Home Care Instructions
Uncomplicated and ideal healing depends on how well you care for yourself. Please read these instructions carefully before your nose surgery and ask us about any questions you may have.
The most important things to do for nasal care in the first 4 days are:
- Keep your head elevated on 2 to 3 pillows (minimum) to help bring down swelling.
- Use lots of cold compresses or gel packs on your eyes to help prevent bruising and swelling
- Use lots of Saline Nasal Spray (Ocean/Sea Mist/Ayr) to moisturize the inside of your nose – 5 to 6 times a day is a minimum. Saline nasal spray can be used as much as needed, even every several minutes.
- Always keep Vaseline on the stitches around your nostrils and inside your nose.
- Clean any crusts that develop on the stitches and around your nostrils with hydrogen peroxide and a Q-tip.
- Change the gauze bandage under your nose as needed to prevent it from soaking through.
- Take Arnica montana pills starting 1 to 2 days before your surgery and continuing until bruising is gone to help minimize and decrease the lifespan of the bruise.
Use cold compresses as much as possible for the first 4 days after surgery. Gel Packs, or face cloths & gauzes soaked in ice water, squeezed out, and folded to cover the eyes and cheeks work well. Gel packs and/or cold compresses can be used continuously. Do not use ice packs for longer than several minutes at a time. Ice cannot be used for longer than several minutes at a time due to the risk of frostbite.
Stay upright as much as possible starting the morning after the operation. Lying down flat in bed aggravates swelling. Sitting up and walking around is advisable. Use at least 2 to 3 pillows to elevate the head while resting or sleeping, and try to stay on your back rather than on your side for the first two weeks.
Wear a folded gauze under your nose for the first few days to catch any secretions. It is normal for the mucous to be blood-tinged for a few days. If your nose does not have any secretions, you do not have to wear the gauze bandage.
Incision lines should be cleaned 1 to 2 times per day with Hydrogen Peroxide and a Q-tip to remove any crusting that may build up.
Vaseline (a thin layer) should always be a kept on the incision line to help the skin heal. Apply Vaseline at least 2-3 times per day or more to keep the incision line moist. It is not necessary to apply Vaseline on the paper tapes, which are placed after stitches are removed. If crusting develops on the suture lines/stitches, gently clean them with hydrogen peroxide and a Q-tip once a day. Do not use Bacitracin, Polysporin, Triple Antibiotic ointment or any other antibiotic ointment unless instructed by Dr. Brunner.
Do not blow your nose for ten days after surgery. If you have to sneeze, keep your mouth open. After this period, blow gently through both sides at once.
Your throat will be very dry, because you will not be able to breathe out of your nose for several days. Keep beverages, especially water, nearby at all times, especially at night. A humidifier may help.
Be gentle to your face. Keep a stiff upper lip. The upper lip is a key area in nasal surgery, so try not to move it too much for the first week after surgery. Avoid excessive talking, smiling, vigorous teeth brushing, and hard-to-chew foods. Normal facial movements are fine. Be careful not to bump your nose, beware of restless children, bedmates or pets. Do not lean on your nose when you sleep. Brush your teeth gently.
No lifting, bending, straining, exercising, or aerobic activity for 3 weeks after your surgery.
Take the pain medication that Dr. Brunner prescribed as you need them. Have regular strength Tylenol at home too. Do not avoid taking pain medication if you are having discomfort. Persistent discomfort or pain may elevate your blood pressure. This can lead to complications such as bleeding, bruising and swelling.
Do not resume blood thinning medications such as Aspirin (including Excedrin, Alka-Seltzer, Asacol, Pepto- bismal), ibuprofen (Advil/Motrin), Naprosyn (Aleve), Vitamin E, Fish oil, Flax seed oil, Glucosamine/chondroitin, Ginseng, Gingko, Glucosamine/Chondroitin, ginger pill supplements, garlic pill supplements, and any other Herbal Medications for at least 2 weeks after your surgery. Ask Dr. Brunner first, before you resume these medications.
