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Stephanie - Septo Rhinoplasty at LBPS

Stephanie walks us through her Rhinoplasty or ‘Nose Job’ diary at London Bridge Plastic Surgery. You can find out more about Rhinoplasty here.

Day one

I didn’t get much sleep for the week leading to my op as I had a niggling cough and sore throat but arriving at the clinic I felt pretty awake though probably through nerves!

Whilst waiting I had a reassuring chat with my nurse and with Christopher Inglefield and soon enough was taken to theatre. The nurses made me feel calm and I was quite surprised how much I didn’t freak out until the minute my arms and legs went heavy and my eyesight went double as I went under the anaesthetic! I woke up in recovery as if I were at home in my bed dreaming I’d had the operation! I felt my face and realised it was all over with no pain at all – my gums were numb, lips and the whole of my nose.

I began breathing pure oxygen to calm me down as I started my usual panic attack symptoms. I must have gone into panic about 3 times, each lasting about 5 minutes and at one point cried suddenly, but the nurses were very kind and supportive which calmed me down, and by breathing slowly and deeply! I’m used to having these attacks and I was fine.

Trying to eat soup and yogurt was hard as the anaesthetic was giving me strange waves of sensation as it wore off through my body and my stomach felt weak. Amazingly my sore throat was gone, even though i was warned it might hurt ten times more because of the tube that gets inserted during surgery! My cough was gone too, maybe due to finally getting a deep sleep and lots of antibiotics.

My mum and friend spent most of the time with me in recovery with the nurses which meant I started chatting with everyone and exhausted myself a bit, getting short of breath and dizzy. Back home I also had a couple of visitors during which I laughed a bit too hard and ever since then suffered horrible pressure pain under the splint on my nose!! Definitely need to keep quiet and rest more!

I’m going to try and sleep as upright as possible tonight. The pressure pain hasn’t completely eased despite painkillers. I have had to change my gauze at least five times because of heavy oozing of blood and fluid which isn’t painful but is quite a sight! Brushed my teeth with a bowl held to my face so I didn’t have to bend down! Swelling has developed around my tear ducts and under my eyes which makes my vision quite blurred when turning my eyes but no dark bruises yet!

Day two

I slept on and off last night as I kept using a water spray to moisten my throat. The swelling around my eyes has really come up now and the pressure under the splint is a lot more painful. After calling my nurse I began taking more painkillers and using ice packs around my face to reduce swelling. It worked gradually but I was spacy for the whole day, very dizzy and not keen to move out of bed. Luckily my mum was making sure I had all I needed and changed my gauze for me about four times. The draining from my nose has finally slowed down to almost nothing and feels a lot more comfortable.

My appetite has been very low which has added to my dizziness. I am eating only a small amount because of nausea as well so I still feel quite weak and have a lot of aching around my eyes. Definitely my worst day of the healing process so far now that all the local anaesthetic has worn off from yesterday.

Day three

I stayed awake again nearly all night, just dozing off when I felt comfortable enough. The swelling in my sinus seems to have become heavier and I can feel a lot of pressure in my ears and all the way down my neck. I have been massaging it non-stop to try and help drain some of the swelling and ease the pressure. Painkillers worked for any twinges in my nose but the pressure was overwhelming me. I felt dizzy even to tilt my head slightly, so I needed constant support to stand or walk anywhere. I rang the nurse and she suggested that I take piriteze or benetol for the anti-histamine in it, to reduce pressure on my sinus. After taking this I transformed! Within a few hours I was able to walk and do a few tasks by myself without feeling too dizzy.

I found that the only food that keeps my stomach settled is porridge in the morning with honey and soft mashed potato and fish or chicken for dinner. Chewing anything too hard hurts my nose because of tensing my facial muscles and anything too flavoured or textured gets stuck in my throat because it is so dry from my constant mouth breathing.

Had a bath for the first time (since the operation of course!) I needed help from my mum to keep my balance, but it made me feel much more human to have washed and feel fresher!

Day four

I managed to sleep on and off all day today, maybe it was the pain killers making me drowsy or I’m catching up on rest from not sleeping the first few days. I got out of bed around 5pm and watched some TV. I made steamed veg, chicken breast, onions and mushrooms which I cut into bite-size pieces with mashed potato and drank lots of water as my throat was so dry from sleeping all day.

