Rhinoplasty surgeries are highly tailored toward each patient’s specific desires and anatomy. The surgery is performed on an outpatient basis at the Lasky Clinic Surgical Center. The operations are almost always done under twilight sedation using propofol, and avoid the need for general anesthesia.
The length of the procedure can take anywhere from one and a half to six hours to complete. Whether an open or closed approach is used for the surgery depends on the situation and the patient’s anatomy, and will be discussed with Dr. Frankel before surgery.
Understanding the process
Preparation
Dr. Frankel individualizes every patient’s care. He invests the time to fully understand patient expectations, learn complete history, evaluate the inside and outside of the nose, and take digital images.
Dr. Frankel will discuss the cosmetic and functional expectations of your rhinoplasty in detail to ensure all your questions are answered. Pre-operative computer imaging, or “photo-morphing,” is performed with all rhinoplasty patients before surgery, so they may have an active role in determining the desired outcome.
What to Avoid
Two weeks before the scheduled surgery date, it is important to avoid taking certain medications, vitamins and herbs that may cause you to bleed more than normal. It is also best to avoid alcohol and very salty foods for three days before surgery to prevent your skin from retaining fluid and swelling.
Our office will provide a comprehensive list of what to avoid. The night before surgery, do not eat or drink anything, except any necessary medicines with a small sip of water.
Day of Surgery
The morning of surgery, you will have your own private room at the clinic, where you will have a chance to speak with Dr. Frankel and your anesthesiologist before you go into the operating suite.
After surgery, you will regain consciousness in the recovery room until you are able to move back to your private room, from where you will eventually be discharged once you are fully alert. You will leave in the care of a family member, friend or caretaker.
Aftercare
Following surgery, a splint will be placed on the nose, both for protection and to help it maintain its new shape. The nose will be moderately swollen and stuffy for several weeks, and the remainder of the swelling will gradually resolve over the course of the next six to eighteen months.
You will be encouraged to keep your head elevated for several days and to use cold compresses to reduce swelling and bruising. You will be able to watch television, use your computer, take walks and prepare meals for yourself, but you should generally take it easy.
Most patients experience more discomfort than pain. Use pain medication as directed or needed, and take with food to help minimize nausea.
Recovery
The splint and any stitches are usually removed on day six or seven. You will be quite swollen immediately after the splint is removed, and your nose may look shiny due to the sebaceous glands being occluded by the dressing. Swelling diminishes over many months and revision surgeries often stay swollen longer.
There is no exact amount of time it takes to fully heal but it generally takes up to 18 months before it reaches some stable point. Every patient heals differently. If you notice that a particular behavior or activity is causing swelling, do your best to avoid that activity until you have healed.
Ongoing Care & Support
To prevent bleeding and increased swelling, avoid extreme physical activity, including athletic activities and intercourse. After 24 hours, you are encouraged to go for light walks and strolls. Light cardio, such as an elliptical machine or spin bike on a low resistance can begin on post-operative day seven.
Do not engage in any heavy cardiovascular activity (running), any activity that involves straining (weight lifting) or anything that involves bending over (yoga, pilates) for at least three weeks, unless otherwise instructed. Dr. Frankel will follow up with you throughout the post-operative course.
If you have any questions or need any additional support, call the office at 310.552.2173.