Tips for surgery

Aesthetic surgeries of the nose and ears
10 years of experience

Behavioral instructions before surgery

  • Quit all nicotine products (cigarettes, e-cigarettes, vape pens) at least 2 months before surgery and avoid them during recovery. 
  • Two weeks before: Do not take aspirin, ibuprofen, or blood-thinning supplements (e.g., vitamin E, omega-3) unless your surgeon tells you otherwise. Do not stop taking prescription medications on your own – bring a list to your consultation.
  • At least 24 hours must have passed since the last alcohol consumption on the morning of the surgery. Alcohol can be dangerous when combined with medications.
  • Do not eat for at least 6 hours and do not drink for at least 4 hours before surgery. Chewing gum is also prohibited.
  • You must not have a cold, fever, or menstruation on the day of the surgery. If you are sick or unable to come, please let us know immediately.
  • Wash your hair the night before the surgery (do not dye your hair, use hairspray or other hair care products). On the day of the surgery, do not wear makeup, perfume, face cream or jewelry (watch, ring, earrings, etc.). It must have been 2-3 weeks since the facial skin cleansing performed by a beautician.
  • Wear clothes that button up (not clothes that can be pulled over your head). Wearing appropriate clothing (hood, hat, scarf) and sunglasses will help to hide the facial area, possible bruising, and swelling when you go home.
  • Bring toiletries for one night and find a reliable driver to take you home - you are not allowed to drive yourself after anesthesia. If you are unable to spend the night after surgery in Tallinn, you must inform your treating physician so that we can arrange your post-operative monitoring differently than usual.

In the first few days, it is convenient to have the necessary things already at home and within reach.

  • Sleeping place: add pillows or a wedge pillow to keep your head elevated.
  • Cold compresses: Choose a soft compress that can be placed on the cheeks and around the eyes, not directly on the nose.
  • Nose care: Only obtain the saline solutions, ointments, and other supplies that the clinic recommends or provides.
  • Food and drink: Keep simple foods and plenty of fluids. Avoid very hot foods and drinks for the first few days if your surgeon recommends it.
  • Practical help: Agree on who will take you home and who can help you during the first 24 hours if necessary.Try to get around with the help of a trusted car owner, relative or friend instead of taking a taxi. 

Contact the clinic immediately. A fever, flu, cold, or respiratory infection can make anesthesia and surgery less safe and the procedure may need to be postponed.

Not necessarily. Many medications affect clotting. Give your surgeon a complete list (prescription, over-the-counter, vitamins, herbals, sports supplements) and follow his or her instructions.

Smoking, in addition to other harmful effects, causes impaired wound healing, increases the risk of surgery, and lowers the resistance of the nose, throat, and lungs to bacterial infections. „Just a few cigarettes“ is no exception.

Behavioral instructions after surgery

  • On the day of the operation, you will be on bed rest; you may go to the toilet and kitchen. For the first 12 hours, you should eat a lighter diet. You should drink plenty of water, 1.5-2 liters per day.
  • The splint (depending on the surgery) is usually worn for 7 days. Removing the splint on your own is prohibited. After removal, the nose may appear wide or asymmetrical – this is swelling, not the final result. Taping instructions: taping after rhinoplasty.
    • If the tape securing the splint comes loose, you will need to cut off the loose tape at home and replace it with new one.
  • Crusts and thick secretions should not be removed with your fingers or by sniffing. This may cause complications. To remove crusts, rinse your nose with saline or a saline solution. Saline sprays available from pharmacies, such as Quixx, are also suitable.
  • The sutures are usually self-dissolving and do not need to be removed. If removable external sutures are used, they are usually removed on the 7th to 10th day.
  • Do not rest your glasses on your nose for a few weeks; after removing the splint, secure them to your forehead with a patch. Contact lenses can be worn from the 10th day after surgery.
  • Keep your head elevated while sleeping. Keep a cold compress (for the first 72 hours) on your cheeks and around your eyes, do not put it directly on your nose or splinter.
  • Alcohol is prohibited for at least 2 weeks. Avoid nicotine for 2-3 weeks. These inhibit wound healing.
  • Avoid saunas, sunbathing, and hot baths at the beginning of recovery. The risk period lasts about six months. The first month is especially crucial.
  • Avoid contact sports and hobbies with a risk of impact (which can cause trauma to the nose) for 2 months.

It is normal if:

  • Swelling is most severe in the first few days (slight bleeding or bloody nosebleeds are common in the first 48 hours);
  • there are bruises around the eyes;
  • the nose appears temporarily wider after the splint is removed;
  • swelling is greater in the morning and decreases during the day;
  • one side of the nose is more swollen after sleeping on your side;
  • the tip of the nose becomes stiffer and less defined over the months;
  • Swelling increases briefly after a hot sauna, strenuous exercise, salty food, or lack of sleep.

