Care guide
Rhinoplasty Care Guide
Everything you need from four weeks before surgery through your six-month visit, in the order you’ll need it.
Masoud Saman, MD & Nigar Ahmedli, MD
Double board-certified facial plastic surgeons
At a glance
The whole journey on one page. Details for each step follow below.
- 3 to 4 weeks before: Medical clearance if needed. Stop nicotine, Accutane, retinoids and peels on the nose. Arrange time off, help at home, and contact lenses if you wear glasses.
- 2 weeks before: Pause GLP-1 medications. Stop blood-thinning medications and supplements. Virtual pre-op with our scheduler.
- 4 days before: Start arnica and vitamin C. Fill prescriptions and shop.
- Night before: Trim nose hair, apply antibiotic ointment, set up your healing corner. Nothing to eat or drink for 8 hours before surgery.
- Surgery day: Clean face, no makeup or jewelry, button-up top. A responsible adult takes you home and stays 24 hours.
- Days 1 to 3: Rest, elevate, ice cheeks and eyes for 48 hours. Saline and nostril cleaning start day 1. Stay within 30 minutes of the office.
- Day 3 or 4: Recovery visit with our medical assistant.
- Day 6 to 14: Cast removal and taping instructions with your surgeon.
- Weeks 2 to 6: Gentle nose blowing after 2 weeks. Exercise after 4 weeks. Glasses after 6 weeks.
- Month 2: Follow-up, in person or virtual.
- Month 6: Virtual follow-up.
How long each restriction lasts
- Bending, lifting over 5 lb1 week1 week
- Alcohol1 week1 week
- Straws1 week1 week
- Hot showers2 weeks2 weeks
- Nose blowing2 weeks2 weeks
- Sneeze with mouth open2 weeks2 weeks
- Exercise4 weeks4 weeks
- Nicotine, vaping, cannabis4 weeks4 weeks
- Glasses and sunglasses6 weeks6 weeks
- Baths, hot tubs6 weeks6 weeks
- Head under water2 months2 months
- Pore strips on the nose3 months3 months
Before surgery
Preparing well makes recovery noticeably easier. Work through these in order.
3 to 4 weeks before
- Medical clearance. If you are being treated for any medical condition, have a significant medical history, or are over 49, we need clearance from your primary care doctor or specialist. Ask early; last-minute clearances can delay surgery.
- Stop for at least 3 weeks before surgery: all nicotine (cigarettes, vaping, patches, gum), cannabis, Accutane, chemical peels and retinoids on the nose. Protect your nose from sunburn.
- Time off. Plan at least 7 days away from work.
- Glasses. Nothing can rest on your nose for 6 weeks after surgery. If you wear glasses, order contact lenses now.
- Help at home. A responsible adult must take you home after surgery and stay with you for at least 24 hours. You cannot be discharged to a taxi or rideshare. Your companion cannot wait in our lobby during surgery; we will call them when it is time to return. Out-of-town patients can ask us to arrange private nursing, billed directly by the provider.
2 weeks before
- GLP-1 medications (such as Ozempic, Wegovy, Mounjaro, Zepbound): pause 2 weeks before surgery.
- Avoid anything that increases bleeding and bruising: aspirin, ibuprofen, naproxen, vitamin E, omega-3 and fish oil, and herbal supplements such as ginkgo, garlic, ginseng, turmeric and St. John’s wort. Use Tylenol for any pain.
- Blood thinners should only be stopped in coordination with the doctor who prescribes them.
- Virtual pre-op appointment with our surgery scheduler to review consents, photos and logistics. Bring anyone who will help with your recovery.
- Optional virtual session with your surgeon if new questions have come up since your consultation. Call the office to set it up.
4 days to 1 week before
- Start supplements 4 days before surgery: arnica tablets as directed on the package, and vitamin C 1000 mg three times a day.
- Fill your prescriptions and check that the pharmacy gave you everything on your medication list. Keep your scripts safe; duplicate pain prescriptions cannot be issued.
- Review your informed consent, photo consent and office policies, and go over these instructions with the person helping you.
- Getting sick? If you develop a cold, fever, cough, COVID or any other illness, tell us right away. Depending on the illness and its severity, we may need to reschedule for your safety.
