• Dr. Waterman

How do I prepare for Rhinoplasty? What to do 1-week Before Surgery.

Updated: Nov 22, 2019

If you are unsure about how to prepare for surgery, contact your surgeon.

Getting a head-start on your surgical recovery can make a real difference in the way you feel, especially during the first few days.

There's a lot that you can do in advance of your procedure to make recovery smooth and seamless.

The major things to consider during the last week before Rhinoplasty are preparing a space for recovery, and preparing yourself physically.

Building your recovery nest.

When you come out of surgery, sleepy from medications and plastered with bandages, you will be so happy to come home to a cozy and comfortable place to nest, with all of your favorite relaxation and recovery needs. Your mission during the week leading up to surgery, is to build your nest. Future-you will be very happy that you've been so thoughtful, or rightfully disappointed and left hanging if you don't get around to preparation.


Building a recovery nest means having all of your essentials, centrally located, easily accessible, in a comfortable space where you can stay for an extended duration of time. Consider it as your home for the first week after surgery (or at least a few days), where you will rest and recover in peace and tranquility. There are 3 broad considerations to building your nest:

***NOTE*** If you have small kids, do what you can to explain to them that you will need personal space. Have a solid plan for addressing their needs, including having someone to help them directly if you are normally their primary guardian. Be especially careful not to bonk your nose when playing with your kids, and hugging or kissing them. Establishing another gesture that expresses your affection to your children before your surgery will help them understand that you still love them dearly even though you have to be physically careful about hugs and kisses. It's a surprising and difficult emotional hurdle for patients with young children, but totally possible to navigate when you see it coming.
  1. Relaxing Environment, you should nest somewhere you naturally feel comfortable. Do you have a favorite chair, or couch? Claim it now, and stock it up with pillows, blankets, books, and a phone charger. Make sure you're already logged-in to your favorite streaming services, or buy some movies to watch.

  2. Medical Supplies, including all the Rx and OTC medications, ointments, rinses, cotton applicators, and tissues. Try to have all your bases covered, so you don't have to stop at the pharmacy on your way home.

  3. Nutrition & Hydration can be a difficult challenge when recovering from any surgery, but especially rhinoplasty because the procedure can make your mouth more sensitive and your sense of smell will be affected during recovery. It's still important to eat healthy and to drink plenty of water while you're recovering. If there are foods you enjoy that are plain, soft, and easy to re-heat, consider doing some meal-prep in advance, and freezing/refrigerating some of your meals so they are ready to go with minimal effort when you get hungry.

I've included a to-do and to-buy list at the bottom of the post that you're welcome to use or adapt.

What to do (and what not to do): Before Surgery

Tip: Before your procedure, do some meal prep so that you can maximize your relaxation time during recovery.

Thankfully, if you've prepared your recovery nest you're already well-set for your recovery and there isn't a whole lot that you need to do otherwise. That being said, your health and wellness are the defining factors for how your recovery begins. Be sure that during the week leading up to the surgery, you do the following:


Do these things:

  1. Make a Recovery Nest (See above) & buy all your personal supplies and groceries.

  2. Fill your prescriptions.

  3. Confirm your ride to/from surgery. You won't be able to drive to or from your procedure, so confirm with your driver that you will have a ride a week in advance of your procedure, and keep them in the loop during the week.

  4. Arrange care for day 1. I recommend having a person stay with you during your first day of recovery to make sure you are comfortable and to help with preparing food, medication, and any other needs. Whether this is your significant other, a sibling or friend, educate them about your procedure, and let them know how much you appreciate their help.

  5. Get nightly Sleep, at least 8 hours a night, make it count. Nap during the day, too, if you get the chance. Allow your body and mind get used to resting during the day, because you will need to keep your activity to a minimum after surgery.

  6. Hydrate, hydrate, hydrate, drink probably twice as much water as you normally do. Drinking lots of water helps the body function better on a cellular level. When the body recovers from surgery,

  7. Wash your face twice a day with a gentle cleanser, and consider using a mild exfoliant to remove dead skin every other day, and follow up with a light moisturizer. Everyone knows they are supposed to wash their face twice a day no matter what plans you have, but this week take it extra seriously. You will have a cast over your nose for a week or so, and won't be able to wash your skin during that time. Starting the week with clean, clear skin will be more comfortable. Wash your face, don't just say you'll do it.

  8. Brush your teeth twice a day. This is another thing you should already be doing, but take it seriously this week. Be extra thorough, without going overboard, because opening your mouth wide during the beginning of recovery can be uncomfortable. You want to start this recovery with a clean slate, or 32 clean slates. Be conscious of your oral hygiene during recovery, too, and do what you can to keep your mouth nice and clean.

