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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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How to Keep Swelling Down After a Rhinoplasty

In every operation, no matter how small, there’s always swelling of the surrounding area of the surgical site. The amount of swelling will vary from person to person. It could be greater if both the inside and outside of the nose have been operated on, or in patients who have undergone surgery to improve the breathing function of their nose. Here’s how to keep the swelling down after a rhinoplasty.

  1. Keep your head elevated or upright as much as possible after surgery. Sleep with the head elevated for at least two weeks following surgery.
  2. When resting, put a cold compress over the nose and mid-facial areas. Cold compresses are only effective for swelling during the first 48 hours after surgery. After that, a cold compress can be used to relieve discomfort. Make sure when you are doing this that the compress is not wet.
  3. Avoid bending over or lifting heavy things for two weeks. Bending over can aggravate the swelling as well as raise blood pressure and increase the chance of hemorrhage.
  4. Avoid hitting or bumping the nose.
  5. Avoid getting excess sun exposure on the face for four months; this will reduce the risk of hyper-pigmentation. Ordinary exposure is fine as it’s not harmful as long as you use a sunscreen with SPF 30. During the summer, sunscreen should be reapplied to the nose every two hours to avoid burning.
  6. When drying your hair, use only a hand-held blow dryer. Sitting under an overhead dryer commonly used at hair salons should be avoided for at least two weeks.
  7. Don’t get the nasal dressings wet. If the tape does become wet, just pat it dry. Normally it won’t come off. If the bandage becomes loose, notify your doctor.
  8. This one’s tough, but try to avoid sniffing for the first week following surgery. Sniffing will not relieve the sensation of blockage most people feel. It will, however, aggravate this sensation, because suction created on the inside will cause more swelling.
  9. Patients should not blow their nose for two weeks after surgery or until instructed by the doctor to do so. The reason is this could cause bleeding. During the second week, patients may begin sniffing through the nose in the shower. Use a saline nasal spray, to help clear the nostrils.
  10. Avoid rubbing the nostrils or the base of the nose with tissues or a handkerchief. Not only will this aggravate the swelling, but it can cause infection, bleeding or dislodge the cartilage inside the nose. If discharge continues, a mustache dressing made of rolled gauze should be used instead.
  11. If there are dissolvable stitches at the base of the nose, clean them four times each day with hydrogen peroxide and apply Aquaphor over the stitches. The stitches on the inside of the nostrils must be kept moist with Aquaphor. Apply with a cotton-tipped swab after cleaning with hydrogen peroxide. This should help keep the stitches and crust soft and more comfortable.

October: Breast Cancer and Domestic Violence Awareness Month

This month marks two very special observances that seek to both protect and empower women

National Breast Cancer Awareness Month is celebrating 25 years of awareness, dedication and empowerment. Even many pro football players are wearing pink shoes, socks and towels to heighten awareness for this devastating disease.  Breast cancer affects women young and old. While Breast cancer isn’t something that I come across as a treating physician since I confine my practice to the face and neck, this subject still holds dear to my heart. I know excellent physicians who dedicate their skills to helping victims. 

I dedicate my expertise to another dreadful cause for human suffering that is also being recognized this month – Domestic Violence.  Every 9 seconds a woman is battered in the U.S. by her partner. Over 500,000 cases of domestic violence are reported each year; however experts say that the incidence may be as high as three times that number. This applies to teenage relationships as well.

We are doing our part by participating in the Face to Face program of the American Academy of Facial Plastic and Reconstructive Surgery. The organization offers complimentary consultations, surgery, counseling and support to shattered victims of domestic abuse who otherwise would not be able to afford reconstructive or facial plastic surgery. My office is taking action against domestic violence and offering pro-bono reconstructive surgery through Face to Face. Facial trauma is a visual reminder that can never be hidden. The brave lady below met with me last spring through the Face to Face program. She had reconstructive surgery of her nose and a deviated septum. Her new nose means so much more to her than just ‘a new nose’. She no longer sees her past while glancing into the mirror each morning. She now has a new career, a beautiful family, and a new reflection on life.

If you know someone who is being abused, you must get them help and out of the relationship. It’s been documented that abuse is most likely to escalate. If you know someone who has been or might be subject to domestic violence, have them call the Women in Distress 24 – Hour hot line at 954-761-1122 or visit

This is the month to protect and empower women who fall victim to two devastating conditions: Breast cancer and domestic violence. There are many ways that you can take a stand and spread awareness on both issues. You can walk a marathon, contribute to charities, or, like many teams on the NFL, show your support by wearing pink! Steven J. Pearlman, MD, FACS

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