1. Why do I have drainage down the back of my throat?
In a normal day, the nose secretes about a cup (8 oz.) of mucus that goes down the back of your throat without your being aware of it. However, once you have surgery and the nose is stuffed up, you become very aware of this normal secretion. It is nothing to worry about.
2. Why do I have more drainage from my nostrils one day after surgery? Can I take an antihistamine/allergy medicine to stop it?
The combination of “normal mucus drainage” and “intranasal swelling” can cause the mucus drainage to come out the nostrils rather than go down the back of the throat. Yes, you can take an over-the-counter antihistamine by mouth or any other medicine that you normally take to dry up a cold.
3. If Dr. Daniel didn’t pack my nose, why am I stuffed up?
It is very common to be “stuffed up” after surgery. The reason is that there is as much swelling inside the nose as outside of it. This swelling will peak on the second day, and then go down slowly thereafter.
4. I have a headache and trouble sleeping. Is this normal? Can I take anything for it?
Unfortunately, headaches are common following general anesthesia and surgery. It is often a good idea to try something like extra-strength Tylenol for your headache and save your Vicodin or Darvocet for pain. After the night of surgery, you may take a light sleeping aid (e.g., Tylenol PM) if you need it.
5. It has been two days since my surgery. Why is my swelling and bruising worse?
Typically, swelling and bruising peak on the second post-operative day. For this reason, it is best if you can ice your eyes and nasal region for the first day and a half post-operatively and sleep with the head of your bed elevated. Also, try to avoid salty foods. The good news is that the swelling decreases rapidly thereafter and the bruising is usually gone by the seventh post-operative day in about 95 percent of patients.
6. Regarding donor sites for ear cartilage grafts or facial grafts from the scalp:
a. Why is there bleeding and oozing?
These areas are highly vascularized, and once the epinephrine wears off from the local anesthesia, you may have “reflex bleeding or oozing.” It is essentially normal and nothing to worry about.
b. How do I clean the area?
You can wash your hair and get the area of the scalp wet where the facial graft was harvested. However, do not get the yellow ear donor site or the nose cast wet.
c. When can I wash my hair?
It is usually best to wait until the second or third day after surgery to wash your hair, and it is often advantageous to have someone wash your hair for you beauty-salon style.
7. Can I clean inside my nose? Why just the edges?
It is important that twice a day you clean all visible suture lines that have black sutures, using hydrogen peroxide and then apply a bacterial ointment (Neosporin, Polysporin). These are permanent sutures and need to be cleaned. In contrast, the clear sutures dissolve, and it is not beneficial to clean them.
8. When can I resume:
You can begin doing long walks relatively soon – by three to four days post-operatively. You can go to the gym and do a treadmill or stationary bike (no spin class) by the second week. You can begin to do light weights and non-head-down exercises by the third week. (Avoid heavy weights that would raise your blood pressure.) By the fourth week you can try any exercise, but stop if you have pain or discomfort.
b. Taking my vitamins and/or regular medications
You can resume all your medications and vitamins as soon as the cast is removed.
c. Wearing my glasses
This is a difficult question to answer, as it depends on the type of surgery done – especially the osteotomies and the grafts. As a rule of thumb, you can resume wearing your glasses one month after surgery.
d. Going out in the sun
The problem with sun exposure is that your nose will be numb for three to six months, and you can easily burn your skin without being aware of it. Therefore, you should make sure your moisturizer has a sunscreen with an SPF 10-15 (a good idea for everyone) and use it daily on the nose. If you are going to be out in the sun, then wear a hat for the first three months and use a sunscreen on the nose (SPF 15-30). If you are going to the beach or on a boat, wear a hat and frequently apply a 45 SPF sunscreen specifically formulated for water sports (Bullfrog, etc.).
9. Why do I occasionally have a funny smell in my nose?
At several weeks post-operatively, you may notice an unusual or bad smell in your nose. It is caused by the accumulation of mucus in the nose due to a reduced mobility of the “mucus blanket” within the nose. As you recall, the nose secretes a cup of mucus a day that is propelled into the back of the throat by the nasal lining cells. After surgery, the physiology of the nose takes four to six weeks to come back to normal, but in the interim you can clear the mucosal blanket with intranasal saline sprays (e.g., Ocean Spray).
10. It has been six weeks since my surgery. Why does my nose swell periodically?
Swelling in the nose decreases in two stages. Stage one is a true fluid type swelling which is generalized and comes down in the first two to three weeks. Stage two is truly scar remodeling that goes on between the skin and the underlying structures. It comes down sequentially from the top of the nose to the tip in a three-to-six-month to nine-to-12-month progression. In the first three months, the nose swells generally from time to time, especially on frontal view – what you see in the mirror. It will diminish with time, and you do not have to worry about it.