Frequently Asked Questions (FAQs)

Rhinoplasty / Septorhinoplasty / Nasal Cautery / Ear Surgery / Grommets / FESS

1. What is a rhinoplasty or septorhinoplasty?
2. Why have a rhinoplasty or a septorhinoplasty?
3. What happens before the operation?
4. How is the operation done?
5. How long will I be in hospital / Will I have to stay in hospital?
6. What will I look like immediately after the operation? Will there be packs or splints?
7. Does it hurt after the operation?
8. Can there be problems?
9. What should I do immediately after I leave hospital?
10. When can I go out post operatively?
11. What about going outdoors post operatively?
12. What happens at my post operative consultation?
13. How can I expect my nose to look post operatively?
14. How long will I be off work?
15. How long before I can wash my hair?
16. How long before I can fly?
17. How long before I can play sports?
18. If I break my nose but do not get it seen to immediately will the repair not be as good?
19. What is the minimum / maximum age for undergoing a nose job?
20. Are there any prescription medicines I should not take prior to my nose operation?
21. I play a brass/ other wind instrument. How long will it be before I can return to playing post operatively?
22. I have been told I need nasal cautery. What is it? How is it done? Does it hurt?
23. How soon after ear surgery/ grommets/ Fess can I swim?
24. How soon after ear surgery/ grommets/ Fess can I fly?
25. How soon after ear surgery/ grommets/ Fess can I play sports?
26. How soon after ear surgery/ grommets/ Fess can I return to work?

1.What is a rhinoplasty or septorhinoplasty?

Rhinoplasty is surgery to change the shape and size of the nose or to improve the breathing. Septorhinoplasty includes surgery on the septum, which is the central partition of bone and cartilage between the nostrils.

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2.Why have a rhinoplasty or a septorhinoplasty?

If you wish to alter the shape of your nose your doctor may recommend this operation. There are a variety of things that can be done to alter the shape of you nose. It is important that you discuss your expectations with the surgeon.

If your main concern is being able to breathe easily through your nose, your surgeon may have recommended this operation to open up the nasal passages. This will often involve surgery on the septum too.

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3.What happens before the operation?

At your initial appointment you will have the opportunity to discuss with your consultant what can be achieved both functionally and aesthetically. Varied factors influence what can be achieved aesthetically and your consultant will take photographs to record in your notes how your nose looked before surgery and use these to plan with you how your nose will look after surgery. Your consultant will be happy to answer any queries or concerns you may have.

Before the surgery date, arrange to have two weeks off work and check you have a relative or friend who can take you home and look after you for a few days after the operation.

On the surgery date, at the hospital you will undergo pre-assessment testing as necessary, complete a health questionnaire and be visited and checked by the anaesthetist. This is to ensure that you are fit for surgery.

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4.How is the operation done?

The operation may take up to three hours and is done under a general anaesthetic. A variety of surgical techniques can be used. Usually a cut is made just inside the nostrils and the skin of the nose is separated from the underlying cartilages and bones. The surgeon is then able to operate on the cartilages and bones and change the shape of the nose. Cartilage may need to be removed or added to create your new nose.

Some surgeons may also make a cut under the tip of the nose between the nostrils. This is necessary for more complex procedures. Occasionally, the surgeon may need to take some cartilage from your ear or your rib and add it to the cartilage of your nose. This will not change the shape or function of your ear or ribs.

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5.How long will I be in hospital?  Will I have to stay in hospital?

You will not necessarily have to stay in hospital overnight. If your operation is straightforward and you meet our day case criteria, you will be able to go home on the day of your operation. We will tell you when you come into hospital whether you can go home on the same day as your operation, or whether you need to stay in overnight.

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6.What will I look like immediately after the operation? Will there be packs or splints?

The doctor may need to put a short dressing on each side of your nose to keep things in place and prevent bleeding. These dressings are called ‘packs’, and they block your nose so you have to breathe through your mouth. They are removed before you go home. Removing them is straightforward although you may bleed a little, but this usually settles quickly.

You will often have a plaster cast or splint over your nose after the operation. This is to protect it and keep the structure of the nose stable. This must remain on your nose until it is removed at your post operative consultation which will be approximately one week after your operation.

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7.Does it hurt after the operation?

The front of the nose may be tender and you may also have headaches. Ordinary painkillers should help. You may get some blood coloured watery fluid or mucus from your nose for the first two weeks or so – this is normal. If cartilage is taken from your rib, it will be sore for a couple of weeks, especially when coughing. Ordinary painkillers should help.

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8.Can there be problems?

Rhinoplasty is safe but every operation has a small risk. Please discuss with your consultant when you visit the practice. The most common problems are:

Some patients will have bruising and swelling around the eyes following the operation. If this occurs, it may take up to three weeks for all signs of the bruising to clear. Sleeping upright with extra pillows can help.

