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Rhinoplasty immediately after plaster removal. Rhinoplasty: what is normal and what is not (Kuzin Danila Aleksandrovich). Side effects and complications during the rehabilitation period

Rhinoplasty is a modern way to achieve perfectly beautiful facial features. An important role is played by the rehabilitation period and the removal of plaster after the intervention. Langet requires special care and respect.

Only careful observance of all the rules and prescriptions of the doctor guarantees an excellent result. The full recovery period of the body lasts for one year. The most important period is the first two months after the operation. Therefore, the patient must be attentive to the body and monitor changes in well-being.

Plaster cast care

In the first days after surgery, there is severe swelling. As a rule, it completely disappears within 2-3 days. Often patients complain of discomfort from wearing it. This feeling usually goes away within four days.

The plaster bandage serves as the basis for fixing the shape of the nose in the postoperative period. It is removed a week after application.

Completely avoid excessive physical activity, especially in the first days after the operation.
Not scratch nose with a toothpick. One wrong move and the bandage will fall off. It also increases the risk of infection.
lighten painful sensations can be achieved with the help of an ice pack that is applied to the cast. Additionally, you should follow a special diet that excludes the use of fatty foods.
cut down conversations and do not sneeze, as this may dislodge the splint.
For four weeks after the operation, blow your nose.
Not wet gypsum , as water can destroy its shape. It is necessary to wash very carefully and make sure that the liquid does not spoil its structure.
Under no circumstances should the design be checked for strength, this can lead to structural failure.
It is strictly forbidden to use spirits drinks, as they provoke bleeding.
It is necessary to protect the face as much as possible from direct solar rays.
Never spend time in basin or sauna.

When wearing a plaster on the nose, it is allowed:

Wear glasses.
mask material tonal cream.

The plaster removal process

The procedure is virtually painless and includes:

Establishment tampons moistened with a special solution and antibiotics into the nasal passages. They are used for additional fixation of walls and tissues.
Withdrawal splints.
Hygienic processing after the end of the procedure.

How long the plaster is removed after rhinoplasty depends largely on the rate of tissue healing. Doctors determine for this period from 7 to 10 days. Therefore, it is in the interests of the patient to follow all recommendations and adhere to the basic rules.

After the removal of tampons, the nasal mucosa requires special care. For this, cotton swabs are used, which are pre-wetted in hydrogen peroxide or special oil.

The procedure can be performed using the essential extract of peach, apricot, grapes, almonds. Their use contributes to the rapid removal of crusts and high-quality hydration of the mucous membrane. It is advisable to perform additional washing of the sinuses with saline.

is an exciting procedure for the patient. This is the most anticipated moment when a person first “gets acquainted” with an updated reflection in the mirror and sees his own, albeit “raw”, distorted by edema, but almost the final result of the operation.

There is another reason for worries: it seems to many that it is painful to remove a cast or splint from an injured nose.
Based on my experience and experience, I assure you: the removal of plaster after rhinoplasty does not provoke pronounced pain.

The most uncomfortable event after rhinoplasty is the removal of splints or turundas from the nostrils. Previously, turundas were long ribbons twisted into tight bundles. It was much more painful to extract them than modern ones - smooth, uniform or hollow. Now the procedure for removing supporting tampons has become more comfortable and faster.

The second "honorable" place in terms of pain is occupied by manipulation to remove sutures. It may be accompanied by stabbing pain or physiological itching in the nose (as before sneezing).

Returning to the topic of removing plaster, I can state with confidence: it does not hurt. And sometimes it's even nice!

Removal of plaster is carried out strictly on an outpatient basis in the clinic. The procedure is carried out by the doctor who performed the rhinoplasty.

Plastic surgeons increasingly prefer splints - modified immobilizing dressings. They perform all the functions of plaster, but look smaller, neater and more aesthetic.

The patient is located in a chair or couch so that the head is in a horizontal or slightly elevated position;
The surgeon takes special instruments and carefully trims the edges of the cast bilaterally;
If the bandage sits too tightly, it is successively pry off with an oblong object from all sides;
Removing the plaster eliminates jerky movements - the bandage should smoothly move away in a single layer;
Holding the bandage at the bridge of the nose, the surgeon slowly lifts it up and disposes of it.

