Below are some guidelines for what you can expect after surgery. While every patient is different, these are the most common post-surgical recommendations. If you have questions at any time, please contact Dr. Markus's office. Your emotional and physical well being are our primary concern.

There are several things to expect after surgery and it is important that you be prepared for them.

• There will be some oozing of blood from your nose. The gauze pad under your nose will catch the blood. You can change the gauze pad as needed and when there is no bleeding or drainage you can eliminate the gauze.
  
• On the second or third day after surgery, you may experience swelling and bruising around your eyes.
  
• Your eyes may be blood shot.

After surgery, if you experience any of the following, please call 847.432.8180.

• Severe pain that does not respond to medication.
  
• Prolonged profuse bleeding-soaking more than 5 gauze pads per hour after the first four hours.
  
• Although some vomiting may be normal, continual vomiting is not.

IMMEDIATELY AFTER SURGERY

Activity

• Rest in bed with 2 pillows for 24 hours.
  
• Do not use the bathroom without assistance.

Medications

• Take medications according to the instruction on the bottle. Because pain medication may make you feel drowsy or "spacey," it is important to have someone else give you your medications.
• Take Extra-Strength Tylenol for minor pain.
• Take antibiotics as prescribed.

Incision Care and Protection

• For 36 hours after surgery, apply ice packs on your eyes and forehead while you are awake. Do not rest ice pack on your nose.
  
• Clean the incision line at the base of the nose twice a day with hydrogen peroxide. After cleaning, place a thin coat of antibiotic ointment over the stitches.
  
• You should breathe through your mouth during the first few days. A humidifier at your bedside may make you more comfortable.

Diet

• Eat only fluids for 2 days; after that you may begin a soft diet of easily chewed low-fat foods such as oatmeal, jello, rice, applesauce, yogurt, and soup. Avoid very hot foods.

THE FIRST WEEK

Activity

• Sharply limit your activity to walking around the house.
  
• Avoid bending at the waist or picking up heaving objects. Over-exertion can result in bleeding.
  
• Keep your head elevated while resting or sleeping using 2-3 pillows. You should avoid turning onto your side.
  
• Control your emotions. Though you may feel a little depressed after surgery, this will pass. Anxiety or crying will increase swelling and may initiate bleeding.
  
• Avoid picking up babies or small children to ensure that they do not inadvertently strike your nose. A soft blow to the nose may cause discomfort, but should cause no problem unless the force is excessive.
  
• Rest and relax. Give your body time to heal.

Pain, Swelling, & Bruising

• Most patients complain more of nasal and sinus congestion than of pain. Any pain should be controlled with the prescribed pain medication. After the first day, pain may subside enough for Tylenol to be sufficient.
  
• Swelling and bruising around the eyes and cheeks varies. Swelling is at a maximum within about two days and then subsides over the next 5-6 days. Do not worry if you have excess swelling around the eyes and cheeks-this will clear completely and will not affect the result. Bruising or discoloration may persist a few days longer, but it will also subside and will have no affect on the result.

Bleeding

• Bleeding is typical during the first 12 hours following surgery. During this period you may need to change the gauze drip pad a dozen or so times.
  
• A pinkish-reddish discharge from your nose and throat is normal during the first 3-4 days.
  
• If you have profuse nasal bleeding, lie down immediately with your head elevated on 3-4 pillows. Apply iced washcloths to the back of the neck and over the eyes. Call Dr. Markus's office if these measures do not stop the bleeding.

Medications

• Avoid medications containing aspirin. Click here for a list of medications with aspirin. Extra-strength Tylenol may be sufficient after the first 24 hours.
  
• Pain and sleep medications may impair your reactions, so avoid performing potentially hazardous activities for 24 hours after taking them.
  
• If the prescribed medications do not control your symptoms or cause nausea, please call Dr. Markus's office. (Nausea is occasionally related to the medication, you should drink small amounts of clear liquids [such as, ginger ale, 7-Up] at frequent intervals.)
  
• Itching under the cast may occur and can be controlled by appropriate medications.

Incision Care and Protection

• Clean the incision line at the base of the nose with a cotton swab and hydrogen peroxide three times a day. Immediately afterward, place a small amount of anitbiotic ointment on the incision line.
  
• Your packing will be removed in 3-4 days. Once the packing is removed, place antibiotic ointment in the nostrils to keep them moist.
  
• Wash your face carefully with a mild soap and a clean washcloth or cotton balls. Avoid the nasal area and getting the cast wet.
  
• You may wash your hair on the third day after surgery, but only with help. When washing your hair, position your face up with your head leaning backward. Do not bend your head forward. You may dry your hair with a hairdryer on a cool/low setting.
  
• Bathe in a tub with assistance. (You may shower after 7 days when the splint has been removed.)
  
• Avoid make-up until cleared by Dr. Markus.
  
• Avoid blowing your nose or sniffing excessively because it will irritate the healing tissue. Sneeze with an open mouth.
  
• Brush teeth gently with a soft toothbrush only. Avoid moving your upper lip while brushing.
  
• Wear clothing that fastens in front or back-avoid pullovers, t-shirts and turtlenecks.
  
• A few days after surgery you may resume wearing contact lenses.

Diet

• For the first 48 hours, restrict your diet to plenty of fluids and easily chewed foods.
  
• No alcoholic beverages for the first week following surgery because it increases your chances of bleeding.
  
• Avoid cigarette smoking or areas with excessive smoke. Smoke irritates the nasal tissue and retards your healing.

Infection

• While infection after rhinoplasty is unusual, it does occur. You should call Dr. Markus's office if you experience a fever over 100°F, excessive pain, and swelling with redness. Infections usually clear up quickly with appropriate treatment.

Post-Operative Visits

• Dr. Markus will tell you when to make your first appointment, but it will generally be 3-4 days after surgery to remove your packing.
  
• Your nasal sutures and the cast will be removed 6-8 days after surgery. When the cast is removed, the nose will be quite swollen and the nasal tip will be turned up. This should decrease over the next 3-4 days, then gradually thereafter.
  
• Dr. Markus may ask you to do nasal exercises to keep the sides of the nose narrow and in proper alignment. Dr. Markus's staff will demonstrate the exercises for you. You should do the exercises 10 times a day and hold them for 10 seconds. You should see visible improvement in 2-3 weeks. Be patient, your nose will assume its final shape several months after surgery.

THE FOLLOWING WEEKS

Activity

• Nasal bones take six or more weeks to heal, so resume your activity gradually.
  
• Strenuous exercise may be resumed in 5-6 weeks.
  
• Semi-contact sports may not resume for 4-6 months.
  
• Swimming is permitted after 6 weeks.

Protecting Your Nose

• Exercise particular caution in the sun, because sunburn will result in prolonged redness and swelling. Use sun block and a visor.
  
• You may resume wearing glasses after 6 weeks. Patients often use tape to keep their glasses from resting on their nose.

Medications

Avoid medications containing aspirin for 2 weeks. Click here for a list of medications with aspirin. Extra-strength Tylenol may be sufficient after the first 24 hours.