  9. Eat, eat, and eat some more. Fill yourself up with nutritious and hearty meals. Include lots of healthy snacks like fruits or nuts intermittently between meals. Try to eat something healthy at least every 5 hours. Many patients have a decreased appetite after surgery, and you will have to fast the day of your procedure, so eating well leading up to surgery is very helpful.

  10. Exercise for the first few days, then take it easy leading up to surgery. Exercise helps you blow off steam if you're nervous leading into your procedure. You won't be able to get much exercise in during your first month of recovery, so enjoy a few jogs, lift some weights -- do what you need to do to get that tension out before your procedure. Then, take it easy for the last few days. Maybe treat yourself to a massage!

  11. Take Vitamin C daily for at least a week before surgery, because vitamin C helps with healing.

  12. Prepare soft, loose-fitting clothing for you to wear after your surgery. You might like to have a hoodie and a scarf with you. Pants with elastic waist, button-up shirts, and slip-on shoes are all good items to plan to wear.

  13. You can take Arnica Montana supplements (30c) the night before your procedure. This supplement is popular among plastic surgery patients and among people with general injuries, too, who claim it can reduce pain and swelling. The mechanism for this is not well-established, and when studied showed similar results as placebos, nevertheless this supplement is used very often for cosmetic procedures. Plenty of our patients skip this.

Don't do these things:

  1. Do not Drink Alcohol during the week before your procedure. Just don't do it. Alcohol will dehydrate you, lower your immune system, and generally impair your recovery. Seek other modes of relaxation during your pre-operative week.

  2. Do not Smoke Cigarettes (ever, but especially) during the week before your procedure or during your recovery.

  3. Do not take Aspirin, coumadin, and other blood-thinning medications. See the list below.

  4. Stop using topical creams on your face at least 4 days before your procedure. Use cleansers and simple moisturizers, only. Avoid Retin-A, AHA & BHA's like Salicylic acid, benzoyl peroxide, Obagi, and other medicated creams. If you are unsure, ask your surgeon about your skincare regimen.

  5. Avoid prolonged sun-exposure before and after your procedure. UV light can be damaging to the skin and complicate the healing process.

  6. Do not Eat or Drink anything after midnight the night before your procedure, or the morning of your procedure.

  7. Don't let anxiety get you down. Many people feel nervous before a surgery like Rhinoplasty, and that's absolutely normal and even to be expected, to some degree. Don't let those nerves create anxiety. Worry will not improve your results, and you're going to be OK!

Before elective surgery, there are some supplements and medications that should be avoided because they can affect blood flow or recovery in potentially adverse manner. While there are multiple opinions about some of the medications, these are commonly listed drugs you should avoid. If you're on one or more of these medications, ask your surgeon about alternatives and develop a plan. In most cases, people continue their medication regimen as originally prescribed, but some individuals may need to establish a plan for the week leading to surgery and the week that follows.


Avoid the following Medications (unless your surgeon says so):

Aspirin: enteric-coated, baby, and plain aspirin or any other product containing aspirin. In some cases, we may recommend stopping your aspirin 1 week before surgery.  In others cases, low-dose aspirin may be continued based on your medical condition.  Please discuss with your surgeon.

Coumadin: discuss this with your prescribing physician as to the best time to stop this medication before surgery. 

Celebrex: stop 1 week prior to surgery.

Plavix: discuss this with the prescriber as to the best time to stop this medication before surgery

Vitamin E: except as included in multivitamins, avoid Vitamin E supplements during the week leading to surgery.

Some over-the-counter herbs can also effect bleeding and anesthesia reactions.  These include chondroitin, dan shen, feverfew, garlic tablets, ginger tablets, ginkgo, ginseng, and quilinggao and fish oil. St. John's Wort is known to cause complications with anesthesia, and should be avoided during the week before surgery.


For a more extensive list of what to avoid, click here.


***Note*** Ibuprofen is included often in lists of medications that may cause bleeding after surgery. While Ibuprofen & NSAID medication can exacerbate bleeding, the benefits of reduced inflammation can outweigh the risk of bleeding. Some blood is normal after rhinoplasty, but complications that need to be surgically addressed are very uncommon, and any bleed severe enough to be threatening presents more immediate concerns than the NSAID. I have not witnessed a problematic post-rhinoplasty bleed that was just caused by taking Ibuprofen.


What do I need to buy and do?

Here is an example to-do/shopping list, which you are welcome to borrow and adapt for your needs:


Make lists, and go over them a few times. If you've got everything covered, check again. You really won't want to go back out for a few days after your procedure.

