Pre & Post-op Instructions

INFORMATION FOR RHINOPLASTY PATIENTS

Pre & Post Operative Instructions (For Patients of Dr. Shervin Naderi)

BEFORE YOUR RHINOPLASTY SURGERY:

  •  Make sure Dr. Naderi, or members of our staff, answer all of your questions & concerns, prior to your Rhinoplasty or Revision Rhinoplasty.
  • Arrange your post-operative appointment time before your Rhinoplasty. Usually Rhinoplasty patients will be seen in our office for follow-up the very next day after Rhinoplasty surgery unless staying overnight at the hospital. Occasionally Rhinoplasty patients will skip this appointment and will be seen at their one week appointment for nasal cast removal.
  • Fill all your prescriptions prior to your Rhinoplasty: (Antibiotic pills, pain pills, nausea pills)
  • Get all your necessary recovery supplies prior to your Rhinoplasty: (Q-tips, Hydrogen Peroxide, Bacitracin Antibiotic Ointment, Gel Cold Compresses, Arnica pills, Saline non-medicated spray).
  • You may take your blood pressure medication, heart medication, & seizure medication with a small sip of water the morning of your Rhinoplasty. All patients but especially Diabetic patients should always coordinate their medication management with their primary care doctors.
  • Stop taking Aspirin 2 weeks prior to your Rhinoplasty – but first check with your primary care physician.  Ibuprofen, Motrin, Alleve, Advil and all other NSAIDs can make you bleed excessively as well.
  • Only take Tylenol or Celebrex for aches & pains within 2 weeks of your Rhinoplasty if OK’ed by your primary care doctor.
  • Vitamin E, Fish oil, Flaxseed, Herbal supplements (Ginkgo, Ginseng, Echinacea, Garlic, Omega-3′s and many others) and health food store products, supplements or drinks often make you bleed excessively during nasal reshaping surgery as well. Avoid these 2 weeks prior to surgery. If in doubt, check with your doctor.
  • If you Take Coumadin, Pradaxa, Plavix or Aspirin, check with your family doctor to make sure these are OK to be stopped with enough time prior to your Rhinoplasty. (Need to stop at least 5 – 14 days before and up to 2 weeks after, depending on the medication type)
  • Drink plenty of clear fluids the afternoon prior to your Rhinoplasty as well as after your Rhinoplasty to avoid dehydration and fainting spells.
  • Do not eat or drink after midnight, the night before your Rhinoplasty.  Important medications can be taken with a small sip of water.
  • Arnica is the only herbal supplement you may take around the time of your Rhinoplasty.  Arnica can reduce swelling and bruising after a Rhinoplasty.
  • Pineapple juice or slices can help reduce bruising and swelling as well.
  • Take a shower the morning of your Rhinoplasty surgery and wash your face and hair with a mild soap & shampoo. DO NOT USE ANY MAKE-UP or products on your face after your shower.
  • Do not wear jewelry to the Hospital.  Remove piercings if possible.
  • Wear loose fitting & comfortable clothes with a shirt that buttons down the front. (No tight shirts that can snag on your nose!)
  • Make sure you have someone drive you to your Rhinoplasty surgery and pick you up after your nose job. Make sure you have a friend or relative stay with you for at least 24 hours after your nasal reshaping surgery. (You cannot drive, take a taxi or stay alone)
  • Always check with your family physician, Internist and Psychiatrist, as well as eye doctor if it’s OK for you to have surgery and anesthesia. We require a clearance letter from them most of the time prior to scheduling any elective cosmetic or functional surgery.
  • Lab work and Medical work-up and surgical clearance letters are often necessary prior to your rhinoplasty surgery.  Get this completed well ahead of time in case further work-up or tests are necessary.

