Your complete guide to rhinoplasty with Dr. Susan Tan — from preparation through your final result. This resource is provided to rhinoplasty patients of Hawaii Facial Plastic Surgery. It covers everything you need to know before, during, and after your procedure.
Rhinoplasty is the surgical reshaping of the nose — addressing appearance, structure, function, or all three simultaneously. It is among the most nuanced and technically demanding procedures in facial surgery, because the nose is the central structure of the face. Millimeters matter. Proportions matter. The relationship between the nose and every other feature — the brow, the eyes, the lips, the chin — must be considered in every surgical decision.
There is no universal rhinoplasty. Every surgical plan is built around your specific anatomy, your specific goals, and the functional requirements of your airway. Some patients need structural rebuilding with cartilage grafts. Others need precise tip refinement. Others need both cosmetic and functional correction simultaneously. Your plan was developed specifically for you.
The best candidates for rhinoplasty are individuals seeking improvement, not perfection. Realistic expectations, good health, and patience with the healing process — which unfolds over months, not days — are what allow you to appreciate your result fully.
Rhinoplasty swelling is not like facelift swelling — it is stubborn, slow to resolve, and asymmetric in its timing. The nose you see at one month is not your result. The nose you see at three months is a preview. The nose you see at twelve months is your result. Patience is not a minor part of rhinoplasty recovery — it is the central part. Every patient who has trusted the process has been glad they did.
How well you prepare before surgery directly affects your safety and your healing. Please complete every item on this checklist. Contact our office with any questions.
Surgery day is calm and organized. Here is exactly what to expect from arrival through your return home.
Dr. Tan reviews your surgical plan with you — marking the nose, confirming the approach (open or closed), and answering any final questions. This is your last opportunity to clarify anything before the procedure begins.
You receive MAC anesthesia or general anesthesia from a board-certified anesthesiologist — confirmed based on your surgical plan. You will be completely comfortable and unaware throughout the procedure.
Dr. Tan performs the rhinoplasty with meticulous attention to nasal anatomy and your aesthetic goals. Incisions are placed inside the nose or as a small incision beneath the columella (open approach). If cartilage grafts are used, they are harvested from within the nose or another site. A nasal splint and dorsal splint are placed at the end of surgery to support the newly shaped structure while healing begins.
You will leave the surgery center with a splint on the outside of your nose and a drip pad taped beneath the nose on your cheeks. Both are expected and temporary. Your one-week post-operative appointment is scheduled before you go home.
Rest completely. Keep your head elevated on two pillows — including during sleep. Spend time in a sitting or semi-reclined position. The drip pad will absorb drainage — replace with fresh gauze as needed. Your companion is there to help you manage everything tonight.
Nasal splint — on the outside of the nose. Keeps it dry. Do not remove. You may wash your face carefully, keeping the splint dry throughout. Remains in place for approximately one week.
Dorsal splint — over the nasal bridge. Remains in place until removed by Dr. Tan at your one-week visit.
Drip pad — taped to the cheeks beneath the nose. Catches drainage for the first 24 hours. Replace with gauze as needed. Remove once drainage stops.
Some rhinoplasty techniques require internal nasal splints placed inside the nose. If Dr. Tan places internal splints in your procedure, leave them completely undisturbed — do not attempt to remove them yourself under any circumstances. They will be removed by Dr. Tan at your one-week post-operative visit.
If your surgery includes a fascia graft, a head wrap will be in place. Leave it for 24 hours as instructed.
Rhinoplasty recovery is measured in months, not days. The structure takes time to settle, swelling resolves gradually and asymmetrically, and the final result emerges slowly. The most important thing you can do is follow these instructions precisely and be patient with the process.
Keep head elevated on two pillows at all times including during sleep. Replace drip pad gauze as needed. Take prescribed medications as directed. Eat soft foods — avoid salty foods and excessive fluid which increase swelling. Avoid excessive chewing or talking. Gently brush teeth, minimizing upper lip movement.
You may wash your hair beginning on day 2 — but only with help, so you can keep the nasal splint completely dry. Do not allow water to soak the splint under any circumstances.
Contact lenses may be worn beginning on day 3. Do not wear glasses or sunglasses that rest on the nasal bridge for four weeks if the nasal bones were broken during surgery — tape them to your forehead if needed, or use contacts.
Once drainage from the nose has stopped: use Q-tips soaked in hydrogen peroxide to gently dissolve dried blood at the base of the nose and along incisions. Do this 3–4 times daily. Follow immediately with saline spray — irrigate each nostril gently, letting the spray drain out naturally. No sniffing, blowing, or pulling. This routine keeps the healing tissue clean and moist.
