If the surgeon makes changes only to the outside of the nose, then there is no nasal packing. But if the surgeon does some work for nasal breathing that requires straightening the septum, then small nasal packs may be placed inside each nostril and are usually removed the next morning.

Patients are advised to take a week off from work after surgery. They report that recovery is uneventful. The patients' main job after surgery is just to rest. Most surgeons provide their patients with detailed after-surgery instructions.

The patient will notice some swelling and bruising around the eyes that typically begins to disappear within a few days. Resting with the head elevated helps speed this process. The surgeon will typically remove the nasal bandage in about 6 days. If dissolv­able stitches are used, there are no stitches to remove. After removal of the small nasal bandage (or "splint"), most patients are presentable in public. Most of the author's patients return to work the day after nasal splint removal. There are restrictions on activity for a few more weeks after that. And of course, there is continued healing and reduction of swelling that con­tinues to take place, quickly at first and then gradually for at least a year.

While the major changes will be apparent im­mediately, the more subtle changes do take time to become apparent. This is the case because healing is a relatively slow, gradual process. The author typically advises patients that it takes one year for 80% of the healing to take place.

To the extent that it is possible, it is essential that the surgeon understands what the patient wants, and that the patient understands what the surgeon is planning. With this in mind, the surgeon should have a clear conversation with the patient on this subject. Also, the author reviews computer imag­ing with most patients to improve communication, to make sure the patient and surgeon are "on the same page.''

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