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Post-Operative Instructions

Please review these instructions carefully to ensure a smooth and comfortable recovery. If you have any questions before or after your procedure, please contact our office.

Post-Operative Nasal Surgery Information

What to Expect After Surgery

  • Nasal Tubes & Packing: Small, soft plastic tubes will be sutured inside your nostrils to allow you to breathe and to facilitate drainage. Small cushioning tampons are placed beside them. There is no other removable packing; any deeper materials are absorbable.

  • Tube Care: Breathe through your nose and do not blow it. If the tubes become blocked, gently clean the openings just inside your nostrils using a Q-tip dipped in hydrogen peroxide, then gently sniff to clear them.
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  • Tube Removal: The tubes and tampons will be removed in our office 3-4 days after surgery. This process causes little discomfort. You may take a pain pill before this appointment if you feel anxious.

  • Bleeding & Drainage: Mild bleeding and drainage are normal for the first 24-72 hours. You will have a gauze drip pad under your nose to collect drainage. Change it as needed. For light bleeding, you may place a cotton ball soaked in Afrin in each nostril behind the gauze pad and remove both in the morning.

  • Swelling: If you underwent Rhinoplasty and have a cast, applying ice compresses over the eyes or nose can help reduce swelling and bleeding.

Recovery Guidelines

  • Elevation: Keep your head elevated at a 45-60 degree angle during the day. Sleep in a recliner at a 30-degree angle until your first office visit to reduce swelling and drainage.
  • Sneezing & Blowing: If you must sneeze, do so with your mouth OPEN. Do not suppress the sneeze. Do not forcefully blow your nose until after your second office visit (usually 10 days post-surgery).
  • Activity: Avoid bending, lifting anything over 10 pounds or strenuous exercise for 10-14 days. Do not fly for the first 14 days.
  • Moisture: Use a cool-air vaporizer or humidifier constantly. Use over-the-counter saline spray (like Ocean Spray) frequently during the day to keep tubes clear. Continue using saline hourly while awake for the first few weeks after tube removal if you are not near a vaporizer.
  • Diet: Stick to a liquid or soft diet for the first 8-12 hours or until anesthesia effects wear off. You may then resume a normal diet. Drink plenty of fluids in small frequent sips to help prevent nausea
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  • Throat Discomfort: You may experience throat burning or pain from surgery secretions or the breathing tube. Cool liquids on the first day and warm saltwater gargles starting the second day can help.
  • Nasal Flushing: Begin nasal flushing after your first post-operative visit using a baby bulb syringe and a saltwater mix (1 teaspoon salt per 8 ounces of warm water) or a NeilMed system. Repeat 3-5 times daily for the first two weeks or gently sniff warm water from your cupped hands.

Medications & Safety

  • Pain Management: Take prescribed pain medication as directed. While it won't eliminate all pain, expect discomfort similar to a severe sinus infection. Most patients only need regular pain medication for the first 3-4 days.

  • Medication Restrictions: DO NOT take aspirin, ibuprofen, NSAIDs or Vitamin E for 1 week before and 2 weeks after surgery, as these increase bleeding risk.

  • Anesthesia Effects: It takes 8-24 hours for anesthesia to fully wear off. Nausea is common; you will receive a prescription for Phenergan suppositories if needed. Do not drive, operate machinery or consume alcohol for 24 hours after surgery or while taking prescription pain medication.
Medications photo

Items to Have on Hand:

  • Baby bulb syringe
  • Afrin nasal spray
  • Nasal saline solution (Ocean Mist, Ayr or a generic brand)

Post-Operative Sleep Apnea Surgery (UPPP) Information

Recovery from Uvulo-palato-pharyngoplasty (UPPP) often involves tonsil removal and can be uncomfortable. To ensure your safety, hydration and oxygenation, this procedure may require an overnight hospital stay. This determination is made by the anesthesia department on the day of surgery.

If You Require a Hospital Stay:

  • You will be observed in an Intermediate Medical Care Unit.

  • You will receive continuous face shield humidification to keep your nose and throat moist.

  • A Pulmonary Medicine specialist will monitor your overall medical status and determine if a temporary CPAP is necessary (needed in less than 5% of cases).

  • You may use the bathroom with assistance and shower if desired.

  • Constant liquid intake is critical. No citrus or carbonated drinks for 10-days.

Discharge & Recovery at Home

  • You will be discharged the morning after surgery (approximately a 23-hour stay). You must have someone drive you home.

  • Hydration is Critical: You must constantly drink liquids while awake for the first 10 days. Water, iced tea, popsicles and Gatorade are best for the first 24 hours. After that, dairy products, ice cream, soups and soft foods are acceptable. Avoid citrus and carbonated beverages. (Dr. Gadlage highly recommends egg drop soup).

  • Medications: Take antibiotics, pain medication and nausea medication as prescribed. Pain medication is intended to take the "edge" off so you can comfortably drink fluids. You may resume your regular medications the day after surgery, provided they are not blood thinners, aspirin, NSAIDs or Vitamins C/E. (This will be clarified during your pre-op visit).

  • Elevation & Moisture: Keep your head elevated at least 60 degrees while sitting. Live by your vaporizer; constant moisture is essential.

  • Blood Clot Prevention: Wear the TED hose (anti-embolic stockings) provided before surgery at all times (except when bathing) for the first two weeks to help prevent blood clots while your activity is restricted.

Follow-Up Care

  • Your first office visit will be 3-4 days after surgery for evaluation and potential nasal tube removal.

  • Subsequent visits will occur every 1-2 weeks. If your fluid intake is inadequate, we may administer intravenous fluids.

  • At your six-week follow-up, you will participate in our "Sleep Apnea Survey" to track your progress and weight changes (most patients lose 12-15 pounds in the first two weeks).

Long-Term Outlook

Dr. Gadlage has personally undergone this procedure and understands the recovery is challenging. However, our survey of over 1,000 patients shows that 88% have no daytime sleepiness or witnessed apnea spells at six weeks and one-year post-surgery, and 85% experience no snoring. If symptoms persist at six weeks (which occurs in about 12% of patients), we may suggest a repeat sleep study. For those who cannot tolerate a CPAP or lifetime weight control, the long-term improvement in quality of life makes the initial recovery period worthwhile.

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Contact Information & Emergencies

  • During Office Hours: For questions call 770-495-1955 and speak with one of our Medical Assistants. For prescription refills contact your pharmacy directly. They will send us a refill request electronically, which is the fastest way to process.
  • After-Hours Emergencies: For issues like excessive bleeding, call our office number. The answering service will direct you to the nearest emergency room and notify the on-call doctor. The Northside Duluth ER is the safest place for urgent evaluation and treatment as that is where your surgery was performed.
  • Life-Threatening Emergencies: Call 911 immediately, then notify our office so we can monitor your care.
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