Patient Education and FAQ’s
The idea of surgery on your nose, chin or neck can be intimidating and frightening. Educating patients with respect to expectations, recovery and risks of surgery are important aspects of your surgery planning. The information on this page is designed to help you understand what happens before, during and after your surgery. This page is not meant to replace an in-person examination by your doctor or Dr Bonaparte. The goal of this page is to provide answers to common questions to help you learn more about the process. Any urgent concerns should always be brought up with your Doctor or Dr. Bonaparte.
Rhinoplasty Frequently asked Questions
Liposuction Questions
Chin Implant Questions
General Surgery Questions
Dr Bonaparte’s Patient Education and Blog
Rhinoplasty Frequently Asked Questions (FAQ)
*Disclaimer: the questions below are intended as a guide and to help patients understand their surgery, the surgery risks and typical recovery. It does not replace medical advice or a physical exam by your treating surgeon or doctor. If you have any questions or concerns about your health, please contact Dr Bonaparte or your treating surgeon.
How long will it take for bruising to go away after my rhinoplasty surgery?
How long does the cast stay on my nose after a rhinoplasty surgery?
How long does the swelling on my nose last after a rhinoplasty?
Why does the tip of my nose look so big and swollen after a rhinoplasty?
How long do I have to wait to get the final result of my rhinoplasty surgery?
When can I go back to the gym and start exercising after a rhinoplasty?
Why are there red pimples and small bumps on my nose after my cast was removed?
Why is it so difficult to breath after my nose surgery/rhinoplasty?
My nose feels numb after a rhinoplasty. How long does it take for the numbness to go away?
I had a revision (second) rhinoplasty. What should I expect after the surgery?
How long will it take for bruising to go away after a rhinoplasty?
Everyone who has a rhinoplasty will have some bruising. What is unique about everyone, is the amount of bruising. The most important factor in determining how much bruising you have is the extent of surgery on your nose. A septoplasty typically has no bruising. The most common reason why people develope bruising is when we have to cut or move the bones of the upper part of your nose or to remove a bump on your nose. In patients who don’t have a cut in the bone, bruising is less likely—but still possible—so it is always best to plan, just in case.
If you do develop bruising, it usually lasts anywhere from 7-14 days. Other factors that determine if you will see the bruising is how thick and dark your skin is. It is very rare for people to have bruising after 14 days, but it does happen to some people. Most light bruising can be easily covered up with make-up.
People have tried many things to reduce bruising. This includes taking steroids during surgery and using Arnica. At this point in time, there is no quality research suggesting that these treatments work and therefore, treatments, like steroids, are not recommended. It is unlikely that Arnica causes damage or harm to the nose, so if patients are interested, this is something they can try however there is no good evidence suggesting it makes a big difference.
How Long does the cast stay on after a rhinoplasty
Dr Bonaparte uses a cast is used after a rhinoplasty (or nose job) for a number of reasons. One is that it helps you remember to keep your fingers away from you nose! It also helps keep the bones and tissue straight. The challenge with the nose is that, unlike casts on other parts of the body, a cast on the nose can not completely protect the bone. However, not all patients need a cast on their nose after a rhinoplasty. If you have the bone cut or you have a bump on your nose removed, you will likely have a cast after surgery. If Dr Bonaparte had to use grafts or if he performed an open rhinoplasty, you will also likely have a cast on your nose
A cast stays on the nose anywhere between 5-10 days, our team will typically remove it a week after surgery. If the ast falls off prior to that, it is usually not an issue, but we always tell patients to never remove the cast on their own or try to move the cast; this can result in your bones moving and making your nose heal crooked.
The majority of patients find removing the cast mildly uncomfortable, so we recommend taking one of your pain medications prior to the cast removal. Most patients describe this like removing a sticky bandage; it’s a little uncomfortable.
After a rhinoplasty, my nose looks crooked with the cast on, what should I do about this?
Almost everyone notices some subtle lumps, bumps and twists with the cast on. Dr Bonaparte uses what is called a thermoplastic splint for you nose. This is a type of castthat is made out of a material that softens when warmed in hot water. When we put the cast on your nose it is almost impossible to make it “perfectly” straight. The reason for this is that the cast tends to warp as it hardens. What’s important is that the tissue under the cast is not warped, which is uncommon. The look of the cast in almost all situations has no relationship to how the nose looks under the cast. It is important to remember that you do not want to try to change or move the cast, as this can alter the shape of the tissue under your nose. In some cases, there is a reason why we make the cast a certain shape, so it is best to leave it and try your best not to worry about the shape.
My nose really hurts with the cast on after a rhinoplasty. What should I do about this?
Pain is typically mild to moderate the first few days after a rhinoplasty. If you find that your pain is worsening or your pain medication is not working, it is very important to call your surgeon, visit a local emergency department or contact Dr. Bonaparte as soon as possible to be assessed. Pain shouldn’t increase after day 2 of a rhinoplasty. It should stay mild and slowly improve.. Worsening pain can indicate some uncommon complications such as an infection or something called ‘necrosis.’ Necrosis occurs when the skin of your nose isn’t getting enough blood or nutrients to heal and can cause serious scarring if it occurs. This is very uncommon but critical to recognize as it is reversible.