The night before
- Set up your healing corner: extra pillows to sleep elevated, cold packs, medications, ointment, cotton swabs, hydrogen peroxide, a humidifier, and something to watch or read.
- Trim the hair inside your nose with a nose hair trimmer. No scissors or blades.
- Apply a small amount of antibiotic ointment inside each nostril at bedtime.
- Nothing to eat or drink for 8 hours before surgery, or surgery will be cancelled. Morning medications may be taken with a small sip of water.
Surgery day
- Wash your face with antibacterial soap. Nothing on your face afterward: no makeup, sunscreen, lotion or mascara.
- No jewelry or piercings, no contact lenses, and if possible no press-on nails, hair extensions or false lashes.
- Wear a zip-up or button-up top so nothing passes over your nose.
- Bring a photo ID. Most facilities ask you to arrive 45 minutes before your surgery time.
- Feeling a little nervous is completely normal. You’ve prepared well, and our goal together is a nose that is improved and in harmony with your face.
Traveling in for surgery
- Stay within 30 minutes of the office for the first 72 hours.
- You may fly after day 3 and return for cast removal around day 7. We prefer that you stay in New York for the full first week if you can.
- Book flexible travel. Casts come off anywhere from day 6 to day 14 depending on the surgery and how you are healing. Sometimes your surgeon needs to replace the cast for more healing time, or keep sutures in a little longer if the tissue isn’t fully healed. A changeable return ticket protects you if your treatment needs adjusting.
- Flying home: spray Afrin, 2 sprays in each nostril, the moment you sit down on the plane. If the flight is longer than 6 hours, spray once more as the plane begins its descent for landing. Cabin air is dry and the pressure changes can start a bleed; this is one of the times Afrin is meant for.
Recovery at home
What to do each day, and why it matters.
Rest, sleep and ice
- Sleep on your back with your head raised about 30 degrees (2 to 3 pillows) for at least 1 to 2 weeks. No sleeping flat or on your side.
- Ice for the first 48 hours only: 5 to 10 minutes every hour on your eyes and cheeks, starting right after surgery. Use light packs such as frozen peas. Never place ice on your nose.
- Take short, gentle walks to help circulation. No bending, straining or lifting more than 5 lb for the first week.
Drip pad and nostril cleaning
- Drip pad: use for at least 48 hours and change the gauze as often as needed, which can be 10 to 15 times a day at first. Put a thick layer of antibiotic ointment on each fresh gauze.
- Nostril cleaning, starting day 1: 2 to 3 times a day, gently clean the openings of your nostrils with a cotton swab dipped in hydrogen peroxide, then apply a thick layer of antibiotic ointment or Aquaphor. Keep the area moist and free of crusts.
- Only the openings. Never put swabs, fingers or anything else deep inside your nose. Do your own cleaning; don’t let anyone else do it for you.
Saline, nose blowing and sneezing
- Saline spray, starting day 1: 3 to 4 sprays in each nostril, 3 to 4 times a day. Sniff gently; don’t insert the tip deeply or spray forcefully.
- No nose blowing for 2 weeks. Use saline only. After 2 weeks, you may blow very gently.
- Sneeze with your mouth open for 2 weeks, to keep pressure off your nose.
- Use a cool-mist humidifier at your bedside (see Humidifier below).
- Do not use decongestant sprays such as Afrin unless you are bleeding (see Nosebleeds), flying home (see Traveling in for surgery) or your surgeon tells you to.
Humidifier
- Run a cool-mist humidifier at your bedside from the day of surgery, every night for at least the first two weeks, and during the day when you are resting in one room.
- Dry air dries the lining of your nose, which makes crusting and bleeding more likely. Moist air keeps the inside comfortable while you breathe through your mouth.
- Cool mist only. No warm-mist or steam units near your face; heat can trigger bleeding.
- Empty, rinse and refill it every day with fresh water, and clean it as the manufacturer directs, so nothing grows in the tank.
- Heated and air-conditioned rooms are dry. If you are staying in a hotel or traveling home, a small portable humidifier is worth packing.
Showering and your cast
- You may shower from the neck down with lukewarm water from the day of surgery. No hot showers or baths for 2 weeks; heat can trigger bleeding or dizziness.