THE NIGHT IMMEDIATELY AFTER YOUR RHINOPLASTY SURGERY:

  • Starting the evening after your Rhinoplasty, use Hydrogen Peroxide on Q-tips to clean all your nasal incisions (inside and outside as instructed). Use 4 to 6 Q-tips each time. Then cover the area with a thick layer of antibiotic ointment. Do this regimen at least 4 times a day for 4 weeks on all areas that are NOT covered by tape or cast. Do it frequently but gently. Use the Q-tip soaked with Peroxide as a “paint brush” and not a “scrub brush.”
  • You must keep all areas around and inside of your nostrils blood and crust and scab free, clean and covered with ointment. This is your homework for the 4 weeks following your Rhinoplasty. There are many absorbable sutures inside your nose that must be kept lubricated for them to dissolve. Incisions and scars heal best when clean and lubricated. Work around the tape that may be covering your nostrils to get the nostrils clean but do NOT cut or trim any of the tape.
  • Use Cold Compresses to decrease swelling around your eyes, forehead and cheeks: use cold compresses on your eyes, forehead and cheeks, not your nose. DO NOT place actual ice packs or frozen peas on your nose as these are heavy and will wet your nasal splint. Ice, Ice, Ice even if you do not see much swelling or bruising initially! The 3rd post-operative day is the worst as far as swelling and discomfort and icing frequently the first 2 days helps reduce that.
  • Sleep with your head up on 3 or more pillows or in a recliner to reduce swelling.  Do this for several weeks.
  • Do not get your nose splint or tape wet until the night before your one-week appointment.  You may take showers but wash your face in a way not to wet your Rhinoplasty cast for the entire week after surgery.
  • Use a wash cloth or astringent to wipe your face.  Do not get your face or cast wet!
  • You should use a straw to drink plenty of fluids after your surgery.  Use of straws is completely fine regardless of what you may have heard.
  • Most patients do not need pain medicine after Rhinoplasty with Dr. Naderi.  Since he does NOT routinely pack the nose after surgery, pain is often very minimal.  Most of Dr. Naderi’s patients are very surprised at the ease of recovery.  But each patient has a unique experience and some patients have a tougher time than most.
  • You may take only what Dr. Naderi prescribes you for pain or Celebrex or Tylenol (acetaminophen).  Other pain medicines such as Ibuprophen can cause bleeding.
  • You may have some bloody discharge from your nose for several days. This is normal. Do not wipe your nose. Change the small “gauze drip pad” under your nose as needed or let the drainage come to your upper lip and wipe your lip.  Wiping your nose will move the nasal tip and can snag on sutures.
  • DO NOT BLOW your nose or aggressively SNIFF forcefully for 2-4 weeks. (You will have swelling inside your nose as well as outside, which can make breathing out of your nose more difficult at times).  You may feel like you have a stuffy nose such as with a cold or flu.  Breathe through your mouth while continuing to clean your nose.  As swelling decreases and inside of your nose cleans out, your breathing should improve.
  • Clean the inside of your nostrils with hydrogen peroxide soaked Q-tips then apply antibiotic ointment. Do this at least 4 times a day. (Place the entire cotton tip gently inside your nose but no deeper! This correlates to about ¼ inch inside the nose). You can use straight peroxide or 1:1 diluted with tap water. Use the Q-tips as “paint brushes” to paint the peroxide on the incisions and sutures.  Do not aggressively scrub the area with the Q-tips.
  • Take frequent sips of water or fluids through a straw to avoid your throat drying out due to the potential mouth-breathing. Use Vaseline on your lips to avoid chapping.
  • If you have to sneeze, do it with your mouth and nose open to release the pressure.
  • Take and finish your antibiotics as instructed
  • Although very rare, if you develop a brisk nose bleed, sit in a recliner….take your pain pill….put cool compress cloths across your forehead and eyes and hold pressure on each side of the base of your nostrils for 10 minutes. You may use 2-3 sprays of Afrin or Neosynephrine medicated nasal spray in your nose and repeat in 10 minutes if necessary. If the bleeding does not stop you should be taken to the nearest Emergency Room and ask the E.R. doctors to examine you and then ask them to contact Dr. Naderi with their report.
  • Call 911 if the bleeding is excessive or concerning.
  • Go to the nearest emergency room when in doubt.