Do not smoke. Do not drink alcohol. Do not smoke for 3 months before your procedure and two months after your procedure. Smoking can increase your risk of bleeding, infection and scarring. Avoid alcohol consumption for one week before your procedure and two weeks after. Alcohol will thin your blood and increase your risk of bleeding.
Avoid sun exposure as much as possible for 6 weeks. Use sunscreen SPF 30 or more, if you are outside in the sun or snow. Burning the nasal skin after surgery and lead to damage to the skin and ultimately scarring.
Prior to surgery, arrange for someone to take you home from the hospital or surgery center and bring you to the office for your first post-operative visit the next day. You may also need a ride to the office on the 4th day after surgery.
There will be two visits in the first week (the day after surgery and the 4th day after surgery) and several further visits within the first few months. Your first office visit will be the day after surgery (post-operative day 1). If packing was placed in your nostrils during surgery, it will be removed during this visit. Sutures are removed on the 4th day after surgery and the 7th day after surgery.
One week after surgery (post-operative day 7), Dr. Brunner will remove any remaining sutures and your nasal cast/tapes and stents (if placed). Your nose, especially the nasal tip, will still be swollen.
Bruising and swelling can increase for up to 4 days after your surgery. Everyone gets some degree of bruising and swelling. Cold compresses help decrease bruising and swelling in the first 4 days after surgery. Warm compresses help dissolve bruising after the first 4 days. Make sure the warm compress isn’t too hot and cause a burn. Because the skin has temporary decreased sensation in the region of the surgery, please test how warm the compress is somewhere else on your body.
Fluctuating swelling of the nose and lower eyelids is common in the first weeks after surgery. You may wake up with eyelid swelling in the morning that goes away over the course of the day. Keep your head elevated. Use a cold compress if necessary. It takes 2 months for 80 percent of nasal swelling to resolve. The remaining 20% takes a good year to resolve. This is the refinement stage of the nasal tip swelling. Please be patient.
Avoid sunburns and tanning your facial skin for 3 months. You do not want to injure the healing incision lines. Use sun block with an SPF 30 or more if staying outside in the sun or snow.
Avoid bending over, heavy lifting, straining, exercising and aerobic activity for 3 weeks after your surgery.
Be careful not to bump your nose, eyes or face – beware of restless children, bedmates or pets.
Take Dr. Brunner’s prescriptions as advised. Ask Dr. Brunner when to resume other routine medications you were taking before the surgery.
Bathing/Showering – You may shower or bathe after your first appointment with Dr. Brunner (the day after surgery) if you feel strong enough. Please take a luke-warm shower at first. Hot showers might make you feel light-headed, or start mild bleeding from the nose. The cast can get damp, but do not let water run on the cast directly.
Face washing- You can gently wash your face with a wash cloth. Do not soak the cast with water. Do not use anything abrasive to wash your face.
Shampooing – You can wash your hair in the shower. Do not try to wash your hair in the sink.
Eyeglasses – can be easily worn as long as the cast remains on the nose. Once the cast is removed, please change to contact lenses if possible. If eyeglasses must be worn in the first month after surgery, please use light-weight glasses and wear them for short periods of time.
Contact lenses – may be used once you feel comfortable placing them. This is usually 3 to 4 days after surgery when swelling around the eyes has subsided.
Driving – 4 to 7 days.
Return to work or school – 1 to 2 weeks. Most people return to work for school once the cast has been removed. Jogging, tennis, weight-lifting, aerobics, cycling, sex – 3 weeks.
Competitive sports, contact sports, skiing, diving – 6 weeks.
Smoking, alcohol – 2 weeks.
If you have any questions or concerns, call the office at (609) 921-9497. We have a 24-hour answering service, which will contact Dr. Brunner. On occasions when Dr. Brunner is not available, surgeons at The Medical Center at Princeton will be on call for her. Should you feel it necessary, go to the Emergency Department at The Medical Center at Princeton and ask for Dr. Brunner or the doctor on call for her.
List of Supplies to Purchase
- Hydrogen Peroxide
- Gel packs/gauzes/wash cloths for cold compresses
- Arnica montana pills
- Fill all prescriptions given to you by Dr. Brunner, before your procedure.
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