If the pain is getting worse after day 2, you should contact and visit your surgeon or visit and emergency department or walk-in clinic
After I took the cast off, my nose looks big. Why does it look so big?
This question requires some understanding of skin anatomy and physiology. In order to perform rhinoplasty surgery, we have to cut the skin, as well as “lift” the skin off the deeper tissues off the nose. This occurs in both an open and closed rhinoplasty.
In normal situations, the blood and fluid within the skin of your nose can easily flow in and out as there are small blood vessels and lymphatic (fluid) channels that allows all the fluid and blood to easily flow. Surgery disrupts this normal flow once we cut these channels. Any time you cut the skin, you disrupt the flow of blood and fluid. Making matters worse is that the healing process causes your body to secrete hormones that trigger the healing response and inflammation. This inflammation causes more swelling and more fluid coming to the area that had surgery. Together, normal healing and a disrupted flow causes the swelling to increase and your nose to look big. The skin on your nose doesn’t need much swelling to look big, so even a small amount of swelling can cause your nose to look much bigger.
The critical thing to remember is that this is the early phase of healing. Swelling typically is at is maximum around two weeks after surgery and then, it slowly goes away. Your body will start creating new channels and blood vessels to drain all the fluid.
This whole process can take up to a year or longer. However, you can rest assured as most people will still look great during this healing phase.
The Typical Course of Swelling after a rhinoplasty is as follows.
1) Patients should expect their nose to be very swollen for about 2 weeks
2) Between 2 weeks and 1 month, the swelling show start to quickly resolve but it will still be noticeable.
3) Between 1 and 2 months, your nose will start to look much better, but not perfect. Patients often notice that the upper half of the nose looks better but that the tip is round, shiny and firm.
4) Around 6 months, the swelling should be about 70% resolved. The tip will start to feel softer but still full and thick.
5) Between 6months and 1 year, the swelling should be over 90% resolved.
How long does the swelling last after a rhinoplasty?
This is a complicated question and one of the most common questions we get asked after a rhinoplasty. There are two possibilities:
If you have a closed rhinoplasty, the swelling of the skin usually resolves around the first month. However, the bone can change during the first year.
If you have an open rhinoplasty, the swelling often takes longer. The problem is that swelling can last up to a year and sometimes longer, but that doesn’t mean your nose doesn’t look good during the year after surgery. It will look good, but not “perfect”. Your nose will be very swollen and puffy for the first two weeks after surgery. But after a month, you nose will look natural, but the tip will be swollen and firm. By the sixth month, the swelling will improve; the tip will soften a bit and will be less full, but you will still find it a bit swollen. In a year’s time, the tip should be soft and look great. However, some patients require even longer for all the swelling to go away.
Why does the tip of my nose look so big after a rhinoplasty?
Similar to Question 5 above, we have to cut the skin, as well as “lift” the skin of the deeper tissues of the nose, which disrupts the normal flow of blood and fluid around your skin and tissue. There are microscopic channels that also continue to flow. There is no way to overcome this disruption. After surgery, your body wants to heal so it secretes hormones and other chemicals to trigger the healing response. Healing results in more swelling. As a result, the combination of healing and disrupting causes the swelling to increase and your nose to look big.
It’s been a few months after my rhinoplasty and the tip of my nose still looks big. How long does it take to go away?
The tip of the nose is often the last part of the rhinoplasty to heal. If you look at some of the other questions about swelling, you will see that the tip can take up to a year to heal. However, the tip will look great, but not “perfect” after one month.
It’s been a few months after my rhinoplasty and I can still feel a bump on my nose. Does this mean it is going to come back?
The short answer is no. In rare situations, the bump will still be present after surgery, but this is the exception. After you cut the bone of the nose—or remove the bump on the nose—the bone has to heal. It forms what is called a “callous” that is kind of like a scab on the skin. This allows the bone to heal underneath it. You can, sometimes, see this bone healing and it looks like a small bump. Over time, the body will absorb this and the swelling will go away.
In rare situations, your body may scar or form a thick bone. In this situation, it is possible to see the bone or a small bump. If this was to happen, you should talk to your surgeon to see what can be done to fix it. In nearly all cases, this can be easily fixed with a minor surgery.
It’s been a month after my rhinoplasty and the scar under my nose looks uneven. How can I improve this and why did it happen?
This question is related to other questions regarding swelling of the nose.
Similar to questions five and seven, a rhinoplasty (nose job) requires the cutting of the skin, as well as the “lifting” of the nose’s deeper tissues. Microscopic channels allow blood and fluid to freely flow all around your skin and tissue. Surgery disrupts this normal process and there is no way to overcome this apart from your body forming new channels within the skin. Anytime you cut the skin, you disrupt the flow of blood and fluid.