THE WEEK AFTER YOUR RHINOPLASTY SURGERY:

  • All Rhinoplasty patients need to be seen in our Northern Virginia or Chevy Chase office about 7 days after Surgery for Splint (cast) removal.
  • Make sure you are well nourished. You need energy and protein to heal properly after a Rhinoplasty. This is no time to diet!
  • Typically you can wear water-based makeup as soon as a week out from your Rhinoplasty once the small nasal cast is removed.
  • Your nose skin may be oily or sticky for some time after Rhinoplasty. It also may be dry and peeling. That is normal. Do not aggressively rub, massage or wipe your nose after the Rhinoplasty for at least 4 weeks.
  • No “Biore Strips” after your Rhinoplasty for at least 3 months.
  • You may use an astringent to soak a cotton ball and GENTLY wipe your nose without any pressure on the tip after your cast has been removed.
  • The night before your post-op-week-one appointment and cast removal, get in the shower and thoroughly wet your face and nasal splint for 5 minutes before coming to the office to see Dr. Naderi the next day. (Do not remove the cast yourself). This will make removal of your cast easier.***
  • On the morning of your post-op-week-one appointment, get in the shower again and thoroughly wet your face and nasal splint for at least 20 minutes straight before coming to the office to see Dr. Naderi. (Do not remove the cast yourself). This will make removal of your cast easier and less painful.***
  •   Do not take the liberty to cut any part of the nasal tape or cast off yourself. If you have any questions or concerns such as an itchy or irritated area under the tape, call the office and make an appointment to see Dr. Naderi within 24 hours.
  • No lifting over 10 lbs and avoid bending over for 14 days.
  • You may NOT exercise for 2-4 weeks. Refrain from sexual activity for up to 2 weeks if possible. No contact sports for 3 months.
  • You may wear contact lenses at any point but no eyeglasses or sunglasses on your nose for at least 1-3 months.
  • Elevation of your blood pressure or heart rate will cause more swelling and may cause a nose bleed.
  • Sleep with your head up on 2-3 pillows or on a recliner for at least 2 week or longer after surgery to reduce swelling. This really helps! Also try to sleep by yourself for the first few nights so your partner does not inadvertently hit your nose while asleep.
  • You may have bruising after surgery. It may take up to 2-3 weeks or more for resolution but often after 7 days the bruises are practically all gone or you can cover the areas with water-based make-up.
  • YOU WILL HAVE SWELLING. THIS IS A NORMAL PART OF THE HEALING PROCESS.  Your nose will continue to change and heal for many years after your rhinoplasty.  Swelling continues to go down for many years later. There is no such thing as “final results” and your nose will continue to heal well beyond 12 months after your nose job surgery. The old saying that “you see your final nose job results after one year” is simply not true.
  • However, after 10 days, most of your casual friends and relatives should not be able to tell that you have had a “nose job” and you can start to enjoy the initial results of your Rhinoplasty from this early period! In most cases, you can go back to school or work after 7 days and enjoy your initial early rhinoplasty improvements.
  • MOST PATIENTS’ “DOWN TIME” IS ONLY ONE WEEK.
  • You WILL have scar tissue inside the nose. It is a part of surgery and healing. It is also what makes Rhinoplasty healing somewhat unpredictable. You may need occasional steroid injections into your nose after surgery to reduce scar tissue and swelling.
  • Remember, your nose is a living, healing, changing structure after a Rhinoplasty. Your nose is not made of stone or metal. Expectations of perfect symmetry, perfect smoothness and unchanging results are unrealistic. Expecting meaningful improvement is realistic and the goal of Rhinoplasty.
  • BE PATIENT and feel free to ask questions. You may have slight asymmetries or irregularities and numbness. These will change with time. Your smile, your voice and your smell and breathing can change somewhat. Your nose will feel stiffer than a non-operated nose. This is all normal and will change with time as the healing proceeds.
  • IT IS ALSO NORMAL to get depressed or anxious before and especially after your Rhinoplasty. Understanding this will help you get through it. Sometimes an anti-depressant or Valium prescribed by your family physician can help you get through this period. Do not feel ashamed or frustrated. Everyone goes through this to different degrees.
  • DO NOT LET YOURSELF GET AFFECTED BY NEGATIVE COMMENTS FROM FAMILY OR FRIENDS. They simply may not understand the process of rhinoplasty, no matter how well intentioned. Trust what Dr. Naderi genuinely tells you.  He has your best interest at heart.
  • Your skin may become oily under the tape during the first week. If you would like, our licensed Aestheticians can provide you with a facial peel after your one month post-op follow up to unclog your pores and improve your skin.
  • You will be seen 1 to 2 times during the first week after your Rhinoplasty or Revision Rhinoplasty and then most likely at 1 month, 3 months, 6 months and a year after surgery, for follow up with Dr. Naderi. For local patients, Dr. Naderi prefers to see you yearly or every 5 years after that as well. For long distant or international patients, we can work around your schedule to decrease the need for frequent follow-up flights.
  • Purchase a non-medicated Nasal Saline Spray and starting 1-2 weeks after your surgery gently spray 2 puffs on each side, followed by GENTLE sniffing, to soften up the dry blood and crusts inside your nose.
  • Do not dig inside your nose nor blow too hard for what you may think are crusts or scabs. You may be digging into incisions or scar tissue and may cause a nose bleed.
  • Keep a stiff upper lip. Smiling pushes the nasal tip down prematurely. Avoid excess smiling for 2-4 week. The tip position should drop down a bit over time and you do not want to accelerate that process.
  • Brush your teeth with a baby toothbrush. Use a small spoon and fork to eat.  Use straws to drink.

