DR WILLIAM PORTUESE | 1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
Dr William Portuese - Board Certified Facial Plastic Surgeon in Seattle WA

Complete Guide to Nose Surgery©


Many years ago it was popular to place packing in the nose. This was very painful and unnecessary and is no longer done.


  • Pain associated with a Rhinoplasty is usually very mild and is more associated with a burning sensation or headache.
  • Bruising: Bruising usually occurs in the cheeks and lasts approximately 7 to 14 days after the surgery.
  • Swelling: Patients can expect swelling of the nose to last for approximately one year after the surgery. Surrounding tissues swell at their maximum 48 hours after the surgery and subside rapidly thereafter. The majority of the swelling is gone at approximately the first month after the surgery, but there is still 20-30% swelling that takes a full year to go away. Revision nasal surgery and complicated tip surgery require further prolonged healing in the tip because lymphatics and fluid retention tend to prolong the healing phase.
  • Most patients are congested after their nasal surgery for approximately one week and the congestion does seem to be worse if sinus surgery or a septoplasty and/or turbinate surgery have been performed.


  • Bleeding: Excessive postoperative bleeding can occur after a rhinoplasty and the chance of that happening is approximately 1 in 1000. At that point, packing has to be placed inside the nose to stop any bleeding. This is the only time that packing may be placed inside the nose.
  • Irregularities under the skin are probably the most common occurrence after surgery. The nasal bridge may develop a little callous formation or calcium deposit that requires a rasping or filing down of the nasal bridge to get rid of the offending bump. These are usually minor and are done at no charge in the Seattle Rhinoplasty Center. This happens in approximately 10% of patients.
  • Asymmetry: This is a result of postoperative scarring in the nose underneath the skin that can shift, move or migrate the nasal bones and cartilages in a 3-dimensional format.
  • Infection is extremely rare after a rhinoplasty.


One week after the nasal surgery, patients return to the Seattle Rhinoplasty Center. At this appointment, the cast will be removed, the internal portion of the nose will be suctioned clean and Dr. Portuese will examine to make sure that all of the tissues on the external and internal portions of the nose are healing quite well. The splint is removed from the bridge of the nose and this allows the patient to visualize their nose for the first time. Usually the bridge is compressed from the cast, which tends to slightly widen when the swelling comes down. The tip is quite swollen and it tends to subside over time so that the nose becomes more in balance as the healing process progresses. Once the cast and the splint are removed, patients have a chance to observe the shape of their new nose but this is only the start of the new healing process.


The Rhinoplasty surgery is a very rewarding experience for Dr. Portuese to perform. He enjoys seeing patients feel more confident about their new look.


Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self