On Thursday, July 2nd, 2015 I went in for major nasal surgery. I had been waiting for this surgery for over 9 years.
When I was about 11, I complained of constant congestion. The doctor first thought it was allergies, but then a regular trip to the dentist turned into discovering that I had a pretty major deviated septum. (The septum is the bone/cartilage that divides the nasal cavities. It’s basically the line in the middle! When this is “deviated” it means that it’s crooked or misaligned, which can make it difficult for air to properly flow through the nose.)
Over the next couple of years we met with a few doctors who all said the same thing: a deviated septum can’t really be corrected with surgery until the nose has stopped growing, at about 16-20 years old. I was given nasal sprays to help reduce swelling in the nasal cavities, but other than that I was pretty much out of luck for a few years. At 16, we were told that surgery wasn’t recommended until I turned about 18 years old. By the time I was 16, the structure of my nose had changed considerably since I was a child. From about 9 years old to 16, my nose became significantly larger, and more crooked. While part of the size was due to genetics, you could visibly tell that the nose was crooked/looked abnormal.
My nose before: apart from the extremely large size from the side angle, you can visibly see how crooked it was. As well as the breathing difficulty and constant state of nasal congestion (seriously. It was like having a cold all the time!) there were also quite a few other negative effects.
Mouth-breathing- because I was unable to breathe through my nose, especially while sleeping, I had to breathe through my mouth. Mouth-breathing can lead to dry mouth, weakened teeth, throat problems, and bacteria. I went from never having a cavity in my life, to having 9 potential weak spots – all from mouth breathing. Sleeping Issues- The doctors believe I have developed a mild form of sleep apnea, as my oxygen levels drop low, and I basically stop breathing multiple times an hour during the night. This has resulted in a state of constant fatigue. I don’t remember the last time I got a really good, deep sleep. Difficulty Exercising- have you tried running or working out while you have a bad cold? Yeah, not fun! Further, I needed dental work (braces, and wisdom teeth extraction) which unfortunately could not be done until my breathing was corrected.
Emotionally, it took quite a toll on me. It quickly became my biggest insecurity. Kids at school made comments about it, saying that I had a “bird nose” (and while I luckily didn’t experience a ton of bullying, mean comments still hurt, and you never forget them.) I became obsessively insecure with it. When talking to someone, I was convinced that all they could see was my nose. Realistically, I know that wasn’t the case. But I couldn’t shake this insecurity, no matter how hard I tried. It wasn’t just that it was large, but also that it was so crooked. It was sharp, angular, and crooked. I hated taking pictures, especially from the side angle. I was so insecure, all the time.
I had a septorhinoplasty (correcting the deviated septum as well as the structure and shape. This was strongly recommended by my doctor as the structure had been altered and grown abnormally due to my nose being broken – which I was more than happy to comply. I also had a polypectomy, in which they remove polyps (growths that can form in the nasal passages and sinuses, which cause swelling and obstruct the airways.) On top of that, I had my sinuses cleared (they were swollen and full of some pretty gross stuff due to years of bad allergies!) This surgery is not pretty. If you’re really curious, you can see videos on youtube (they are very graphic! If you’re getting this surgery and are easily scared/squeamish, I HIGHLY suggest not watching them before surgery!)
Before surgery: This was my first experience with surgery, and I was pretty freaked out. When I arrived at the hospital, I had to change into a hospital gown, and get prepped for surgery. I was walked down to the operating room where I laid on a hospital bed. The nurse set up the IV (which was surprisingly not as horrible as I expected!) Then the anesthesiologist came over, and asked me some questions. He and the nurse wheeled me into the operating room, where I briefly spoke with my ENT (who is also one of the surgeons performing my surgery.) I then moved to the operating table/bed, and the last thing I remember is looking up at my surgeon and saying “please make my nose cute!”
I don’t even remember falling asleep. One minute I was looking up at the surgeon, and then I woke up in recovery! The day of surgery was probably the worst. I was so out of it and so groggy from the anesthesia. Overall, I was in surgery and recovery for about 7 hours. They kept me for observation for about an hour or so (which I barely remember because I was so groggy and out of it!) With a surgery like this, you need to have someone that can drive you home. My mum stayed the entire time, and drove us home. I pretty much slept for the entire day, waking up mainly to take painkillers and change the dressing.
The pain: it wasn’t excruciating, more of an intense ache and major soreness. The first day, I couldn’t eat anything because my nose/mouth area were so sore. (I highly suggest things like pudding, or foods that don’t require any chewing. I was on painkillers for the first week (initially prescribed Tylenol 3 which I hated as they cause digestive issues and didn’t seem to be effective) so after consulting my doctor I switch to Torodol which was much better.