Good luck and enjoy your experience.  Nasal Reshaping is an elective luxury and you should enjoy it.  We are here every step of the way to prepare you and make this as easy as possible for you.

Rhinoplasty
Specialist
Specialization Matters!RM
Find out more about Dr. Naderi:
CONTACT DR. NADERI:
  • This field is for validation purposes and should be left unchanged.
Share
TESTIMONIALS
"I can not thank Dr. Naderi enough. Beginning to end he is a master visionary that actually can do what he promises for you"
Janice Alexander, Chevy Chase
Bethesda Magazine 2011
Best Surgeon
Sometimes I know the best way to help a person is to talk them out of surgery they don't need, Naderi says.
Learn More
EDUCATION & CREDENTIALS
Dr. Naderi went on to train above and beyond completing a fully accredited fellowship in Facial Plastic & Reconstructive Surgery with Dr. Stephen W. Perkins, one of the world's top cosmetic Facial Plastic & Rhinoplasty Surgeons and a past president of the American Academy of Facial
View Credentials
ABOUT THE NADERI CENTER
Plastic Surgeon Dr. Shervin Naderi is a member of an exclusive & highly specialized group of Board Certified Facial Plastic Surgeons who have dedicated their surgical practice and expertise to helping those who are looking to improve their appearance and quality of life
View Naderi Center
DR. NADERI IN MAGAZINES
  • New Beauty 2012
  • Capitol File 2011
  • New Beauty 2011
  • New Beauty 2010
  • Northern Virginia 2011
  • Best of Bethesda 2011
  • GO Loudoun 2006
THE NADERI CENTER RHINOPLASTY & COSMETIC SURGERY
Dr. Naderi is exclusively a face specialist.
He is a clinical instructor for Allergan and Medicis, in addition to having his own courses teaching other Dermatologists and doctors how to properly inject Botox/Dysport and Dermal Fillers.
*Rhinoplasty is surgery and all surgeries have potentially significant life threatening risks but when performed by a specialist in the proper settings, the risks are reduced.
© 2014, The Naderi Center for Rhinoplasty & Cosmetic Surgery. All Rights Reserved.
ABFPRSNew BeautyPatient Choice AwardsPatients Choice 2010Talk of the TownMost Compassionate Doctor 2010Patients Choice 2008Patients Choice 2009BBBEliteGoogle +FacebookTwitterFacebookTwitter