The fear attached to nose surgery is real, and most patients brace for a level of pain that never arrives. Dig into it and what they are actually dreading is the packing afterward, and the moment it has to come out. Both parts of that deserve a straight answer.
Is rhinoplasty painful?
Of all the aesthetic operations we perform, nose surgery is among the ones that involve the least pain. The amount of pain afterward is genuinely low.
That depends on your own threshold, of course. Some of our patients have almost no pain at all, others have a little. But it is never the ordeal people fear. I would go as far as calling it the least painful of the operations we do.
The need for pain medication is also lower than people expect. The large majority of our patients are comfortable with a few days of painkillers, and most of them have tablets left over from what we gave them.
How long does pain last after rhinoplasty?
The heaviest period is the first two days. Pain stays at a moderate level through the second day and then drops away quickly. Within a few days to a week it either fades or goes entirely. For most of our patients, painkiller use is limited to a day or two.
We go through exactly how to take your pain medication at the pre-operative consultation.
Is the main feeling after rhinoplasty pain or blockage?
What patients describe to us in the first days usually isn’t pain at all. It is a blocked nose and a feeling of pressure across the middle of the face. Having to breathe through your mouth, a dry mouth, a sense of fullness around the eyes.
There are two reasons for that. The first is the packing inside the nose, the second is swelling of the lining. The nose stays swollen for four to six weeks after surgery, and then the swelling drops noticeably. Reaching the final shape depends on your skin. With thin skin we can say the result is there at 6 months, and with thick skin it takes 12 to 18 months. On average the nose settles into its final shape within a year.
So what you should expect isn’t a throbbing toothache. It is a blocked, full nose. Knowing that in advance makes the first days far easier.
How long does rhinoplasty surgery take?
In my hands a rhinoplasty takes 2 to 3 hours on average. It can run longer in cases with a lot of detail and shorter in noses that need less work. Because I take extra care over every part of the nose, I generally can’t bring it under 2 to 3 hours.
Patients assume a longer operation means a more painful recovery. There is no such relationship between the two.
Do you use nasal packing in every patient?
Yes, in every patient. Here is how I explain it.
Using packing after surgery is like wearing a seatbelt. You can drive a hundred times and nothing happens, but because there is a chance of an accident on the hundred and first, you put the belt on. The same applies in the nose. We do a hundred operations and nothing goes wrong. But on the hundred and first, if bleeding occurs, packing stops that blood pressing on the tissue inside and damaging it.
The medical reason behind it is this. Blood collecting inside the nose presses on the septal cartilage, disrupts its blood supply and can cause the cartilage to be lost. What follows can be a perforation of the septum and a collapse of the bridge, both of which are permanent. I am a careful surgeon, so I use packing in every patient.
Does removing the nasal packing hurt?
When people hear the word packing they picture the pain of having it pulled out. That fear comes from the older generation of packing.
We no longer use those old, difficult ones. The silicone splints we use are soft and come out very easily. Having them removed isn’t an uncomfortable experience.
While the packing is in your nose you do feel a fullness, and that is true. But the moment of removal doesn’t go the way you are dreading. Most of our patients get through it far more easily than they expected.
We tell you how many days yours will stay in, and give you your removal appointment, after surgery.
Which painkillers can I take after surgery?
Don’t reach for whatever happens to be in your cupboard.
Aspirin, anti-inflammatory drugs and herbal supplements can increase bleeding, and we don’t want you using them in this period. When you are in pain, ask us and we will give you something suitable. We hand you your medication list in writing when you are discharged.
Frequently Asked Questions
Will I feel pain during rhinoplasty surgery?
No. The operation is performed under anesthesia and you feel nothing throughout. We explain which anesthetic method we have planned for you at the pre-operative consultation.
Can I get through recovery without painkillers?
In some of our patients the pain really is close to zero and they barely need anything. Even so, we recommend taking the medication we give you regularly in the first days. Waiting for pain to start and then taking something makes for a harder day.
When is my pain not normal, and when should I call you?
Pain decreases steadily after the first two days. If it is increasing instead, or if you have marked blockage on one side, a fever, or bleeding that won’t stop, don’t wait and hope it passes. Call us directly.
Will my breathing be clear as soon as the packing comes out?
There is a noticeable relief when it comes out, but the swelling inside the nose carries on for a while. Breathing opening up fully can take weeks. Following the nasal care we give you makes that easier.
If you want to know how the swelling and bruising of the first weeks normally progress, our article on swelling and bruising after rhinoplasty is the place to look. And if you want to know when you can go back to training, exercise after rhinoplasty will help too.
Dr. Alper Eskalen talks patients through pain and packing after rhinoplasty with all of these details in mind.
