1st Appointment after Rhinoplasty -1 What happens?… stitches, taping nose, anti-swelling medicine


Hello, my name is Dr.
Julian De Silva. I’m a London based facial and
cosmetic and plastic surgeon and I’ve recorded this animation
video, to give my patients further
information on what happens in the appointment 1 week
after having Rhinoplasty. The aim of this video is really
to give you general information of course every individual
patient has individual treatment and individual
management may vary but this is really to give you
over view of this appointment. So, what exactly happens in
the 1 week appointment after Rhinoplasty? Well firstly your cast
is removed then if you have stitches these are removed. I personally suction
my patients noses so that you breathe
better after the appointment. I also use anti- inflammatory
medicine that will help reduce the swelling and
speed up healing. Finally I give clear
instructions to all my patients on how to tape your nose
after to Rhinoplasty in order to reduce
the swelling faster. In terms of removing the cast
after Rhinoplasty well, the cast plays
an important function in that it protects your nose,
it reduces swelling, however, after a 1 week this is really
the right time to take it off. Sometimes at 1 week it really
can be quite irritable or itchy. Now in terms of taking the cast
off well, generally this takes 2-3 minutes in order to remove
the cast off and can cause minor discomfort, sometimes
it can be more stuck down and it can a little longer but
generally for most patients its relatively comfortable
procedure. For some patients there may
be stitches that remain after rhinoplasty
and removing these stitches is usually done
1 week after surgery. A number of my patients are
often concerned is there going to be pain or discomfort in
removing these stitches? In terms of removing these
stitches I take special measures I use extremely fine
dissolvable stitches which only need
to be trimmed off after surgery. and so although this isn’t very
sensitive part of the nose, for most people the general
level of discomfort when I ask patients,
is a score of 3 out of 10. It’s fair to say that every
single patient is different when it comes to sensitivity and for some people it
can be more sensitive. However, for the great majority
people taking the right precautions and using fine
stitches, for most people the level of discomfort is
relatively small and generally the length of time
it takes to take the stitches out
is approximately 2-3 minutes. For my patients I like patients
to breath as best they can after surgery. So, at 1 week after the surgery
I personally suction all these debris out of your nose and
all patients will breathe significantly better
once that is completed. This could be important because
1 week after the surgery it’s very important that
you don’t blow your nose for one further week. So, to help reduce feelings of
congestion, I often suction my patient’s nose, so you can
breathe better immediately after
your appointment. Suction your nose or hovering
your nose well, its certainly isn’t the most pleasant feeling
in the world but because you’ll breath better
after doing this it’s generally a worthwhile
thing to complete. All patients have some degree
of swelling after surgery and this is a normal
part of healing. I personally prefer to give
patients some anti- swelling medicine 1 week after surgery,
as this will speed up the resolution of swelling and
essentially speed up healing. The only way to do this is to
introduce some anti-inflammatory medicine into the nose
with a fine injection. Then usually the nose is still
relatively numb at this point in time. So, most patients may feel a
little bit of pressure or tension just for like
a period of about 10 seconds and then this is complete. Many patients feel very little
at all because of this numbness. On average when I ask patients
what level of discomfort patients have, most patients
give a score of approximately 3 out of 10. However, the anti-inflammatory
medicines does speed up healing and particularly for patients
with thick ethnic skin will definitely give a faster
healing and better results in terms of
more definition in the nose. To help reduce the swelling
faster I give all my patients instructions on how to tape your
nose at night, when you sleep
at least for the first month. what this tapping will do well,
it puts a little bit of pressure on the nose, helps reduce
swelling, speeds up healing, and particularly with patients
with either thicker skin or ethnic skin, well, it speeds
up the resolution of the swelling which tends
to be more associated with the skin type and also
can give a better result as it gets more definition as
the result of the fine pressure. I give patients the tape in
which to use and this tape is a special tape and is hyper-
allergenic which means that it’s very rare to have issues
with the tape itself. It’s also latex free and this
tape what it will do is do the equivalent put a little bit
pressure on your nose when healing to help enhance recovery
and speed up final result. The way to apply this tape, is
to have the tape coming down your forehead, down the bridge
of your nose, round the tip of the nose then back up the other
side of the bridge of your nose
onto your forehead. The tape can then be pressed
down so it is relatively firm and it could stay over
this area overnight. There’s certainly no reason to
use the tape during the day as that will limit all your
activities but using it last thing at night while you
sleep means that in the morning there will be less swelling
in your nose than otherwise. I would encourage most patients
to do this for the first month
to speed up the healing. So, in summary well we’ve have
talked about what happens at the 1st week appointment
and really this could be summarized as removing the cast
removing the stitches as necessary, suction your nose
to improve the breathing after Rhinoplasty,
use anti- inflammatory medicine that could speed up
the reduction of swelling and get you to the final
results faster and also how to tape your nose to reduce
swelling particularly faster.