- Keep your cast completely dry. Clean around your face with face wipes, avoiding the nose.
- Morning of cast removal: let lukewarm water soak your face and cast for about 20 minutes in the shower. This loosens the adhesive so removal is easy and comfortable.
- Don’t cut, pull or trim the cast. If it starts to lift, email us a photo.
- Redness, bumps or increasing itch under the tape can be a tape reaction. Let us know.
Eating and drinking
- Eat a low-salt diet to limit swelling. Soft foods and small bites are easiest while you breathe through your mouth.
- No alcohol for 1 week. No straws for 1 week.
- Continue avoiding the bleeding-risk medications and supplements listed under “2 weeks before” for 2 weeks after surgery, unless they are on your medication list.
- Drink plenty of water, about 8 to 10 glasses a day.
Getting back to normal
- Work: most people return after cast removal, depending on the job and bruising.
- Exercise: none for 4 weeks. Then build back gradually, and avoid anything that risks a blow to the nose, such as contact or ball sports, until your surgeon clears you.
- Glasses and sunglasses: nothing resting on the nose for 6 weeks.
- Nicotine, vaping and cannabis: not for at least 4 weeks after surgery.
- Water: no baths or hot tubs for 6 weeks; no putting your head under water in a pool, lake or ocean for 2 months.
- Sun: the skin of your nose burns easily for months. Use SPF 30 or higher and a hat when outdoors.
- Makeup: concealer around the eyes and cheeks is fine once you feel up to it. Ask your surgeon at cast removal before applying anything to the nose.
- Protect your nose: be careful around pets, small children, hugs and crowds. No pore strips on the nose for 3 months.
- Events and photos: plan big events 2 to 3 months out, when most visible swelling has settled.
Nosebleeds
Some spotting is expected, especially in the first few days and when sneezing or cleaning. Here’s how to prevent bleeding and what to do if it happens.
Prevention
- Keep your head elevated, including when sleeping.
- No bending, straining, heavy lifting, nose blowing or hot showers.
- Keep the inside of your nose moist with saline, ointment at the openings and a humidifier.
- Avoid blood-thinning medications and supplements unless prescribed.
If your nose starts to bleed
- Don’t panic. Sit upright and tilt your head forward, not back, so blood runs out of your nose rather than down your throat.
- Spray Afrin, 2 sprays in each nostril.
- Pinch the soft, compressible lower part of your nose firmly between your thumb and fingers, below the bony bridge and the cast, and hold constant pressure with your head down.
- Time yourself and hold for a full ten minutes. Don’t let go to check: releasing early starts the bleeding again, and constant pressure is what stops it.
- Clots may come out, and it can look alarming. Stay calm and keep holding good pressure.
- After ten minutes, release. If your nose is still bleeding, repeat the whole routine for another ten minutes.
- If it is still bleeding after the second round, call us, and do not wait or hesitate to call 911 or go to the nearest emergency room. Keep holding pressure while you wait.
Afrin is for active bleeding and for the flight home, or when your surgeon tells you to use it. Don’t use it for congestion, and don’t use it for more than 3 days in a row.
Call us and go to the nearest emergency room if bleeding continues after two ten-minute rounds of pressure, if you’re soaking through gauze in under 5 minutes, or if you feel blood or clots running down your throat. Keep holding pressure the whole time.
Your visits
Your full follow-up schedule is booked the day your surgery is scheduled, so every appointment is already reserved for you. Please keep these dates; they’re planned around key points in your healing.
| When | Visit | With |
|---|---|---|
| Day 3 or 4 | Recovery visit | Medical assistant, in person |
| Day 6 to 14 | Cast removal and taping instructions | Your surgeon, in person |
| Month 2 | Follow-up | Your surgeon, in person or virtual |
| Month 6 | Follow-up | Your surgeon, virtual |
Day 3 or 4: recovery visit
With our medical assistant. We examine your nose, clean the incisions and suture lines, and give you a lymphatic massage, LED light therapy and a gentle facial to refresh your skin, plus anything else indicated for you. Most patients leave this visit feeling reassured and much more comfortable.
Day 6 to 14: cast removal
Your surgeon decides the exact day based on the work done, especially on the bones, and how you are healing. Soak your cast in the shower that morning (see the video under Showering and your cast). Your surgeon will remove the cast, trim any irritating sutures, and go over taping: whether you need it, how to do it and for how long.