Sometimes your nose bleeds after the operation and we may need to put packs in it to stop it. Some patients have nosebleeds at home. These are usually minor but if they continue, contact your nearest A&E department or the hospital where you had your operation.

Infection is very rare after this operation, but if it happens it can be serious. So if your nose is getting more painful or more blocked make an appointment to see your consultant or see your GP.

Rarely the operation may leave a hole in your septum, which causes a whistling sound when you breathe because air goes from one side of the nose to the other. Usually it causes no problems and needs no treatment but further surgery can be carried out if necessary to repair the hole.

Very rarely, you may have some numbness of your teeth which usually settles in time.

About one or two out of every ten patients needs operation to further adjust the shape of their nose.

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9.What should I do immediately after I leave hospital?

You can sniff to clear your nose but do not blow your nose for 48 hours and try to sneeze with your mouth open as your nose might start bleeding. If it does bleed do not pinch your nose but hold some tissues at your nostrils for 10 minutes whilst sitting upright with your head tilted forward. It also helps to suck ice.

Try to avoid hot food and drinks for 48 hours as these can increase the chance of bleeding.

If you have nasal pain take the painkillers as prescribed.

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10.When can I go out post operatively?

Your nose will be stuffy and blocked for one or two weeks and during this time you should try to stay away from dusty or smoky places. We may give you some drops or a spray to help reduce the congestion.

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11.What about going outdoors post operatively?

Following your operation the skin of the nose is very sensitive to the sun. It is important to wear a strong sunscreen (factor 25 or more) for at least six months – even in the winter.

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12.What happens at my post operative consultation?

One week after your operation we will see you in the consulting rooms to remove your plaster cast and any stitches you may have under the tip or your nose, or on your rib or ear. There will be some stitches inside your nose but they will dissolve or fall out by themselves.

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13.How can I expect my nose to look post operatively?

Due to swelling following surgery, your nose may appear slightly larger and feel a little stiff and numb. It can be six weeks or more before the swelling goes away and up to nine months for the subtler contour changes to settle.

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14.How long will I be off work?

You will need to rest at home for a week afterwards. If you do manual work you should take two weeks off. If you work outside you will need to wear a factor 25 or more sunscreen to protect your nose.

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15.How long before I can wash my hair?

You may wash your hair straightaway but you should avoid getting the nose wet. You must keep the plaster dry.

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16.How long before I can fly?

It is best to avoid flying for two weeks post operatively to avoid infection and bleeding.

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17.How long before I can play sports?

If you are keen on contact sports such as rugby or martial arts you will need to avoid them for at least two months, so if necessary, discuss deferring your surgery with your consultant until a suitable recuperation period is possible.

You may return to regular exercise such as running, the gym or swimming after two weeks.

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18.If I break my nose but do not get it seen to immediately will the repair not be as good?

If you break your nose, you should be seen within the first two weeks after the injury.

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19.What is the minimum / maximum age for undergoing a nose job?

There is no maximum age. The minimum age varies from person to person. We generally advise to consider aesthetic rhinoplasty surgery once the patient has reached maturity. This does not apply in cases of trauma.

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20.Are there any prescription medicines I should not take prior to my nose operation?

You should avoid taking aspirin or any other drugs which affect the clotting of your blood as there would be increased risk of bleeding and more extensive postoperative bruising.

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21.I play a brass/other wind instrumen). How long will it be before I can return to playing post operatively?

You should avoid blowing your nose hard or play any brass/wind instrument for two weeks.

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22.I have been told I need nasal cautery. What is it? How is it done? Does it hurt?

Outpatient cautery with silver nitrate is done under local anaesthetic and the offending blood vessel sealed off. It is a little uncomfortable but most patients are able to manage with simple analgesia such as Paracetamol.

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23.How soon after ear surgery/ grommets/ FESS can I swim?

Do not swim after ear surgery until you consultant says it is ok to do so. Please ask your consultant at your post operative consultation
After grommets it is ok to swim straight away.
After a FESS do not go swimming for 10 days to two weeks.

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24.How soon after ear surgery/ grommets/ FESS can I fly?

After ear surgery you may need to avoid flying for one week and should check with your consultant.
After grommet insertion it is ok to fly straight away.
After a FESS do not fly for 10 days to two weeks – check with your consultant at your post op.

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25.How soon after ear surgery/ grommets/ FESS can I play sports?

After ear surgery you should avoid playing sport for at least two weeks and check with your consultant before resuming.
After grommet insertion you can play sport the day after.
After a FESS your should not play sports for up to two weeks

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26.How soon after ear surgery/ grommets/ FESS can I return to work?

After grommets you can return to work the following day.
After other ear surgery it will be a week to ten days
After a FESS you will need one to two weeks off work and should check with your consultant.

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