What will I see in the mirror after the cast is removed?

Keep in mind that the first impression of a "new" nose may disappoint you. The nose will seem 1.5-2 times more massive and larger than you expected, and this is due to external and internal swelling. Moreover, gypsum partially restrains it, which means that after removal, stagnation increases and becomes more distinct. I urge patients not to panic and not judge the result of rhinoplasty at this point. However, you can trace the absence of obvious defects that bothered you before the operation.

Assessing the general shape and condition of the nose after the removal of the plaster, expect that it will change throughout the year. Mentally "reset" 30-50% of the volume from it - this will give a more accurate idea of the results of rhinoplasty.

The final stabilized effect will come after 9-12 months. But the most pronounced edema is eliminated in the near future - up to 1 month.

Timing for plaster removal

Usually, the removal of plaster after rhinoplasty is carried out on the 7-10th day. Depending on the individual, this may happen earlier or later.

Can I remove the cast myself?

Would you like to reduce to zero all the efforts of the surgeon and your own financial costs? - Shoot.
But be aware that any surgeon has every right to refuse responsibility for the result of rhinoplasty if such actions are suspected on the part of the patient. The prohibition of "amateur" applies to turundas (splints), and to seams, and to gypsum.

It happens that the gypsum or splint completely or partially leaves on its own. In the first case, do not panic, but consult a doctor immediately. In the second, also call the surgeon and tell the surgeon that you need an emergency appointment, but don't "help" the rest of the bandage come off the nose.

Gypsum is a kind of “shield” for a vulnerable nose that has undergone rhinoplasty. It not only maintains bone and cartilage structures in the right position, but also protects the nose from accidental injury. The main rule after removing the cast is to eliminate any potential risks of the latter:

Refrain from wearing heavy-framed glasses;
Sleep on your back;
Watch for sharp hand movements;
Buckle up in the car;
Suspend sports activities (including fitness and gym);
Avoid mass gatherings of people (concerts, festivals, rallies, etc.);
Try to use public transport during unloaded hours and avoid rush hour;
Wash your face and treat your face with tonic / micellar water as gently as possible.

These simple rules will help you protect your nose from any mechanical damage.

Plaster cast care

The plaster bandage serves as the basis for fixing the shape of the nose in the postoperative period. It is removed a week after application.

Completely avoid excessive physical activity, especially in the first days after the operation.
Not scratch nose with a toothpick. One wrong move and the bandage will fall off. It also increases the risk of infection.
lighten painful sensations can be achieved with the help of an ice pack that is applied to the cast. Additionally, you should follow a special diet that excludes the use of fatty foods.
cut down conversations and do not sneeze, as this may dislodge the splint.
For four weeks after the operation, blow your nose.
Not wet gypsum , as water can destroy its shape. It is necessary to wash very carefully and make sure that the liquid does not spoil its structure.
Under no circumstances should the design be checked for strength, this can lead to structural failure.
It is strictly forbidden to use spirits drinks, as they provoke bleeding.
It is necessary to protect the face as much as possible from direct solar rays.
Never spend time in basin or sauna.

When wearing a plaster on the nose, it is allowed:

Wear glasses.
mask material tonal cream.

The plaster removal process

The procedure is virtually painless and includes:

Establishment tampons moistened with a special solution and antibiotics into the nasal passages. They are used for additional fixation of walls and tissues.
Withdrawal splints.
Hygienic processing after the end of the procedure.

After the removal of tampons, the nasal mucosa requires special care. For this, cotton swabs are used, which are pre-wetted in hydrogen peroxide or special oil.

The second "honorable" place in terms of pain is occupied by manipulation to remove sutures. It may be accompanied by stabbing pain or physiological itching in the nose (as before sneezing).

Returning to the topic of removing plaster, I can state with confidence: it does not hurt. And sometimes it's even nice!

Removal of plaster is carried out strictly on an outpatient basis in the clinic. The procedure is carried out by the doctor who performed the rhinoplasty.

Plastic surgeons increasingly prefer splints - modified immobilizing dressings. They perform all the functions of plaster, but look smaller, neater and more aesthetic.