Your most important early visit. The morning of your appointment, get your nose wet in the shower to loosen the cast — do not force it off, but it may fall off on its own. Dr. Tan will remove the splints, external sutures, and any internal splints. After this visit, discontinue hydrogen peroxide cleaning — switch to saline spray once daily only to keep the nasal interior moist. Use the adhesive remover pads provided to gently remove any glue residue from the nose — do not apply pressure.
Bruising resolves over 2–3 weeks. Swelling persists — particularly at the tip — and is normal. The nose will look different week to week as swelling shifts and resolves. Do not evaluate your result during this period. Continue sleeping on your back with head elevated. Avoid any activity that raises your heart rate — this includes cardio, yoga, weights, and any strenuous movement. No bending at the waist.
Most restrictions lift at 4–6 weeks, confirmed at your 4-week visit. No working out for 4 weeks minimum — anything that elevates your heart rate causes the nose to swell and that swelling is very difficult to resolve. Avoid sleeping face-down or on your stomach for 4–6 weeks.
By month 3, most major swelling has resolved and the nose begins to look like your final result — though refinement continues. The 4-week and 6-month visits are important milestones for Dr. Tan to assess your healing and address any questions.
Rhinoplasty healing is complete at one year. The nose has settled fully into its new structure, swelling has resolved entirely, and the final result is visible. This is why the 12-month visit is essential — it is the moment Dr. Tan can fully assess the outcome and discuss any additional refinement if desired.
Avoid excessive chewing and talking for the first week — movement of the upper lip puts tension on healing nasal structures
Brush teeth gently, avoiding excessive motion of the upper lip
Salty foods and excess fluids increase nasal swelling — which is very difficult to resolve. Minimize both, especially in the first two weeks
Sun protection after rhinoplasty is one of the most important aftercare steps — and the one most frequently skipped. UV exposure on healing incisions causes pigmentation changes and can permanently darken scar tissue.
The nose rarely swells symmetrically — one side often appears more swollen or different from the other. This is temporary and resolves as healing progresses.
The nasal tip retains swelling longer than any other area — often 6–12 months. The tip you see at 3 months is not your final tip. Patience here is essential.
Nasal airway changes may occur while swelling is present — breathing may feel different or slightly restricted. This typically resolves as the swelling resolves. Contact our office if breathing changes are severe.
Temporary numbness of the nasal skin is common and expected. Sensation returns progressively over months as sensory nerves recover.
Sudden significant increase in swelling on one side · Heavy or persistent bleeding · Signs of infection: fever, increasing redness, warmth, or pus · Difficulty breathing that concerns you
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Every surgical procedure involves risk. The risks below were reviewed with you at consultation and are included here as a reference. The majority of patients do not experience these complications — but understanding them is part of making an informed decision.
Normal after rhinoplasty. Skin near the surgical site may appear lighter or darker temporarily. In rare situations, swelling and discoloration may persist for extended periods.
The human face is naturally asymmetrical. Some variation between sides is expected and is often temporary. Scar tissue formation during healing also changes nasal symmetry over time.
All surgery creates scars. For open rhinoplasty, a small scar beneath the nose is expected and designed to become inconspicuous with time. In some cases, scars may require revision.
Temporary or permanent changes in nasal skin sensation are possible. Numbness in the nasal area may not fully resolve after surgery.
Changes to nasal airflow may occur following rhinoplasty or septoplasty. Most resolve with healing. In some cases, additional treatment may be needed.
Rare — a hole in the nasal septum. Additional surgical treatment may be necessary. In some cases it cannot be fully corrected.
Good results are expected, but no guarantee is expressed or implied. Additional surgery may be necessary to improve the result. Revision within one year: no surgeon fee charged; facility and anesthesia fees apply.
Some areas of the nose may heal slowly or not heal normally. Smokers and revision patients are at significantly greater risk of wound healing complications.
Nasal implants may become infected, exposed, or warped over time — requiring removal. The decision to use an implant and its risks are discussed at consultation.
Unusual but possible. Postoperative bleeding may require treatment. Increased activity too soon after surgery raises bleeding risk. Avoid aspirin and anti-inflammatory medications as instructed.
Uncommon after rhinoplasty. If infection occurs, additional antibiotics or treatment may be necessary. Report any signs of infection to our office promptly.
The nose continues to change with aging, weight fluctuation, sun exposure, and other life factors — not related to surgery. Future treatments may be beneficial over time.
Revision policy: If surgical revision is planned or performed within one year of your original procedure, there will be no surgeon fee charged by Dr. Tan. A facility fee will be charged by the surgery center, and anesthesia fees apply if anesthesia is required. A nominal fee for supplies applies for in-office revisions.
Dr. Tan sees every patient personally at every post-operative visit. Call us with any concern between visits — there are no unnecessary questions during recovery. Your safety is our priority.