At-Home

  • Decide where you will recover, and let people know to give you some space when you're recovering there.

  • Set up Entertainment options (Movies, Books, Friends who you don't mind seeing with a cast on your face) to stay busy while you rest

  • Meal-Prep some small plates or sides that you can reheat and eat after surgery. Freeze or refrigerate, but having something ready-to-go can be a life saver, especially if you're recovering mostly independently.

  • Blankets and multiple pillows to support you, elevate your head, and cozy up your spot.

  • Talk about your procedure with the people who are a part of your daily life, and help them help you by answering questions that they have in advance.

  • Confirm ride to/from the surgery center, and care for day 1.

  • If you are in a relationship, let your partner know that you're taking this seriously. Let your kids know that you're going to be OK and that they don't need to be worried when they see you in a cast after surgery. Everyone (See: Romantic partners, children) will have to be careful not to physically bump your face, but they should also be respectful of your other recovery needs, including a peaceful and comfortable environment.

  • Put some ice-packs in the freezer. We'll give you another when you're coming out of surgery, but it's nice to have a few ready to go (always 10-minutes on, 20-minutes off when gently icing) once you're home.


Pharmacy

  • Rx Medication - Fill all your prescriptions.

  • OTC Pain Killers (Acetaminophen & Ibuprofen)

  • Afrin - Helps with congestion and nasal bleeding

  • Triple Antibiotic Ointment

  • Hydrogen Peroxide

  • Q-Tips or similar swabs

  • Tissues

  • Saline nasal spray

  • Pedialyte, in case you're feeling dehydrated

  • Arnica Montana (30c dosage) - If you choose to use Arnica Montana, take one sublingual tablet the night before and the morning of your procedure, and every few hours during the first few days of your recovery. Inform your surgeon, if you plan to use Arnica Montana. Usually available in Health Food shops if not at your local Pharmacy. Pharmaca, across from our office in Madison Park sells Arnica Montana supplements for about $8.


Grocery

  • Favorite food that is plain and you don't have to chew too much (I love dishes like Ham & Potato casserole and Homemade Macaroni & Cheese, because they reheat easily in small quantities in the oven or microwave, and they will stay fresh in the fridge during the week)

  • Fruit Juices that you prefer. Sometimes the hunger just isn't there, but you can at least get some nutrition in a glass of juice until you're properly ready to eat.

  • Fruits! Apples, berries, tangerines -- whatever you enjoy most, stock up. These healthy snacks will keep you feeling great.

  • Something salty, something sweet. You'll want to have some munchy snack foods, keeping in mind that chewing tough foods may be difficult. Avoid particularly sticky & chewy candy or snacks, and prioritize small bites if you can. Opening up wide can be hard or painful at first. I recommend gummy bears and salted almonds or cashews. Mix them together, and you've got what I call "Nutty Bears". It's delicious.

  • Reusable Drinking Straws - If you don't already have these, get some and some pipe cleaners! I will give you a pipe cleaner if you need one. You will find straws to be very helpful during the start of your recovery because your lips might be sore or little numb for a few days. Don't be wasteful, a metal or glass reusable straw is very inexpensive if you don't already have one, and your local planet will thank you.

  • Tea of any variety can be helpful to soothe the back of the throat, which can be swollen and affected by the procedure.


Other

  • If you wear glasses, look into devices that suspend your frames so they won't rest on your nose. We can provide recommendations, but people have varying opinions about the numerous styles, so it is worth exploring on your own. Typically these must be ordered online.

  • If you regularly smoke tobacco, purchase nicotine gum or patches so that you won't need to smoke during your recovery. In addition to being generally terrible and ill-advised, smoking slows the physical healing processes that will make your nose job beautiful. Don't risk recovery complications because you think you need a smoke. Get some alternatives, and maybe quit for good!

  • Consider any other routine responsibilities that you have, and make arrangements to cover your bases during the first week or two of your recovery. If anyone is dependent on you for essential needs, be sure that they are taken care of during your recovery.

  • Childcare arrangements for recovery days 1 and 2 if necessary.


Chapters:

  1. Introduction: How should I prepare for a Nose Job?

  2. 1 Week Before Surgery: Building your nest.

  3. What to do the day of your procedure: Arriving home and getting comfortable.

  4. Week 1: What to know about the longest week ever. (Coming SOON)

  5. Month 1: Getting back on your feet.

  6. Up to 3-months: The waiting game.

  7. After 3 months: Preparing for long-term care.



Updated November 19, 2019.


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