The patient is located in a chair or couch so that the head is in a horizontal or slightly elevated position;
The surgeon takes special instruments and carefully trims the edges of the cast bilaterally;
If the bandage sits too tightly, it is successively pry off with an oblong object from all sides;
Removing the plaster eliminates jerky movements - the bandage should smoothly move away in a single layer;
Holding the bandage at the bridge of the nose, the surgeon slowly lifts it up and disposes of it.

What will I see in the mirror after the cast is removed?

The final stabilized effect will come after 9-12 months. But the most pronounced edema is eliminated in the near future - up to 1 month.

Timing for plaster removal

Usually, the removal of plaster after rhinoplasty is carried out on the 7-10th day. Depending on the individual, this may happen earlier or later.

Can I remove the cast myself?

Refrain from wearing heavy-framed glasses;
Sleep on your back;
Watch for sharp hand movements;
Buckle up in the car;
Suspend sports activities (including fitness and gym);
Avoid mass gatherings of people (concerts, festivals, rallies, etc.);
Try to use public transport during unloaded hours and avoid rush hour;
Wash your face and treat your face with tonic / micellar water as gently as possible.

These simple rules will help you protect your nose from any mechanical damage.

Rhinoplasty is a surgical method for correcting a congenital or acquired deformity of the nose, performed to improve its functional state and/or for aesthetic purposes. In most cases, these operations are quite traumatic, and the rehabilitation period after rhinoplasty is characterized by duration, possible side effects and serious complications.

They can cause not only emotional and aesthetic problems for the patient, but also serious violations of his health. This largely depends on the qualifications and experience of the surgeon, the individual characteristics of the patient's body and the latter's compliance with the doctor's recommendations during the recovery period.

Some features of rhinoplasty

One of the features of these operations is a certain unpredictability of tissue changes during the recovery period. To some extent, this is due to the small volume of soft tissues in the nose area, which creates conditions for its deformation with postoperative scars already during the recovery period. In addition, post-treatment rehabilitation is lengthy and strict. They are quite debilitating for some patients, and the latter often lack the patience to follow the surgeon's recommendations. According to statistics, about 30% of operated people need, in connection with this, in corrective or repeated plastic surgery.

To reduce the severity of postoperative side effects and prevent possible and frequent complications, it is necessary not only to follow the doctor's recommendations correctly throughout the entire recovery period, but to do this consciously based on a general idea of the course of surgery, possible complications and stages of the rehabilitation period.

Briefly about the methods of online access

Depending on the nature of operational access, all types of operations are combined into 2 groups:

open

They consist in making incisions not only in the nasal cavity, but also, most importantly, in the area of the external folds of the nose, including across the vertical skin fold (columella) that separates the nostrils. This allows you to shift the soft tissue upward in order to be able to perform manipulations on the nasal bones and cartilage. An "open" operation is performed with a significant amount of surgical intervention or the need for re-correction.

Closed

When they are carried out, one or more incisions are made from the side of the nasal cavity, that is, without violating the integrity of the skin and the formation of postoperative scars on it. After that, soft tissues, including skin, are shifted upward for further manipulations. The possibilities of access to the cartilage and bones of the nose in this type of operation are quite sufficient to eliminate typical aesthetic defects. At the same time, rehabilitation after closed rhinoplasty is easier and with fewer complications. Therefore, in plastic surgery clinics, the closed method is mainly used.

Side effects and complications during the rehabilitation period

The period of postoperative recovery is accompanied by unpleasant, but natural side effects of surgical intervention and its possible early and late complications, which may be accompanied by undesirable aesthetic consequences.

Side effects are:

Hematomas and petechial hemorrhages directly in the nose, around it and in the periorbital zone, and sometimes subconjunctival hemorrhages of various sizes, which are associated with tissue detachment during the intervention and inevitable, even with the most sparing plastic surgery technique, vascular rupture.
Severe swelling of the tissues in the nose and under the eyes, which can pass to the cheeks and descend to the chin area.
Increased body temperature in the first 1-2 days after surgery.
Severe difficulty in breathing through the nose, and sometimes its complete impossibility, associated with swelling of the mucous membrane and hemorrhages under it.
Lack of smell.
Temporary partial or complete violation of the skin sensitivity of certain areas or the entire skin in the operated area.
The development of temporary asymmetry of the nose due to the displacement of its soft tissues by uneven edema.

