Nose surgery: Swelling and wound healing

Every surgical intervention affects the naturally grown structure of the tissue in varying degrees. The fascinating thing about our body is that every kind of injury leads to targeted wound healing. 

We are all familiar with superficial skin injuries: Initially, a scab will form, which protects the wound from dirt and germs like a natural patch. Repair processes are now running under this scab, which will finally leave a more or less visible scar. The scab falls off. After several months, the scar discolors and pales. 

The phases of wound healing always remain the same - starting with visible phases and progressing to the invisible ones.

The main manifestations of the wound healing process are more or less severe swelling and stiffness, but also redness, excessive tissue growth, changes in sensitivity, tension, distortion and sometimes local inflammatory reactions. All these processes take place at a faster pace on the surface. The body attempts to restore the original condition as much as possible. The blood and lymph vessels, for example, have to regrow, and separated tissue has to grow together again. 

Nevertheless, the wound healing is always first completed after several months. The larger and more complex the wound, the longer it takes. By the end of wound healing, the tissue in the area of the scar is tighter and firmer since more connective tissue fibres have now been formed than originally existed. This can result in the occurrence of irregularities. In this respect, soft tissue, such as skin and connective tissue, react differently than cartilage and bones. It is therefore very important that a stable framework is created as part of the aesthetic nose surgery. This is the only method of preventing changes caused by wound healing to the greatest extent possible. 

Significant swelling after surgery is a frequent issue. This is something that cannot be prevented. Basically, swelling develops when the lymphatic vessels that discharge the fluid from the tissue are ruptured by surgical dissection. These have to be reconstituted first. This results in accumulation of tissue water. 

Moreover, the mechanical stress exerted on the tissue during the operation and the subsequent repair processes lead to increased blood circulation. Consequently, more blood and tissue water have to be transported via fewer outlets. 

Swelling of the nose may persist over a varying period of time. Reason for this is the thickness of the skin and soft tissue mantle as well as the severity of the surgical modifications. Therefore, the thicker the skin and soft tissue, the more fluid they can absorb. It is important to note that the more significant tissue damage has occurred, the more lymphatic channels will need to be reestablished.

It is considered that there are three different types of swelling phases. 

1. The first phase manifests itself immediately after the surgery. It is the most distinctive phase. A significant reduction usually occurs within almost two to three weeks, and the patient is then able to resume social life. 
2. The second phase lasts for several months and focuses mainly on the tip of the nose, as the skin is thicker in this area. 
3. During the third phase, only subtle changes occur due to the subcutaneous tissue. This phase is completed in one or two years after the healing of the wound has been accomplished. 

In addition to medicinal measures, the swelling can also be favorably influenced in a targeted manner by mechanical measures. Elevation of the upper body in the first few days after the operation and, if necessary, cooling of the nose will reduce the swelling more rapidly. We apply medication in a targeted manner where it is essential. 

There are many factors that can influence wound healing both positively and negatively. First of all, age plays an important role. The younger a person is, the faster the wounds heal. The recovery mechanisms still operate at full capacity. Pre-existing conditions, such as diabetes mellitus ("sugar") or kidney dysfunction, will slow down the wound healing process. 

This mainly includes nicotine consumption. Smoking impairs wound healing in many different ways due to the numerous toxins. It is recommended to stop smoking as much as possible after an aesthetic nose correction, at least, however, to refrain from smoking for several weeks. 

A healthy diet is crucial for rapid and effective wound healing. The body largely requires vitamins and trace elements such as vitamin C, zinc and selenium for the support of the reparative processes. A balanced, varied diet consisting of fruit, vegetables and pulses, among other things, provides us with these nutrients. Too much salt, sugar and phosphates, that can be found in particular in convenience foods and soft drinks, weaken our bodies. 

Exposure to intense sunlight or severe cold immediately after an operation also have a negative impact on wound healing. 

We recommend the use of nasal douches and nasal ointments/oils to ensure good mucous membrane care after nasal surgery. This reduces the number of germs in the nose and wound area and protects the mucous membrane. 

Medication can be used to reduce the formation/build-up of connective tissue. The skin in particular plays a decisive role in this process. The thicker it is, the greater the likelihood that a thick scar plate will form beneath the skin. 

We apply pharmacological therapy only in individual cases. We will therefore assist you in our practice for several months after the operation so that we can take appropriate measures in good time to ensure that the wound heals properly.