 weeks if possible to avoid the pressure of eyeglasses over your nose. If you have to wear glasses during the first week, Dr. Lam can provide you with a special type of headband that will hold your glasses up from your forehead. After a week when the splint comes off, he will give you back your splint to take home and you can use that splint whenever you want to wear glasses like for reading, sun protection, or daily wear. During the COViD crisis of 2020-2021, if you are wearing a metallic pinching mask like an N100, N95, K95, etc., then you should wear the splint when you pinch the mask down over your nose. You will need to wear a splint when wearing glasses for the first 6 weeks following rhinoplasty. If you are wearing your glasses after 6 weeks and notice them denting the skin inward, then you must wear the splint with your eyeglasses for another two weeks and try again.
You should avoid showering for the first week or getting your splint wet to minimize it falling off during that time. If your splint does fall off, Dr. Lam is not worried about it but would like for you to try to keep your splint dry and to keep it on your nose for the first postoperative week if possible. Thereafter, you may begin normal showering but still you should not submerse your face under bath water for the first 6 weeks. You can take a bath from the first day after the rhinoplasty so long as your face is not submersed under water for the first 6 weeks.
For the recommended follow-up appointments, please see the section on follow up.