Dr. Melyssa Hancock, MD

Liquid rhinoplasty uses fillers that are not permanent, with results typically lasting about a year. It is limited in aesthetic changes, primarily adding volume to make the nose bigger or changing only one part/angle, rather than providing a comprehensive change to the entire nose shape or making it smaller.

Having fillers in your nose at the time of a surgical rhinoplasty consultation may prevent your surgeon from properly evaluating and counseling you.

To ensure safe sinonasal irrigation, use only distilled or sterile water (available at most grocery stores/pharmacies), or tap water boiled for 3-5 minutes and cooled to lukewarm (use within 24 hours). Clean irrigation devices like Neil Med bottles or Navage with the same type of water. Neil Med bottles should be replaced every 3 months. Dr. Hancock provides all her patients with clear instructions on proper sinus/nasal rinses.

The first two weeks after rhinoplasty are crucial. Clean the incision twice daily with hydrogen peroxide followed by an antibiotic ointment (Bacitracin, Bactroban, or Mupirocin are recommended; never use Neosporin). Avoid picking crusting, makeup, and direct/indirect sunlight. Weeks three and four: discontinue hydrogen peroxide and antibiotic ointment, apply Aquaphor or Vaseline, and continue sun protection. From week five onwards: continue Aquaphor/Vaseline and start a medical-grade topical scar treatment. Always use sunscreen. Itchiness or dryness from week five usually indicates healing. Consult your surgeon before starting any exfoliators or retinols like Accutane. Following these recommendations helps avoid scars.

To speed up healing after rhinoplasty, follow all post-operative instructions, which include specific medications, wound care, and activity restrictions. Avoid alcohol, tobacco, vaping, and unapproved medications/supplements. Eat a healthy diet rich in fruits, vegetables, and lean proteins, and avoid salty, spicy, and fatty foods which can worsen swelling.

After rhinoplasty, patients typically experience more discomfort than actual pain. Days two and three are usually the most uncomfortable. Internal splints are removed on day five, after which patients often feel significantly better, and recovery improves rapidly. While pain perception varies, Dr. Hancock notes that men sometimes report higher pain levels.

Existing nose piercings must be removed before rhinoplasty surgery due to increased infection risk, obstruction of the surgical field, and potential for skin burns from electrical current. After surgery, Dr. Hancock strongly advises against new nose piercings, recommending a wait of at least six months to a year. New piercings can disrupt structural grafts, negatively impacting long-term surgical outcomes. A fake piercing is suggested as a safer alternative.

After rhinoplasty, avoid all alcohol, as it causes water retention and worsens swelling. Also, avoid salty, carbohydrate-rich, or sugary foods to minimize swelling. Keep your head elevated and avoid laying flat. Refrain from exercise or any strenuous activity that increases heart rate or blood pressure, as this can cause increased bleeding or swelling, especially immediately after surgery. Do not push hard during bowel movements; a stool softener is recommended. Crucially, do not blow your nose for at least two weeks, as the pressure can compromise surgical results.

Dr. Hancock frequently uses ultrasonic rhinoplasty, which she considers 'next level' and a more predictable way to refine nasal bones using ultrasonic vibrations. While traditional chisels and mallets still serve a purpose in skilled hands, she prefers ultrasonic methods. It's important to note that ultrasonic rhinoplasty does not necessarily guarantee faster recovery or less swelling/bruising; these factors are more influenced by the surgeon's overall technique, patient health, and other variables.

If you have a nosebleed, sit or stand up, tilting your head slightly forward (never back, as swallowed blood can cause nausea). Pinch the soft, bottom part of your nose (not the bony top) and hold pressure for 20 minutes without peeking. Applying ice to your cheeks and forehead can also help. An additional trick is to use 2-3 sprays of Afrin in each nostril, then hold pressure. After the bleeding stops, avoid blowing your nose to prevent dislodging the clot. Seek emergency care if bleeding continues for over 30 minutes, or if you feel dizzy, sick, or experience foggy vision.

A tipplasty is a surgical procedure to change only the lower third of the nose, which consists of cartilage, soft tissue, and muscles. It may be suitable if you have a bulbous tip without any bumps on the bridge of your nose and desire more definition, or if your nostrils are asymmetric/flared and you seek improved symmetry or contour, or if your nose base is wider than the width between your eyes. However, changing just the tip can alter the overall appearance of the nose, as it's a complex structure. Suitability is determined on a case-by-case basis through consultation with a rhinoplasty surgeon.