Virtual visits and your photos
Your surgeon reviews photos before every virtual visit, so please email them to vip@samanmd.com before your appointment. Good photos let your surgeon assess your healing accurately.
- Front
- ¾ left
- ¾ right
- Left side
- Right side
- Someone else takes the photos with the phone’s back camera. No selfies or front-facing camera; it distorts the nose.
- Stand about 6 feet away, camera at the level of your face.
- Bright, even light facing you, with no shadows on your face. A plain background behind you.
- Hair pulled back, no glasses or makeup, relaxed expression.
- Send all five views above, plus close-ups of any area you are concerned about.
Concerns between visits
Our in-person schedule is fully booked well in advance, and it is very difficult to add visits outside your scheduled appointments. Keeping your booked follow-ups is the best way to make sure you are seen at the right times.
- Not an emergency (a small bump, asymmetry, or something new you’ve noticed): email photos using the guide above. Your surgeon will review them and, if needed, see you virtually. Your surgeon decides whether you should be seen in person sooner.
- An emergency: call us right away. We will do our best to see you, but if we can’t see you immediately, go to the nearest emergency room.
Your medications
Choose your surgeon to see your usual prescriptions. Your prescriptions may be adjusted for you; the labels on your medications always come first.
Select your surgeon above.
For everyone: if you take opioid pain medication, start a stool softener such as Miralax with your first dose. Don’t drive or make important decisions until 24 hours after your last dose of opioid pain medication or Xanax. If you feel drowsy or unwell, tell us right away.
What’s normal
Healing looks different day to day. These are all expected parts of recovery.
Swelling and bruising
Both peak around days 3 to 5, then improve steadily. Bruising shifts from purple to yellow-green and usually clears within 2 to 4 weeks. Swelling can briefly increase after the cast comes off. The tip holds swelling longest: major improvement takes about a year, and full refinement can take several years. Heat, sun, exercise and flying can make swelling fluctuate.
Congestion, sore throat and smell
Your nose will feel blocked from internal swelling, and smell and taste may be dulled for a while. A sore throat from the breathing tube is common for a few days; warm tea or lozenges without herbal ingredients help.
Numbness, stiffness and your smile
The tip may feel numb for weeks to months, sometimes up to a year. Your upper lip may feel stiff and your smile may look different for a while. Both return with time.
Small asymmetries and ridges
Some swelling and minor asymmetry, inside and outside the nose, are always present while healing. Small irregularities where bone and cartilage are healing, including a slight step on the bridge, usually smooth out as tissues settle. Please don’t press or massage these areas; we monitor them at your visits.
Skin and sutures
The skin on your nose may feel dry or oily; use gentle cleansers and moisturizers and avoid rubbing. Sutures dissolve on their own. Don’t pick at or cut them. If you have thick skin, ask about skin-care options at your follow-up.
The emotional side
- First 2 weeks: fatigue, swelling and moments of doubt are common. This passes.
- Week 2 to month 2: as swelling eases, it’s natural to scrutinize small details. Your nose is still changing.
- Months 2 to 6: the tip refines and the nose begins to look more like your own.
- Six months and beyond: most patients feel their nose looks natural and settled, with subtle refinement continuing for a year or more.
Is this normal?
A place to check in during your recovery, especially in the first few months, when it’s hardest to tell what’s expected.
Your date stays on this device only. We never receive it.
A note from Dr. Saman
We want you to know that we expect you to worry. Almost every patient does at some point, and many have a moment, or a few days, of wondering whether they made the right decision. Those feelings are part of recovery, and they tend to arrive at predictable times. Knowing that ahead of time makes them easier to sit with when they come.
Your nose will change a great deal over the coming year, and much of that change happens where you can’t see it. Swelling after rhinoplasty sits deep in the tissue, especially at the tip, so your nose can look finished in the mirror while it is still quite swollen underneath. It can look better one week and worse the next, or change from morning to evening. Everyone heals on their own timeline, so try not to compare your recovery with a friend’s or with someone online.
