Rhinoplasty

Why does my child need rhinoplasty?

Rhinoplasty (rie-no-plas-tee) is a procedure to change the shape and/or function of the nose. The procedure may help with nasal breathing and change the appearance of the nose.

How is rhinoplasty performed?

A rhinoplasty is a surgical procedure performed in the operating room under general anesthesia. General anesthesia is very safe and your child will be carefully monitored during the procedure. Ask your anesthesiologist any questions you have about anesthesia on the day of surgery.

During the surgery, the skin of the nose is lifted off of the cartilage and bone that give your child’s nose is structure and overall appearance. This is done using a series of small incisions (cuts) under the tip of the nose and inside the nostrils. Once the skin has been lifted away, the surgeon adjusts the shape of the nose. Additional pieces of cartilage (called grafts) may be used strengthen and reshape the nasal structure. Once done, the incisions are closed with sutures or stitches. Surgical tape and a small plastic splint may be used to protect the nose.

Are there any instructions I need to follow before surgery?

Your child should NOT take  Motrin^® (ibuprofen) or other medicines that can increase bleeding risk for at least 3 days before surgery.

Your child must have a physical examination by his or her pediatrician or family doctor within 30 days before surgery. The doctor you see needs to complete the History and Physical form provided by our office. Bring the completed form with you the day of surgery.

It is very important your child has an empty stomach when anesthesia is given. Follow Children’s Hospitals’ Eating and Drinking Guidelines. If you do not follow these guidelines, your child's surgery will be canceled.

What can I expect after surgery?

The procedure usually takes 3 to 4 hours. Your child will wake up in the recovery room after surgery. This can take 30 to 60 minutes. When your child is awake, they will be taken to the discharge area to complete the recovery. They may spend another 2-3 hours in this second phase of recovery. You can be with your child once they have been transferred to the discharge area. Although most patients can go home the same day, your child may need to stay in the hospital overnight if there is significant pain or bleeding after surgery.

Symptoms

Your child may experience:

• Nasal pressure and stuffiness, especially in the first week after surgery. Pain medicine may not help with the pressure. After 7 days, the nasal bandages are removed and the pressure will improve.
• Bloody and/or crusty nasal drainage. Your nurse will show you how to change the bandages to keep the area clean and germ free.
• Bruising after surgery
• Swelling around the eyes. It usually peaks on day 2, and then improves.
• Nose swelling that may make your nose look uneven. This may be alarming to see. These changes are temporary and will improve slowly over the next 6 to 12 weeks.
• Numbness in the tip of the nose, upper front teeth, or roof of the mouth. Feeling slowly returns to normal over the next 3 to 12 months.
• Loss of the sense of smell and changes to taste. This gets better after 1 to 2 weeks.

Pain Control

• Mild nasal or facial pain is normal after surgery. Give your child Tylenol^® (acetaminophen) or Motrin^®(ibuprofen). If the pain is severe, your doctor may prescribe pain medicine.

Wound Care

• Follow-up with your child’s surgeon in the clinic 1 week after surgery
• Keep bandages dry. Bathing is OK but do not soak the nasal area and dressing.
• Surgical tape and a plastic nasal splint may be on the outside of the nose. Soft rubber splints are often placed inside the nose. Both the internal and external dressings are removed one week following surgery. If the nasal splint falls off before your child’s first post-operative clinic visit it can be held in place with surgical tape.
• Nasal Saline
• Begin using saline nasal spray the day after surgery and continue for 3 weeks
• Spray each nostril 4-5 times a day to make the splint removal a week after surgery easier and more comfortable
• Nasal saline is available without a prescription at all drug stores
• Hydrogen peroxide mixed with an equal amount of water
• If the incision or nostrils have crusted with blood or dried mucus, soak a cotton tipped applicator (e.g., Q-tip^®) with the peroxide-water mixture and gently roll it over the incision two times daily
• If incisions are clean, then use an applicator moistened with plain water
• Aquaphor^® ointment
• After cleaning the external incision, place Aquaphor^® on the incision two times a day.
• Aquaphor^® is available without a prescription at all drug stores

Activities

• If your child wears eyeglasses, your nurse can show you ways to no sit on the nose. Glasses must not rest on the nose for more than a brief period of time within the first 3 to 4 weeks following surgery.
• Your child should NOT blow their nose after surgery. It could cause bleeding and change the result of surgery. If your child needs to sneeze, have them sneeze with their mouth open.   
• Your child should not do any forceful exercise or activity for at least 2 weeks. Walking is okay. Do not run, play sports, or lift weights. Do not participate in any competitive sports for 6 weeks.
• Avoid sun exposure for several months after surgery to not damage the nasal skin. Use sunscreen with a protection factor (SPF) of 15 or more to protect the nasal skin..
• Do not fly by airplane for one week after surgery due to the risk of sinus pain and blockage.

When should I call my doctor?

• Fevers up to 102.0 F are considered normal after surgery. Call your provider for fevers over 102.0 F that do not come down with acetaminophen (Tylenol) and/or Ibuprofen 
• Nasal bleeding that completely soaks the bandages in under 15 minutes
• Any injury to the nose

Questions?

The information provided in this brochure is not specific to your child. This information is provided as a service to our patients. The information is for educational and informational purposes only and should NOT be used as a substitute for the advice of your child’s physician.

If you have any questions, please call Children’s ENT and Facial Plastic Surgery Clinic.

Reviewed 10/2022

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