Traditional endoscopic sinus surgery (ESS) involves widening of natural sinus openings to improve drainage of secretions and decrease inflammation and infection.
Preparing for sinus surgery involves stopping use of aspirin and other nonsteroidal anti-inflammatory drugs for two weeks prior to surgery. Supplements which thin blood should also be discontinued at this time.
Pain
Your nose may be swollen and tender after surgery. A pain medication will be prescribed, with dosage to be taken as prescribed; pain should subside with decreasing swelling. Avoid blowing, picking at or inhaling smoke/strong odors etc as irritants – instead sneeze through your mouth as needed! Regular usage of saline spray (4 to 6 times a day or 8 ounce irrigations twice daily will help maintain minimal crusting; using 8oz irrigations twice per day with 8oz irrigations should help keep crusting to an absolute minimum while low grade fever should subside after several days post surgery; to monitor fever severity contact our office if this persists please increase fluid consumption or seek advice.
Bleeding after sinus surgery is common. While usually minimal, bleeding may occasionally require nasal packing to stop. Change the gauze pad under your nose as needed after each drainage.
After sinus surgery, some individuals experience vision changes and pain around the eyes that typically subside after some time; however, additional medical treatment such as antibiotics or additional surgery may be required for full resolution.
Patients sometimes develop new, persistent or recurrent sinus infections after nasal surgery. These may be related to the type of surgery performed, or due to other underlying medical issues which must be resolved first.
Most people will require follow-up visits with their physician to aid in the healing process. Your physician will remove internal stents, clean your nose and nasal passages and restore proper airway flow re-establish it during these appointments, which may be uncomfortable due to congestion. It is advised to take painkillers 45 minutes prior to each follow-up visit so as to minimize discomfort during these appointments.
Bleeding
Minor bleeding during nasal surgery should be expected; as delicate blood vessels within the nose and sinuses can be damaged during surgery and lead to some loss of blood. Most patients only lose small amounts, though some experience more severe forms of hemorrhaging which could prove harmful to health. Some cases of excessive bleeding result from forcefully blowing one’s nose too hard, or failing to follow their doctor’s post-op instructions. Bleeding that persists despite using nasal packing may be controlled using polyvinyl alcohol sponge tampons placed inside the nasal cavity where they expand and press mucosal membranes against each other, eliminating dead space where clot formation and lysis could happen; typically when they are removed the bleeding is immediately stopped.
Other possible complications of endoscopic or functional endoscopic sinus surgery (FESS) include the inability to open up blocked sinuses using endoscopic or functional endoscopic sinus surgery (FESS). Patients may develop persistent or recurrent disease or excessive scarring at the operative site. Sometimes there can be septal perforations — creating holes in the septum — and cerebrospinal fluid leakage, both of which require subsequent surgeries to correct.
Some patients may experience chemical sensitivities to the ointments, sutures, taping materials and nasal packing used during nasal surgery. Though this is relatively rare, it is essential that any suspected sensitivities or allergies to these materials be reported to your surgeon prior to surgery so they may offer appropriate alternatives or take extra measures to minimize discomfort you might experience during recovery. In particular, any individuals allergic to aspirin and other nonsteroidal anti-inflammatory drugs should avoid them for several days prior to their procedure to prevent increased bleeding risk and ensure successful recovery.
Bruising
Rhinoplasty is a popular surgical procedure to enhance both the appearance and functionality of a nose. While this procedure can produce stunning results, bruising and swelling may occur as side effects; to minimise these adverse reactions it is crucial that post-operative care recommendations are adhered to.
Bruising occurs due to damage to small blood vessels near the surface of the skin. When disturbed, these blood vessels break, leading to bleeding that builds up over time and results in dark-colored bruises. Furthermore, damaged endothelium releases chemicals which narrow blood vessels further and help minimize bleeding by blocking capillaries and forming clots which will then dissolve over time and restore normal tissue functioning.
Large bruises may cause significant pain, as well as becoming life-threatening. Their color often shifts from red or purple to yellow as hemoglobin is broken down by white blood cells and released through lymphatic systems into extracellular spaces and eventually cleared away by your body.
Larger bruising after nasal surgery often arises when surgeons make adjustments to bone or cartilage structures, disrupting blood supply to these structures and leading to additional bruising that extends down both sides of the face and neck. While this bruising may take time to subside as your nose heals, eventually it should diminish over time.
Preventing post-rhinoplasty bruising requires taking some preventative steps, including avoiding medications that decrease your body’s ability to clot such as aspirin; ibuprofen (Advil, Motrin IB and other versions); naproxen sodium (Aleve); warfarin (Jantoven); dabigatran (Pradaxa); rivaroxaban (Xarelto) or apixaban (Eliquis); applying cold compresses several times per day will speed up recovery while lessening severity.
Discomfort
Nose surgery provides ample blood supply, making infection rare following recovery. If you notice signs of infection such as fever, unusually unpleasant-smelling nasal discharge or excessive swelling please call our office or 911 immediately as sinus infections differ significantly from normal sinus congestion and require prompt evaluation in order to avoid potential complications such as septal perforations.
Anesthesia for rhinoplasty surgery typically comprises both intravenous sedation and general anesthesia. Patients will be under the care of an anesthesiologist who monitors vital signs, heart rate and oxygen levels during the entire procedure; while general anesthesia puts patients into an unconscious state where they will remain unaware of their surroundings.
An anesthesiologist will place a trachea tube in your throat to monitor breathing throughout surgery, while also administering anesthetics as needed. If you suffer from gastroesophageal reflux disease (GERD), which makes swallowing difficult, special care may need to be taken during anesthetic administration.
As part of the surgery process, you will experience pressure on your nose and an increase in facial fullness. Once the anesthesia wears off, however, you may experience dryness, crusting or soreness; resting as much as possible and avoiding strenuous activity is strongly advised during recovery; expect some bloody nasal drainage for several weeks post procedure as well as our office’s instructions on how to safely and quickly remove nasal packing without further bleeding and bruising.
Nasal Irrigation
The nasal cavity contains hundreds of small spaces called sinuses that drain mucus into them, known as sinusitis. If these become infected, symptoms include facial pain, pressure headaches, green or yellow nasal discharge and fatigue – usually the result of deviated septum or allergies which can often be treated through rest, hydration and Vitamin C supplements; if symptoms continue or worsen seek medical advice immediately.
Nasal irrigation with saline solution is an affordable, home treatment that can help clear your sinuses of dust and pollen while loosening thick mucus, relieving allergy symptoms, colds, or sinus infections. Saline rinses can be purchased at pharmacies, health food stores or online. A neti pot can be used to administer the saline solution but other delivery devices like squeeze bottles or bulb syringes are also suitable. When using an irrigation device be sure it is clean and completely dry prior to each use – rinse after each use with distilled or sterilized or previously boiled and cooled water then leave open air-dry.
After sinus surgery, some patients may require medical therapies such as nasal sprays and steroids for continued or recurring sinus issues due to poor wound healing, scarring or other medical conditions that require additional surgeries to achieve maximum results. These could require additional surgeries in order to achieve the best outcomes.