I don’t need to change my gauze as much now. I just did it once today and it wasn’t totally soaked, just old and dried up. I find that I need more painkillers every 4-6 hours. The arnica cream I have been using on my bruises has really helped to reduce the blue colour. The swelling is still quite bad inside my eye socket nearest to the bridge of my nose and under my eyes and it hurts if I squint my eyes or have a bright light on like watching TV. I took another piriteze to help reduce pressure pain which is working 🙂

I’m able to have baths by myself now as I’m not so dizzy – I only wash my chin and forehead with a tiny bit of face wash and I can use the sink to brush my teeth now as the gauze under my nose isn’t as thick to catch the blood and I’m not so dizzy so I can bend slightly.

Day five and six

I spent both of these days in bed all day, only getting up for painkillers or food 🙂 the painkillers kept me sleepy all day which was good.

I started getting itchy nostrils so I started flaring them a little to shake whatever it was! Just itchiness from the bandages being on my skin and the dried blood.

My bruises have turned bright yellow! They hurt more to the touch now but the swelling has reduced under my eyes a lot. It’s still quite bad between my eyes though. The stuff draining from my nostrils has turned clear -must be a good sign! I had a nightmare last night though which made me knock my splint on the pillow and woke myself up. I also hit the tip of my nose on the window glass when looking out the window at the snow! I guess I still can’t gauge small distances with all these bandages on!

Mum has given me nutrition drinks – the powder stuff you mix with milk or water. It’s pretty good when my throat is so dry as food tends to stick in a ball somewhere down in my throat and that hurts to shift!

Day seven

Today I got up about 11 and watched the snow falling for ages, then daytime TV for the rest of the day! I haven’t needed so many painkillers so I’m not as drowsy. I have gone back to bed now though – it’s about 7pm and my eyes are a bit achy from the TV and probably the bruising so I feel like dozing.

I had a bit of a stomach ache this morning. I think I gulped air when trying to drink water so much in the night. My mouth gets so much drier at night time when I’m asleep. I wake up and try to swallow what feels like a razor blade deep down the sides of my throat, some awakenings are worse than others though!

Day eight

I had my cast and packs taken away today!! I didn’t get to shower in the morning to soften the splint, big mistake! It took a while to soak off while I was lying holding a towel around my neck at the clinic! Pulling it off was very uncomfortable too because I felt like my nose was going to come off with it! It was so tender!

Pulling the packs out really did shock me. The nurse warned me beforehand that it feel like you are giving birth out of your nose! I don’t have kids but that’s not what I wanted to hear – that is meant to be the worst pain in the world so this must be second to worst! Each one was pulled out in just a couple of seconds but the sensation! OH MY GOD I screamed for the first one! It was like the pain of shampoo or a strong force of water hitting the back of your nose, but rushing out instead and it lingers just like the way the pain from shampoo up your nose does! For the second one I had psyched myself up knowing what to expect.

Then the nurse cleaned my nostrils a bit, there was no blood, just some pinkish fluid draining away, while Mr Inglefield prepared a new splint for me which I have to wear every night and day apart from at work for the next 6 weeks. When he pressed the soft plastic onto my nose to mould the shape, the pressure pain was intense – I squirmed a bit on the bed, really hoping it was all set and done but it took a few minutes to set. I didn’t enjoy that feeling much!

I felt a little anxious about looking in the mirror for the first time at my new nose and it did feel quite alien at first!! It was so small and much flatter, wider and smoother at the bridge and the tip shape was totally evened out – I did not recognise any part of it!! I cried a little bit and the swelling still makes me look like an avatar but I’m really starting to get used to my new nose and new shape!

Mr Inglefield informed me that my voice could change a bit now that my airway is open more and it’s funny how friends and family are noticing my slightly different pitch and just how different I look!

I can do anything around the house now. I don’t feel dizzy when I bend down and I can touch my nose gently without pain, but the skin is very tight, even if I lift my eyebrows. When I talk, I can feel the skin tighten at the tip of my nose! So I think the appearance of my nose still has a long way to go. My nose has become more clogged as time has gone on, probably draining fluids which keep drying inside my nose, but the nurse advised me to leave it completely alone for another week. No hard sniffing, blowing my nose or sticking anything up there!! I’m still mouth breathing mainly, so I haven’t fully enjoyed my new wide open airways! I know it’s better though – I tried breathing gently when the packs were first taken out and I felt a very cold sensation in both nostrils at the back of my nose. Air is definitely travelling up there much more easily but it was still quite sniffly even then… I can’t wait to clean it out!

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Mr. Christopher Inglefield

Mr. Christopher Inglefield BSc, MBBS, FRCS(Plast) was born in Trinidad, West Indies, and obtained his Medical Degree from the University of the West Indies in Jamaica and Trinidad in 1985.

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