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PRIOR TO SURGERY:
- Avoid all aspirin, salicylates, salicylamide, and ibuprofen-containing products for 2 weeks prior and 1 week after surgery (see separate list). Tylenol is an acceptable alternative.
- If you smoke, you must stop at least 1 week prior to surgery and should not restart for at least 1 week after surgery.
- Schedule pre-op appointment with our office 2 weeks prior to surgery.
- Fill all prescriptions for post-surgery medications prior to the day of surgery.
- You may wish to use a homeopathic remedy called Arnica Montana to cut down on bruising. This is an over-the-counter product that can be purchased at most large pharmacies or health food stores. It usually works best if started 3-7 days prior to surgery and continued for 3-7 days after surgery.
- Pre-operative testing (i.e., labs, EKG, chest x-ray) should be completed at least 5 days prior to surgery, and the results should be faxed to our office.
- You may take a sleeping pill or anti-anxiety medication the night before surgery if you desire.
- Do not eat or drink anything after midnight.
- You will need to arrive one hour prior to your surgery time.
- You will be contacted by the surgical facility 1 – 2 days prior to surgery regarding specific instructions and possible alterations to the instructions above.
THE DAY OF SURGERY:
- Wear a buttoned or zippered shirt, loose fitting pants, and flat shoes. Do not wear a pullover top or pantyhose.
- Do not wear contact lenses.
- Do not wear any jewelry.
- Remove all make-up and nail polish.
- The operating room time (including time to go to sleep, time to set up, time for surgery, time to wake up, and time to transport) is approximately 4 – 6 hours (times may vary depending on the exact nature of the surgery).
AFTER SURGERY:
- Recovery room time will vary from 1- 3 hours depending on the patient.
- Pain medication will be given in the recovery room, and you will be instructed when the next dose may be given at home. Do not take pain medication on an empty stomach (will cause nausea). Use of narcotic pain medication can lead to constipation and may require the use of stool softeners.
- Antibiotics should be started the evening following surgery.
- Antibiotic ointment should be placed on all stitches and slightly inside each nostril 3 – 4 times per day starting the day of surgery.
- Anti-inflammatories / steroids should be started the day after surgery and divided in 2 or 3 doses per day.
- Diet: avoid hot and spicy foods for 5 days. Be sure to maintain hydration with adequate liquid intake.
- Keep your head elevated as much as possible for the first three days. Sleep with your head elevated on pillows.
- Place ice packs (frozen peas, crushed ice in zip lock, etc.) on eyes and cheeks (not directly on nose) as much as possible for the first three days.
- Change the gauze pad under the nose as needed depending on drainage. You may remove it and keep it off when the drainage subsides.
- Keep the tape and splint dry. Use caution when bathing. Avoid steamy showers as the steam can loosen the tape and splint. Avoid any manipulation of the tape and splint.
- Avoid all physical activity / exercise / straining / lifting for 2 weeks following surgery. Light exercise may be started in the third week.
- Most patients can return to school or work in 7 – 10 days.
- You will require 2 – 3 follow-up visits in the first week (usually day #1 = packing removal, day #5 = stitch removal, day #7 = tape / splint removal). These visits should be scheduled prior to your surgery. You will also require additional follow-up visits during the first two years after surgery in order to ensure appropriate healing and take postoperative photographs.
HEALING ISSUES:
You may experience any of the following after this type of surgery:
- Bruising / swelling around the eyes and cheeks. This can be severe in the first 2 – 3 days, but it will usually resolve over 7 – 10 days.
- Ear pressure. Everyone will feel excess pressure in the ears for the first day when the packing is in place.
- Bloody mucus drainage. This will usually resolve in 3 – 7 days.
- Nasal congestion / blockage. Packing, internal swelling, mucus crusting / scabs, and dried blood will all lead to congestion. This can last up to 2 – 3 weeks. Irrigating the inside of the nose with distilled water or saline (salt water) can help alleviate this condition. Irrigations can be performed with a bulb syringe while standing over the sink.
- Decreased smell and taste. This is common following surgery due to the internal nasal swelling and congestion. It will usually improve as the congestion subsides.
- Soreness in shoulders, elbows, knees, ankles, back of head. This often happens because of prolonged pressure on these areas during surgery. We pad these areas very well, but even this does not completely eliminate the postoperative soreness that some patients experience. This will usually resolve in 2 – 3 days.
- Swelling / fullness of external nasal skin. Due to the nature of this surgery, the external nasal skin will always get thick and swollen following surgery. This will be obvious when the splint is removed one week after surgery and will take many months to resolve completely. Therefore, the final cosmetic result will not be achieved for approximately 6 – 18 months following surgery.
- Numbness / firmness of nose. Everyone will notice some numbness and firmness of the nose following surgery. This will usually become more pronounced over the first three months and then subside over the next three months.
- Numbness / tingling of roof of mouth or front teeth. This is common after nasal surgery due to swelling around the nerves that go to these areas. It will resolve with time.