Mild swelling of the tip of the nose may persist for 12 months or longer. In the case of a nose with thick skin, the contour may take 12 to 24 months to clear.

For some people, salty foods can temporarily increase fluid retention. This will not affect the outcome of the surgery, but it may make the nose more swollen the next morning.

Avoid swimming pools, hot tubs, sea swimming, saunas, and long-term hot baths for about four weeks, as heat can increase swelling and swimming increases the risk of infection.

Contact the clinic if the swelling begins to increase significantly after initial healing or is accompanied by:

  • increasing redness or feeling of heat;
  • increasing pain;
  • pus or foul-smelling discharge;
  • fever;
  • purplish, dark or sharply pale color of the tip of the nose;
  • profuse bleeding;
  • rapidly worsening unilateral swelling.

These symptoms do not automatically prove an infection or blood supply disorder, but require prompt professional evaluation.

It depends on the nature of the work, the bruises, and how you feel. Many people return to office work after the splint is removed or in the second week, but for physical work, a longer break should be considered.

Longer walks can usually be started after the first week, light non-impact exercise in the second or third week, and heavy lifting after the fourth week. Contact sports should be resumed after at least two months and with the surgeon's approval.

Reoperations

Rhinoplasty The final result depends not only on the surgical technique but also on the healing process. The final scar formation may take more than a year, and during this time aesthetic defects may appear that, upon the joint decision of the doctor and the patient, require a repeat operation. The need for some amount of repeat surgery is approximately 10-15% rhinoplasty patients.

Reasons:

  • A remaining or reoccurring bump, dimple, or other unevenness on the bridge of the nose
  • Unwanted shape change, such as a nose tip that is too upright or drooping
  • Fullness at the tip of the nose (pollybeak) or weakening of the support at the tip of the nose
  • Too low a bridge of the nose or weakness in the middle of the nose
  • Deviation of the nasal axis, permanent asymmetry of the nostrils or nasal wings
  • Stiffness or deformity due to scarring
  • Persistent nasal breathing obstruction
  • Previously planned surgery in two stages

In most cases, the volume of revision surgeries is small and limited to the repair of isolated defects. In more severe cases, however, the revision rhinoplasty may be significantly larger than the previous surgery and the recovery may be longer. For a successful revision surgery, it may be necessary to transplant cartilage material to the nose. In this case, the donor site is either the auricular cartilage or the costal cartilage.

A good decision for revision rhinoplasty is based on a clear problem, completed healing, and a realistic goal for correction, not just the disappointment of early recovery.
 

If you are not satisfied with the result of a previously performed rhinoplasty, please Book an appointmentso that we can find a solution to your problem together.

After rhinoplasty, the nose changes over the months. Swelling decreases, scar tissue softens, and the shape of the nose may therefore change over time. For these reasons, the need for revision surgery cannot usually be reliably assessed within the first 6-12 months.

In patients with thick skin or extensive surgery, the final result may take up to two years to become clear. Intervening too early means operating on swollen and actively scarring tissue, making the result less predictable.

The exception is a problem that requires urgent treatment, such as an infection, a blood supply problem in the skin, severe respiratory obstruction, or other urgent condition. complication.

Previous surgery alters anatomical planes and creates scar tissue. There may be less cartilage in the nasal septum, and the existing cartilage may be weakened or deformed. Therefore, the surgeon often needs alternative graft material.

For small defects, remaining septal or atrial cartilage can be used. For more extensive reconstruction, costal cartilage may be needed because it is abundant and strong, allowing for a more stable support structure. The need for a graft does not automatically mean that the previous surgery went „badly“; sometimes the cartilage in the nose itself is simply insufficient.

Is costal cartilage always necessary?

No. The need depends on how much septal or ear cartilage is left and how strong the supporting structure needs to be restored.

No. A small localized problem can often be corrected using a closed approach. Extensive structural reconstruction is usually done using an open approach.

For your follow-up visit, bring previous surgery descriptions, before and after photos, and a list of nose surgeries, trauma, and filler injections. Describe separately what is interfering with the shape and what is interfering with breathing.

Useful questions:

  • What problems are still changing due to swelling or scar tissue?
  • Which part needs minor adjustments and which needs restoration of the support structure?
  • Does the surgery also improve breathing?
  • What kind of cartilage might be needed and why?
  • What limitations are imposed by skin, scar tissue, or previous tissue removal?
  • What is a realistic recovery time?