All of the above phenomena that create a feeling of discomfort, sometimes significant, and gradually disappear within 7-14 days, are natural and do not relate to complications. However, serious complications are possible during the rehabilitation period. The main ones are:

The development of microbial infection and various additional complications caused by it.
The occurrence of necrosis of the skin, cartilage or bone tissue, usually due to their excessive dissection, damage to blood vessels, coagulation to stop bleeding, infection. All these factors can lead to impaired blood supply to tissues and, accordingly, to their necrosis (death).
The divergence of postoperative sutures, which contributes to the formation of a rough scar.
The formation of hypertrophic and, not only worsening the aesthetic results of the operation, but also capable of leading to functional disorders (difficulty in nasal breathing and impaired sense of smell).
Nose deformity.

In terms of the frequency of complications during the rehabilitation period, the second place (after the fault of the surgeon) is occupied by reasons associated with non-compliance with the recommendations of the doctor.

Stages of recovery after rhinoplasty

The rehabilitation period begins with the introduction of gauze tampons into the nasal passages, which prevent nasal breathing (but they are soon removed) and plaster splints are applied. The duration of the recovery period, due to the volume of the operation, the quality of its implementation and the individual characteristics of the patient's body, ranges from six months to 1 year, and in some cases even more. Conventionally, it distinguishes four stages.

I stage

The duration is 1-2 weeks. The main goal of the first stage is to ensure the immobility of the bone and cartilage structures and soft tissues of the nose. This is achieved by means of special fixatives or (more often) a plaster splint, as well as the introduction of hemostatic tampons into the nasal passages, which also provide additional tissue fixation.

Why is plaster applied?

During the operation, cartilage and bone, as well as soft tissues are corrected. A plaster splint, despite the fact that it causes discomfort, itching of the skin and a general feeling of discomfort, allows you to:

fix the final necessary shape and anatomical proportionality of the nose;
prevent displacement of bone and cartilage plates;
protect the operation area from unwanted external mechanical impact;
when an antiseptic preparation is added to the layers of the plaster cast, it also plays the role of an agent that suppresses the development of infection.

II stage

The average duration is 1 week. It starts with the removal of the plaster cast. In addition, hemostatic tampons are removed from the nasal passages and the latter are washed (in order to remove blood clots and crusts) with an antiseptic or 0.9% sodium chloride solution. Almost all unresolved surgical sutures are also removed. By this time, there is an improvement and stabilization of the general condition, and after the removal of the tampons, breathing becomes easier.

On what day after rhinoplasty is the cast removed?

In cases where the fixing ability of the plaster bandage has decreased, it has become deformed, accidentally or intentionally damaged by the patient, it has become wet during water hygiene procedures, it must be removed and replaced with a new one. Finally, the plaster splint is removed on the 7-14th day.

Edema at this stage is still preserved and may even increase. If, after removing the cast, the swelling has increased, this is quite acceptable and should not bother the patient. The fact is that a rigid plaster cast not only supports the structures of the nose, but also restrains soft tissue swelling, redirecting it to the surrounding areas. After removal of the obstacle, edema also appears in the freed areas, but it is no longer dangerous, since it cannot lead to deformation of the fused bones, and quickly disappears due to a decrease in the degree of the inflammatory process.

Can you remove the plaster yourself?

Sometimes patients want to check the strength of its fixation, lift it up or even temporarily remove it in order to get rid of discomfort or to check whether the fusion of cartilage and bone plates has already occurred. It is impossible to conduct such experiments, since the correction performed by the surgeon may be violated, as a result of which the entire aesthetic result of the operation can be reduced to "zero".

Stage III

It lasts an average of 2-2.5 months and is a period of cosmetic recovery. During this time, swelling and bruising almost completely disappear, and the shape of the nose, except for its tip and nostrils, takes on an almost final appearance. This stage is also important psychologically, since the patience of many patients is already running out by this time. However, they can already tentatively evaluate the results of plastic surgery.

IV stage

Lasts up to 1 year, and sometimes a little longer. This is the period of final healing and appearance formation, during which various defects may disappear and, conversely, new deficiencies may appear in the form of asymmetry in shape, irregularities, scars, the formation of visually identifiable callus, etc.