While many patients focus on the end-goal of a rhinoplasty (aka “nose job”), there are some details to be aware of before undergoing the scalpel. Upon completion of the procedure, you will be given prescriptions for specific medication to make you as comfortable as possible postoperatively to allow your body to heal. Routinely, this includes medications to help treat potential pain and/or nausea as well as nasal saline spray to keep the nose clean and moist while you are healing. Depending on the details of your surgery, I may also prescribe antibiotics and/or steroid pills to be taken during the recovery period.
For optimal pain control with the best side effect profile, I recommend alternating acetaminophen 1,000 mg and ibuprofen 600 mg every three hours for the first two days and then decreasing the frequency as the pain subsides. I do also provide a limited number of narcotic pills (oxycodone) to be used for pain that is not able to be controlled with the first-line choice. Most patients undergoing rhinoplasty will not need any of the prescription pain medication, but it is helpful to have it available for those patients who need better pain control to allow for restful sleep while recovering. Rarely does a rhinoplasty patient require narcotic pain medication for more than seven days after surgery. Common side effects of narcotic pain medication include constipation and/or nausea. To prevent constipation from narcotic pain medication, I ask patients take a stool softener.
To prevent nausea associated with anesthesia and/or the postoperative pain medications, I typically will order anti-nausea medication like ondansetron. This medication should be taken at the sign of any queasy sensation in the stomach in order to stave off vomiting, which can lead to postoperative swelling, bruising, and even bleeding. Side effects from this medication are fairly uncommon.
Antibiotics are almost universally administered intravenously immediately before or during surgery to prevent post-operative infection. I may also prescribe oral antibiotics like cephalexin or clindamycin after surgery if there is evidence of an infection at the time of surgery and/or if an implant is being left in for the recovery period (including nasal septal splints). Typically, patients take oral antibiotics for about seven days after surgery. Side effects from these medications include gastrointestinal upset.
For rhinoplasty procedures involving controlled fracture of the nasal bones or when I anticipate significant post-operative swelling, I may provide a prescription of steroidal anti-inflammatory medication like prednisone or methylprednisolone. Steroids work to improve the recovery by reducing the discomfort and tissue distortion that can be associated with swelling. Common side effects from steroids include insomnia, mood changes, increased appetite, and stomach irritation. These symptoms are typically limited to the duration of treatment, but it can be helpful to take an antacid medication like famotidine to reduce the chance of stomach irritation while on this medication.
It’s easy to get wrapped up in the anticipation of the changes that will come from rhinoplasty, but I want all my patients to be fully informed and prepared to experience as comfortable a recovery as possible. As a patient undergoing surgery, it is essential you feel comfortable with your surgeon and well-informed about your surgery, including what to expect with your post-operative recovery.
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