Something happens to almost everyone as they heal. In the beginning, you notice the big changes: the hump is gone, the tip is refined, your face looks more balanced. Over time, those improvements become familiar, and your attention shifts to small details. A slight asymmetry or a tiny irregularity can start to feel much larger than it really is, simply because you are looking at it every day, up close, under bathroom lighting. Please try not to overanalyze your nose during this period. What you see at six weeks is still very early in your healing.
It also helps to know that the excitement of having your surgery done naturally fades after a few months. It’s a bit like buying a new car: the thrill is strong at first, and then the car simply becomes your car. When that happens with your nose, it can sometimes feel as though the result isn’t as good as you imagined. Usually nothing has changed except that your new nose has become your normal. Looking back at your before photos is often the best reminder of how far you’ve come.
If you’ve had revision surgery, your healing will take longer. We are working with tissue that has been operated on before, which has scar tissue and has already been altered, so swelling lasts longer and small irregularities are more common and take more time to settle. Please give yourself extra patience.
The goal we set together was a nose that is improved and in harmony with your face. Try to compare your nose to where you started, and to notice what has gotten better. Small asymmetries are part of every face, including the one you had before surgery.
If something worries you, check this page first. If it still worries you, send us photos and we will look.
Dr. Saman
When can we talk about refinements?
During the first three months, there are simply too many moving parts to judge the final shape of your nose: swelling rises and falls, tissues are softening, and the skin is still settling onto the new framework. For that reason, any discussion of a revision or minor tweak takes place at your six-month visit or later. Until then, the most helpful thing you can do is protect your nose, keep your follow-up appointments, and let it heal.
How healing unfolds
- Bruising: mostly gone in 2 to 3 weeks
- Visible swelling: mostly settled by 2 to 3 months
- Breathing: improves steadily as internal swelling resolves over the first few months
- The tip: continues to refine for 12 months or longer
- Thick skin and revision surgery: expect everything to take longer
What to expect at each stage
Week 1
Normal and expected
- swelling and bruising around the eyes and cheeks, peaking around days 3 to 5
- blocked nose and mouth breathing
- blood-tinged drainage
- a dull headache or pressure
- feeling tired, low or teary
- sore throat
Mention at your next visit
- itching or redness under the tape
- a cast that feels loose
Call us now
bleeding that continues after two ten-minute rounds of pressure, fever over 100.4°F, spreading redness, or severe or worsening pain.
Weeks 2 to 3
Normal and expected
- the nose looks swollen or wider right after the cast comes off
- the tip looks upturned or bulbous
- one side looks different from the other
- bruising turning yellow-green
- a numb, stiff tip
- a stiff upper lip or a smile that feels different
- crusting inside the nostrils
Mention at your next visit
- taping questions
- a pimple or small bump on the skin of the nose
Call us now
new swelling with redness and warmth, drainage that looks like pus, or fever.
Weeks 4 to 6
Normal and expected
- the nose looks great one day and swollen the next
- more swelling in the morning or after exercise, heat, salty food or flying
- the bridge looks narrow while the tip still looks full
- small ridges you can feel on the bridge
- doubt as the first excitement fades
Mention at your next visit
- a firm spot that isn’t changing over several weeks
- one side that stays blocked
Call us now
a sudden change in shape after a bump or injury to the nose, or signs of infection.
Weeks 7 to 12
Normal and expected
- noticing small asymmetries more than before
- the tip still feeling firm and numb
- friends saying they can’t tell you had surgery
- swelling that others can’t see but you can
Mention at your next visit
- anything you’d like reviewed. Remember that aesthetic refinements are discussed at six months or later
Call us now
signs of infection, or an injury to the nose.
Months 3 to 6
Normal and expected
- the tip gradually becoming more defined
- the nose looking more like your own
- feeling of numbness slowly returning to normal
- occasional swelling after exercise or travel
Mention at your next visit
- any area that has stayed the same for several months and still concerns you. Your six-month virtual visit is the right time for this conversation
Call us now
an injury to the nose, or new redness, swelling and pain.
Months 6 to 12
Normal and expected
- slow, subtle refinement, especially at the tip
- sensation returning fully
- the nose feeling natural and settled
Mention at your next visit
- if you’d like to discuss a refinement, now is the time. Call to schedule a visit
Call us now
an injury to the nose.