The scar on your nose is called the columellar scar and acts like a water dam. It disrupts the flow of fluid and the fluid tends to build up above the scar. This gives the impression that your scar is not perfectly lined up as the skin above the scar is swollen and the skin below is not. All patients who have an open rhinoplasty have this for 6-12 months while the swelling goes down. It is usually not a concern, but some patients are worried the scar will not heal perfectly. This scar usually looks fantastic once the swelling is gone.
WHow long do I have to wait to get the final result of my rhinoplasty?
If you scour the internet, you will find the same answer: 12 months. This is a bit arbitrary and it’s different for all patients. I usually tell patients that by the second month, your nose will look great and by the sixth month, it will look fantastic. However, it can take one to two years for it to be fully healed. Most people are not bothered by the small amount of swelling that resolves over time, but it’s important to remember that it can take time for all the swelling to go away.
When can I start blowing my nose after a rhinoplasty?
After a rhinoplasty, there are a few parts of the nose that could potentially move if you blow your nose:
The bone
The stitches
The septum
If you had the bone of your nose cut, there are some pieces that can move if pressure is applied to them. If you blow your nose, there is a chance that they could move. It is also possible that a stitch will pop out because of this. When we do a rhinoplasty, its common that have a septoplasty at the same time. This allows us to harvest some material to help build and shape your nose. If you blow too hard, you can potentially damage this.
I tell my patients that they cannot blow their nose for the first week. After a week, if you spray some saline water in your nose you can do a very gentle blow to help remove some mucus. After three weeks, you can start to blow a bit harder while applying the saline spray before doing so to loosen up the material. After a month, you can get back to normal.
When can I go back to the gym and start exercising after a rhinoplasty?
After a rhinoplasty, there is the potential for bleeding in your nose. This can be severe in rare cases and if it happens, it can affect the result of your surgery. This is why we are very cautious about anything that may increase the risk of bleeding. Exercise can increase your heart rate and blood pressure and that can increase the risk of bleeding. I recommend people wait at least three weeks before they start exercising; it is uncommon to have a nose bleed after three weeks. However, exercise can also increase the swelling in your nose. Some people find their nose swells a little more after they exercise in the first month or two.
Why are there red pimples on my nose after my cast was removed?
When we do a rhinoplasty, we use special glue and tape on your nose. This helps keep the swelling down, as well as allow all of the tissue and skin to stay in the right place. In some people, the tape can block your pores and cause a breakout similar to acne. If you are prone to acne, we can help limit this by starting a special skin treatment prior to surgery. Ask us about this and we can help. In almost all cases, the breakout will go away once the tape is removed and the skin is cleaned, but we are here to help if there are any issues.
Some of the stitches fell out after my rhinoplasty/nose surgery. Is this a problem?
When we do a rhinoplasty surgery, we use different stitches for different purposes. Some of these stitches are dissolvable and fall out on their own; some are designed to be removed by our professionals. However, the tissue in the nose tends to heal quickly and once this happens, the stitches fall out. In some situations, the stitches can fall out in a few days while others can last a few weeks if they are not removed. In almost all cases, a stitch that falls out early is likely to not impact the results of your surgery. If you are concerned, we always recommend following up with Dr. Bonaparte to take a look and see if anything needs to be done. But rest assured, most times one or two stitches falling out early is not a problem.
Why is it so difficult to breath after my nose surgery/rhinoplasty?
One of the most important things that patients need to consider when they plan for a rhinoplasty or any type of nose surgery, is the risk to their breathing after surgery. Although we do our best to limit any effect the surgery has on breathing, there is always a risk that people temporarily or permanently have reduced breathing through their nose. After surgery, almost all patients have trouble breathing through their nose. This is due to some swelling in the nose, as well as the stiches.
Additionally, the mucus doesn’t move around the way it should after surgery and this can also affect your breathing. Between the second and fourth week after surgery, this will usually return to normal.
Understandably, patients are concerned about permanent breathing problems. Any time you make the nose smaller, you risk affecting breathing through the nose. This is a part of cosmetic surgery, although we do everything we can to prevent this. If you do have breathing problems after surgery, it is important to talk to your rhinoplasty surgeon. In many cases, this can be improved and/or fixed.
My nose feels numb after a rhinoplasty. How long does it take to go away?
After you have an open rhinoplasty, it is not uncommon to have some numbness at the tip and under the nose. This is due to cutting some small nerves in this area and happens whenever you cut through the skin. In almost all cases, this will resolve itself between six to eight months after your rhinoplasty, but it can take up to a year in some cases.
I am about to have a revision (second) rhinoplasty. What should I expect after the surgery?
A revision rhinoplasty is significantly more complicated than a primary rhinoplasty. This is mainly due to scaring from the previous surgery. The most important thing to remember is that healing can take longer. The swelling often lasts longer than a primary rhinoplasty.