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Does rhinoplasty hurt?
Most people expect a nose operation to be agony and it usually is not, which is a genuine finding rather than reassurance. In the small published series where pain was actually measured, patients reported moderate pain for around two days and used very few painkillers. The same series recorded scores near the top of the scale for somebody, so an average is worth reading carefully, and the discomfort most people describe afterwards is not pain at all.
The short answers
- Moderate pain, after rhinoplasty
- 1.9 days on averageDays at 40 or more on a 0 to 100 scale, standard deviation 1.9, in 22 patients at one American centre.
- Any appreciable pain
- 2.9 days on averageDays at 30 or more on the same scale, standard deviation 2.9, in the same 22 patients.
- The range in that group
- 0 to 88 out of 100Somebody in this small series recorded pain near the top of the scale. The average is not a forecast for one person.
- What people describe instead
- A blocked noseNHS patient guidance for nasal surgery describes the blockage afterwards as feeling like a heavy cold.
The honest version of the answer has two halves that pull in opposite directions, and both belong in it. The measured pain after rhinoplasty is lower than almost anybody expects. And the study that measured it followed 22 people, one of whom rated their pain at 88 out of 100.
What was actually measured
A study published in the Laryngoscope in 2019 asked patients to record their own pain daily on a visual analogue scale running from 0 to 100, and to record how many painkillers they took. It covered 22 rhinoplasty patients and 13 septoplasty patients at a single American centre.
| Rhinoplasty (22 patients) | Septoplasty (13 patients) | |
|---|---|---|
| Days at 40 or more out of 100 | 1.9 (SD 1.9) | 0.9 (SD 1.1) |
| Days at 30 or more out of 100 | 2.9 (SD 2.7) | 1.4 (SD 1.1) |
| Range of scores recorded | 0 to 88 | 0 to 78 |
| Opioid tablets used, mean | 4.4 (SD 4.0) | 4.1 (SD 4.4) |
The authors concluded that both operations are associated with mostly mild pain and that painkiller requirements are low, low enough that prescriptions after them could reliably be reduced.
Twenty two people is not many
This is a small series from one hospital, and it is the most specific measurement of this that we found. It is enough to describe what happened to that group and not enough to promise anything to a reader. Treat the shape of the finding, which is that pain was lower and shorter than people expect, as better supported than any individual number in it.
Why "mostly mild" is the wrong thing to plan around
The most useful number in that study is the one least often quoted. Scores ranged from 0 to 88 out of 100. Somebody in a group of 22 had a bad time, and no average containing them tells you whether you will be them.
Averages of this kind are worth reading as a description of a group rather than a forecast for a person, and pain is particularly unsuited to being averaged: it varies with the extent of the surgery, with whether bone was cut, with anxiety, with sleep, and with how much the person expected in the first place. A page that tells you it will be fine is guessing about you.
- An operation that cut bone is not the same experience as one that reshaped cartilage, and the studies rarely separate them.
- A revision takes cartilage from a rib or an ear, which adds a second site that hurts in its own right and for longer.
- Packing, where it is used, is widely described as the least comfortable part, and removing it is its own event.
- Expectation moves the score. People who have been told to expect agony report worse pain than people who were told what actually happens.
The complaint people actually make
Ask somebody a fortnight after nasal surgery what the worst part was and the answer is usually not pain. It is that they cannot breathe through their nose, cannot blow it, cannot sleep flat, and have to keep their mouth open to breathe at night. NHS patient guidance for nasal surgery describes the blockage afterwards as feeling like a heavy cold, and that is the sensation most people are actually describing when they say the recovery was hard.
- Blockage, from swelling inside the nose and from dried blood, for one to two weeks in most accounts.
- Sleeping propped up, which most people find harder than the operation.
- A dry mouth and sore throat from breathing through the mouth overnight.
- Pressure rather than pain, often described as a dull ache across the bridge and behind the eyes.
- Numbness of the tip and the upper lip, which is not painful and is unsettling.
Which of these is worth reporting
Discomfort that is slowly improving is the ordinary course. Pain that is increasing rather than decreasing, pain on one side with a blocked nostril and a fever, or a sudden change after several settled days, are different, and belong in the warning signs rather than in a page about what is normal.
What people took, and why that number does not travel
In the same series, rhinoplasty patients used an average of 4.4 opioid tablets and septoplasty patients 4.1. The authors used that to argue that surgeons could safely prescribe far fewer than they do.
This is a fact about American prescribing, not about your nose
Routine opioid prescription after minor surgery is an American practice pattern with no direct equivalent in British or Turkish care, where paracetamol and an anti-inflammatory are the usual starting point. The figure describes what those patients were handed and chose to take. It is not a dose, it is not a recommendation, and it does not predict what you will be offered or need.
The practical question for a consultation is not how much it will hurt but what the plan is: what you will be given, what to take if that is not enough, who to ring, and whether anything will be packed inside your nose. The consultation checklist has room to write the answers down.
Questions to ask a surgeon
Take these to a consultation. The consultation checklist is built to be printed and written on, and our doctors will answer questions sent through the site before you travel.
- What will I be given for pain, and what should I take if that is not enough?
- Will anything be packed inside my nose, and when does it come out?
- Will bone be cut in my operation, and does that change what I should expect afterwards?
- If cartilage is taken from my rib or my ear, how long does that site hurt for?
- Who do I contact, and how, if the pain is getting worse rather than better?
Sources
Every source below was opened and checked. We link to health authorities, peer-reviewed journals and professional bodies, and to nothing else.
- Postoperative pain and analgesic requirements after septoplasty and rhinoplastyThe Laryngoscope, via PubMedMeasured pain scores and painkiller use after both operations, in a small single centre series.
- Septoplasty and septorhinoplastyUniversity Hospitals Sussex NHS Foundation TrustNHS trust patient information covering the operation and its recovery.
- Rhinoplasty recoveryAmerican Society of Plastic SurgeonsProfessional society guidance on the recovery period and post-operative care.
- Nose reshaping (rhinoplasty)NHS, United KingdomNational health authority overview of what the operation involves, recovery and risks.