Rhinoplasty and Cosmetic Surgery

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436 North Bedford Drive Suite 201
Beverly Hills, CA 90210

Pre-operative Functional Nasal Surgery

  • Follow the general preoperative instruction sheet.
  • Gentlemen are requested to trim the nasal hairs five days prior to the procedure.
  • We have provided mupirocin (generic Bactroban®) antibiotic ointment. This is to be used only inside the nostrils. Squeeze approximately 1/2 inch of the ointment onto the cotton head of a Q-tip applicator. Transport all the ointment into the nostril until the point where the cotton tip has nearly disappeared within the nose. The aim is to deposit the ointment into the hair-bearing, first 1/2 inch of the nasal cavity. Rotate the cotton-tipped head 360 degrees to contact the lining skin and then remove the applicator tip. Then both nostrils should be closed by pinching together the sidewalls of the nostrils. Then release and repetitively close and release the nostrils for one minute. Use a massage-type motion when closed. The aim is to spread the ointment about the internal nostril lining.
  • These antibiotic ointment applications should be done twice daily, morning and evening, for five days prior to the surgery date.


Post-operative Office Visit

  • We will see you in the office 4-6 days after surgery to remove the KOTLER NASAL AIRWAY™ and small antibiotic-laden tampons, which have been placed within your nose. The right and left internal tampon are connected by a single strand of colored string sitting outside the nostrils. This stitch is not attached to the nose; rather, it merely connects the two nasal packs to prevent them him slipping further into the nose. When you come into the office, we will dribble liquid anesthetic inside your nose to shrink the lining and anesthetize it; airway and pack slide out easily.
  • The outside, plastic protective splint will also be removed 4-6 days post-operatively.


Care After Nasal Pack and Airway Removal

After your airway and nasal packs are out, we wish to accelerate healing. To reduce swelling inside the nose and therefore improve your breathing, use the nasal decongestant (generic Afrin) for five days after the packs are removed. Here are instructions for its use:

  • Into each nostril, deliver five sprays, sniffing in while spray delivered; wait five minutes; repeat the five sprays.
  • This medication lasts approximately 8-12 hours; therefore, you can plan on “re-spraying” every 8-12 hours for the next five days. Therefore, the rule is: “Five sprays, wait five minutes, five sprays again, for five days.”

We have also included samples of a nasal saline (salt water) product, which can be used as often as necessary to moisturize the nose and make it feel more comfortable. After surgery, the nose tends to be more dry than usual and, therefore, humidification is an important part of the postoperative care. Dryness is the enemy of internal nasal healing. Shower steaming is a great way to loosen thick mucus.


  • Most significant swelling is gone by 10 days. The nose “looks better and better” as time goes on.
  • For five weeks after surgery, avoid glasses resting on the bridge of your nose. We will teach you how to suspend glasses from your forehead.
  • Contact lenses can be worn 1-2 days after surgery.
  • Some bruising is expected, but is usually gone by 7-10 days. This is easily concealed with makeup.
  • Avoid exposing the unprotected nose to the sun for six weeks. Use zinc oxide, Nose Kote or sunscreen.
  • Hair can be washed at any time, but try to keep the plastic shield dry. . Fresh papaya and pineapple have great healing powers! They are both delicious to eat and will assist in diminishing your bruising.

Some Things to Remember

  • Frozen peas, corn or crushed ice in sturdy Ziploc bags are great to reduce swelling and bruising; one pair can be kept in the freezer while the other is in use. This should be done for the first 24 hours.
  • Do not blow your nose for 10 days after surgery. If you have to sneeze, please do so with your mouth open.
  • While the nasal packing and KOTLER NASAL AIRWAY™ are in place, you can clean the crusts and remove the mucus around the Airway with Q-tips soaked in peroxide. Then dry and apply the mupirocin antibiotic ointment to keep the rims of the nostril soft and to keep crusts from reforming.
  • No strenuous exercise for 10 days after surgery, e.g., running, aerobics, lifting. Sorry, but no sex for the same 10 days. Walking is perfect. You can expect a blood-tinged drainage from the nose for several days; it is normal. Likewise, the nose will be “stuffy” for the first two weeks after surgery.
  • Narcotic pain meds pre-dispose to constipation. So, less is better. Lots of fruit, lots of liquids and walking ( perfect exercise any time) will help prevent it.

Contact the office, 8-5, M-F (310-278-8721) if you have:

  • Excessive pain, not controlled by the pain pills.
  • Temperature over 100 degrees orally.
  • Any injury to the nose.
  • Excessive bleeding, e.g., a small gauze pad soaked completely in five minutes or less, or you are coughing up bright red blood continuously.