The swelling/bruising: this is often what people are the most curious about. I had very minor bruising luckily, but this will totally depend on your body and how it heals. You can see the slight bruising on my eyelids and below my eyes, but it cleared up within a few days! The swelling, however, took about 1 month before it started to look normal. As you can see in the photos, my entire face felt swollen, especially the nose area, cheeks, and sinus area.
What to expect the first week post-op:
The first day, you will be most likely be out of it. Sleeping is best, in an elevated position. I slept on a reclining chair with a neck pillow to support my head and neck, and keep it upright. My nose area was very sore and uncomfortable, and accompanied by a headache. I had a splint/cast on my nose, and gauze pads taped beneath to catch any dripping. The first 2 days, the gauze pads needed to be changed every few hours as a lot of blood and other nasal nastiness drains. (This part is pretty nasty, I won’t lie.) You can see some dried blood around the base of the nose, which is where the incision was made. The day after, the internal packing had to be removed. This part was probably the worst. Imagine an extra wide tampon being pulled from a very thin naval cavity that has just been operated on. Yeah, not pleasant.
Over the next few days, the pain and headaches started to subside. I still felt very weak and fatigued. It’s recommended to continue sleeping elevated for at least 2 weeks to help drain and reduce swelling.
After 1 week, the cast/splint was removed along with the sutures (stitches). This did hurt a bit as the nose area was still so sore. Immediately after splint removal, I could finally see my nose! It was extremely swollen (I felt a bit like an elephant) but was straight!
The next couple of weeks:
The pain was mostly gone, except for some headaches and major congestion. At about 1 & 1/2 – 2 weeks after surgery, you can begin doing nose rinses to help clear out the nose. I also had a saline spray and an ointment to be used a couple of times a day. I mostly tried to take it easy, rest, and eagerly wait for the swelling to go down! Unfortunately after about 3 &1/2 weeks, I started to smell this really bad smell in my nose (this can be very common after surgery, but can also be a sign of an infection.) I also started feeling dizzy and weak, and after a check up found out I had developed a bad sinus infection. This can happen sometimes when the dissolvable packing doesn’t dissolve right away, and starts collecting bacteria. I was prescribed antibiotics and a more intense cleansing nasal spray, and the sinus infection cleared up within 2 weeks.
Also, your nose will be very oily. Because the cast/splint was blocking the pores for about a week, once removed all the oils and gunk that builds up in your pores starts to come to the surface. This results in an abundance of stubborn blackheads, and a very oily nose area. Also, because the skin had stretched and begins to shrink as the swelling goes down, you may notice that the texture of your skin on your nose area is scaly, peeling, and perhaps even flaky. After about 2 weeks (if you’re gentle and careful) you can use mud masks/pore masks to help clear out the pores, as well as very gently exfoliating to help remove dead skin.
1 Month After and Beyond:
The nose area will remain sore/tender for the next few months, and even up to a year. Most of the extreme swelling will subside within 2-3 months. It won’t really be visible to other people, but you and your doctor will still notice swelling. It’s customary for doctors to not take a post-op picture until 6 months, because that’s usually how long it takes for most of the visible swelling to go down, and to get a true idea of how the nose will look. My doctor recommended that I continue to use nasal rinses everyday, as there was still a lot of buildup inside that needed to come out. Because my nose has taken longer to heal, this has also resulted in the swelling taking longer to heal.
You will also notice that your nose changes a little every week. Some days it might seem less swollen, other days it might seem more so. There’s a small bump on the right side near the bridge of my nose that has appeared, disappeared, and then appeared again. My doctor assured me that this is just the nose shifting, settling, and the swelling going down. Try not to stress over anything like this, you truly do need to wait at least 6 months to know what your nose is really going to look like.
Overall, the surgery process was definitely not fun. However, it’s not as bad as other major surgeries. The first week is the worst, but keep in mind that your recovery process completely depends on the surgery you’re getting. I had very major nasal surgery, which is why my recovery took so long. A septo-rhinoplasty is much more common, and requires much less recovery time.
Despite the not-so fun parts, I absolutely do not regret getting this surgery. Firstly, because it was necessary and I’ve needed it for so long, but also because it truly was life-changing. Depending on your circumstance, you may not require external correction. However, if you’re like me and your nose didn’t grow properly and affected your self-esteem so deeply, it will honestly feel like a weight has been lifted from your shoulders.
I can’t describe how amazing it feels to no longer have to worry about what used to be my biggest insecurity. Now I just have to patiently wait for it to heal to tell if I’ll be able to breathe properly! I’ll be updating this post with pictures over the next few months!