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Nose | Rhinoplasty

rhinoplasty 02 updatedThese include procedures which reshape the nose by reducing or increasing its size, removing humps, changing the shape of the tip or bridge, narrowing the width of the nostrils, or changing the angle between the nose and upper lip.

Where breathing anomalies exist these are frequently corrected simultaneously.

Duration:

Surgery takes between one and three hours

Anesthesia:

Typically, general anaesthesia. For minor nasal tip corrections, sedation with local anaesthesia may be used.

Inpatient/Outpatient:

This is an generally an outpatient procedure however more extensive or complex nasal surgery may require overnight admission.

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BEFORE YOUR SURGERY

Arrange to have a responsible adult over 18 years of age stay with you the first evening after surgery. The procedure will be cancelled if you do not have support.

SMOKING

Smoking increases the risks of complications significantly and should be ceased 4 weeks prior to surgery.

ALCOHOL

No alcohol 48 hours before surgery.

DIETARY REQUIREMENTS

Be well nourished, hydrated and rested before your surgery.

MEDICATIONS

A script will be issued for antibiotics and pain tablets. You will need to purchase them from a chemist and bring them with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.

Certain over the counter products and prescription medicines can cause complications before and after surgery.

They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery. These include medications containing aspirin & anti-inflammatories (Voltaren, Brufen etc) they should not be taken 2 weeks prior to your procedure. Avoid Vitamin C & E supplements and red wine 3 days before your operation.

Stop all herbal medications 1 week before surgery. These include Echinacea, Ephedra, Garlic, Ginseng, Ginkgo, Kava, St. John’s Wort, and Valerian. *(Please ask us for a more comprehensive list if required.)

Please consult Dr Geldenhuys before ceasing any chronic medications. Arrange to have someone fetch you on discharge & stay with you for 2 nights.

ADDITIONAL PRECAUTION & ADVICE

Report any signs of a cold or infections; skin (boils, bites scratches etc) dental etc within two weeks of your surgery. These may increase the risk of surgical infections and may require delaying your surgery for a few days/weeks.

Obtain any desired “comfort items” for after surgery e.g. music, comfortable clothing, pillows, healthy prepped meals, anything that will facilitate a pleasant environment for your recovery. Avoid sun/UV exposure for two weeks prior to surgery. Any evidence of sunburn will result in your surgery being cancelled.

Do not save questions for the morning of your surgery. This is a busy time for us and it should be a relaxing time for you. Please contact the office PRIOR to your surgery if you have any questions.

DAY OF SURGERY

On arrival at the clinic you will be offered a pre-med, this is to ensure you are relaxed & calm for the procedure. Prior to surgery, Dr. Geldenhuys & your anesthetist will see you in the ward. You should have nothing to eat or drink for 6 hours before your operation. If you are required to take chronic medication during this time please do so with a sip of water.

WHAT TO BRING WITH YOU

  • Any current medicines and those which have been prescribed.
  • Medical Aid membership card
  • ID Document
  • Credit Card or other agreed means of payment
  • Toiletries if required.

WASHING

Medicated soap will be provided to be used on the morning of your operation.

PRODUCTS

Do not apply make-up, perfume/deodorant, nail polish or hair products after washing.

JEWELRY

Remove all jewelry.

CLOTHING

Wear loose, comfortable clothing and footwear. Front opening garments with buttons or zips are ideal.

POST-OPERATIVE INSTRUCTIONS

MOBILITY

During the first week, you will sleep on your back. Get out of bed every 2-3hrs and walk a little bit, then back to resting. Avoid any strenuous movements and heavy lifting. Heavy exercise or straining can cause bleeding or swelling during the first few weeks. Return to normal activity should be a gradual process and should never cause discomfort. Stop if you are uncomfortable!

  • First 3 weeks: You may take a gentle walk within a few days, “short Sunday stroll”. You may drive when you are comfortable and have discontinued all medications, typically 10 days post operatively.
  • Weeks 4-6: Legs & light cardiovascular exercise only (lower body movement, no arms)
  • Week 7-12: Gradual increase in cardio exercise & light upper body training ( abdomen, biceps - no peck exercises for first 3 months )

COLD COMPRESS & BRUISING:

You may use cold compresses around your eyes for 24 hours. You may still develop bruising around your eyes (lower or upper and lower) and around your cheeks.

NASAL PACKING:

If nasal packing is in place it will usually be removed in 24 – 48 hours.

SPLINT:

The splint put on your nose at the end of surgery is intended to provide protection, serving as a sort of small external skeleton. It will be removed in 5-10 days.

POSITION:

Keeping your head (and nose) elevated tends to reduce swelling. If possible, sleep on two or three pillows.

CLEANSING:

After surgery, some oozing and bleeding usually occurs for a day or two, and dried blood will collect in the nostrils. Keep the nostrils clear using wet cotton buds to gently wipe away any crusts. You may want to carry some tissues with you for a few weeks after surgery, as your nose may “drip.” Do not blow your nose, softly dab your nose clean.

BATHING & SHOWERING

Bathing until your dressings are removed after which you may shower. If you prefer to bath, do not allow the incisions to soak for more than a few minutes. After your stitches have been removed you may shower normally.

ICE PACKS

Significant amount of swelling & bruising accompanies rhinoplasty. Ice packs can be helpful with both swelling and discomfort. The swelling and bruises will go away within several weeks.

SUN

Scars take at least one year to fade completely. During this time, you must protect them from the sun. Even through a bathing suit, a good deal of UV radiation can reach the skin and cause damage. Wear a sunscreen with a skin-protection factor (SPF) of at least 30 at all times when in the outdoors.

SCAR MANAGEMENT

The incisions will be covered with Bactroban ointment for about 2-3 weeks after surgery, then topical Vit A or Silicone for 8-12 weeks. ( this will be explained to you after surgery )

MEDICATION - Take medications as directed

Contact Dr Geldenhuys if you develop nausea, heartburn, diarrhea, constipation or bloating. If pain persists despite pain medications please contact Dr Geldenhuys.

DIET

Have 3 meals a day with plenty of fiber, protein & carbohydrates. Hydrate yourself with plenty of noncarbonated drinks: water & freshly squeezed juices.

HEALING

Requires time. Swelling depends on the extent of the surgery, surgical technique and your physical condition. Healing continues over a long period of time, up to 18 months. Most of the swelling develops in the first 48 hours. As healing progresses, swelling and bruising decreases. About sixty to eighty percent of your swelling will disappear in the first two months and the remainder gradually thereafter until a year later.

CALL ROOMS (021) 424 5218 IF YOU HAVE:

  1. A temperature greater than 37’C.
  2. Bleeding from the NOSE or back of throat - some oozing is to be expected in the first 2-3 days.
  3. A sudden increase in pain, or swelling.
  4. Any questions regarding your care.