Worries we hear often
“My nose looks worse than it did last week.”
Swelling rises and falls, especially in the first three months. Salt, heat, exercise, flying, sleep position and even the time of day can change how your nose looks. A bad week rarely means anything has gone wrong.
“One nostril looks bigger than the other.”
Swelling is almost never even on both sides, and nobody’s nostrils were ever identical, including before surgery. Most of this evens out as swelling settles.
“It looked great when the cast came off, and now it’s swollen again.”
Very common. The cast holds swelling down; once it’s off, swelling often increases for a few days to weeks before steadily improving.
“My tip looks round, wide or turned up.”
The tip holds swelling longest and refines slowly over 12 months or more. It is one of the last areas to settle.
“I can feel a bump or ridge on the bridge.”
Small edges where bone and cartilage are healing are common and usually smooth over as tissue settles. Please don’t press or massage the area; we’ll check it at your visits.
“My friends say they can’t tell I had surgery.”
That usually means your result looks natural, which is what we aim for.
“I’m regretting my decision.”
Many patients feel this at some point in the first weeks, often when swelling is at its worst or the first excitement fades. These feelings nearly always ease as healing progresses. Look back at your before photos, and give your nose time.
“I had revision surgery and it’s taking longer than my first.”
That’s expected. Previously operated tissue has scar tissue and heals more slowly, so swelling and small irregularities take longer to settle.
Habits that help
- Look at your nose kindly and briefly. Use normal light at arm’s length. Avoid magnifying mirrors and close-up selfies; front-facing phone cameras distort the nose and make it look wider and larger than it is.
- Take progress photos once a month, in the same spot and light, and compare them with your before photos. Daily checking hides gradual change.
- Step away from filters and social media comparisons. Most noses you see online are edited.
- Keep busy. Once you’re cleared, returning to work, friends and routines helps take your attention off the mirror.
About how you feel in the first weeks
Fatigue, anesthesia, steroid medication, disrupted sleep and being home more than usual can all lower your mood in the first one to two weeks. Feeling down, irritable or teary during this time is common and passes. Lean on the people around you.
What other people say: early comments often focus on bruising or swelling and don’t predict your final result. When people can’t tell you had surgery, that’s usually a sign your result looks natural.
When worry becomes something more
If thoughts about your nose are taking up much of your day, keeping you from going out, or affecting your sleep, work or relationships, please tell us. You don’t have to wait for your next visit. We care about how you’re feeling as much as how you’re healing, and we can help you find support.
Call (212) 597-2257 or email vip@samanmd.com.
Shopping list
Have these ready before surgery. For convenience, many are on our Amazon list (opens in a new tab), but buy them wherever you like. Skip anything you’re allergic or sensitive to and ask us for an alternative.
Essential
- Your filled prescriptions
- Tylenol, and ibuprofen if it’s on your medication list
- Arnica tablets
- Vitamin C 1000 mg tablets
- Saline nasal spray (Simply Saline or Ayr)
- Afrin, for bleeding and for the flight home
- Antibiotic ointment and Aquaphor
- Cotton swabs and hydrogen peroxide
- Light cold packs or bags of frozen peas
- Cool-mist humidifier
- Antibacterial soap (Dial is fine)
- Face wipes and lip balm
- Lozenges without herbal ingredients
- Contact lenses, if you wear glasses
Nice to have
- Wedge pillow or extra pillows
- Zip-up or button-up tops
- Soft, low-salt meals ready in the fridge
- 3M ½-inch tan surgical tape, if taping is recommended
- Benadryl, in case of mild allergic reactions
- Books, shows and podcasts for rest days
When to call
Call the office at (212) 597-2257
After hours, follow the prompts to reach your surgeon.
- Fever over 100.4°F
- Spreading redness, warmth, worsening swelling, or pus-like drainage
- Pain that keeps getting worse despite medication
- Bleeding that continues after two ten-minute rounds of pressure, soaks gauze in under 5 minutes, or runs down your throat
If we don’t answer right away, or your situation can’t wait, go to the nearest emergency room.
Call 911
- Chest pain or difficulty breathing
- Leg pain or swelling
- Lightheadedness that doesn’t quickly pass, or severe vomiting
- Nose bleed that is extensive or does not stop with digital pressure