Patient Portal

Hey, how’s it going? This is Derek Steinbacher and I’d like to discuss your postoperative rhinoplasty course today. So first off, you will have a splint in place that we put on postoperatively. There will be no packing and there will be a couple tubes inside the nose that keep the septum straight, but you’ll be able to breathe through these if you can keep them clean. There can be a variable amount of bruising postoperatively and we take steps to try to minimize or avoid these steps so that there’s no nausea and vomiting, but we want you to avoid strenuous lifting or exercise. No hanging the head low. Also, applying ice, especially to the lower eyelids is helpful. We like and recommend using green tea bags, steeping these, and then keeping several in the freezer, placing them to the lower eyelids. There’s also a few dietary and topical considerations.
Pineapple juice has an enzyme bromelain that seems to block and lessen bruising. Arnicare as well is an herbal supplement that you can place topically in the lower eyelids as well as dissolve a tablet under the tongue and doing all these things leading up to and after surgery has a positive effect. Vitamin K ointment on the lower eyelids after surgery too will help limit or lessen bruising. In terms of medications and keeping the area clean, we want no water on or underneath the splint because we want this to stay in place. We would like for you to clean the nostrils in the area of blue sutures. In doing this, we’d like for you to use a Q-tip with hydrogen peroxide or soap and water and gently curl this back and forth to clean any debris as shown here on this gag gift pillow with my rendering.
We also will give you nasal sprays. We’ll give you either Afrin or Neo-Synephrine and would like for you to use two sprays per nostril, three to four times per day, stopping after the third day. Additionally, we’ll give you a saline nasal spray. Frequently, Ocean spray nasal spray for this, please use it four times per day and each nostril and continue this until we see you. A few other things to consider. Please keep your head elevated while sleeping on two to three pillows. Take it easy. As mentioned, no exercise. Glasses are okay while the splint is in place, but once we remove the splint, no glasses for at least four to five weeks and this includes sunglasses. Flying is okay if you’re traveling for surgery, you may want to stay nearby for one day postoperatively, depending on the time we finish the case. If you were more local or regional and flying at some point postoperatively, that’s fine too. We may just want to give you some Sudafed to help with any ear or sinus pressure before and during the flight. We typically will see you back at about seven to ten days following surgery at which point we will remove the splint tubes and sutures.
This image shows a young woman at about the eight-day post-op mark just having those things removed. We actually studied over a hundred of my own patients and showed looking at edema or swelling, that 70% of it goes down by about four to six weeks postoperative, but the remaining 30% takes the better part of a year to completely go away. And these images are from our study showing at various time points how the nose takes shape as the edema comes down with time. So, we’ll finish off this short video just showing a couple postoperative results. This is about one year postoperative and showing that when you adhere to the recommendations that we describe, this will help your recovery go smoothly and we can both look forward to your final results. Remember, every case is different, and please discuss with us in person for any specific situation and contact us anytime during your recovery phase. See you soon and looking forward to your results in your rhinoplasty. This is Derek Steinbacher.

Hey, how’s it going? This is Derek Steinbacher and I’m going to talk to you today about jaw surgery recovery and post-operative instructions. Typically, you stay in the hospital for one or two nights following this procedure. The bruising and swelling tend to peak at the third post-operative day, so when you’re at home, but there are things that we will do to try to minimize this, including medications we give you and having ice applied. Your teeth are not wired together, but we do place rubber bands that are tight for the first week or so. We then loosen them at the first post-operative visit to enable you to open and close your mouth a bit better. If you happen to have Invisalign, we place small screws in the gum tissue that help hold the rubber bands. Feeding for the first several days or week is facilitated by using a small syringe with a catheter.
We will want you on blenderize no-chew food for at least the first three weeks. It will be normal to have some nasal secretions for the first several days or week following surgery. To help control this, we will give you neo synephrine. Please take this only for two days. Then utilize saline nasal sprays, several sprays per nostril several times a day, and you’ll continue this for several weeks after surgery. Ice will be important to help keep down the bruising and swelling, especially the first three to five days. We also recommend the use of green tea bags that have been steeped and then frozen as this help cut down bruising and swelling very effectively. At day five, you can buy a small child’s toothbrush and gently brush the teeth and braces only, not the gum tissue. Immediately after surgery and going on for several weeks. We’ll want you to use a parodontax type mouth rinse several times per day.
It also is important to rinse with saline or salt water several times a day, especially before and after meals. Pineapple juice is good to ingest or drink, and it helps cut down bruising and swelling, but make sure to rinse with water and saline afterwards. Taking bromelain as well as applying or taking arnica is also helpful. Some patients will find comfort in managing secretions by using a home suction machine. We will show you where to purchase this. The day after surgery while still in the hospital. We’ll obtain a cone beam scan depicting the new jaw position. Ask us more specifics about activity levels, but basically no hardcore intense or contact sports for six weeks post-op. Also, you can resume a normal diet at six weeks, including hard, chewy things, but take it slow at first.
We are always available to help you post-operatively as well. Please call or contact us and we’ll be seeing you at regular intervals to make sure the process is going smoothly for you and your family. To finish off, I’d like to show you some actual before and after orthognathic or jaw results. In each case, you can see the improved balance, aesthetics, and appearance, as well as function is improved in all of these patients. We look forward to shepherding you through this process in obtaining the best possible results we can together. Thanks for listening, and we look forward to your great orthognathic results.