The Day Finally Arrives
For Mariana (@justvisaa), surgery day was years in the making. The Bay Area creator had rhinoplasty and septoplasty with Dr. Michael Macdonald in San Francisco to soften her features and finally breathe properly after living with a deviated septum. On the day, she was excited, nervous and ready, and she filmed everything to share the whole process.
Watch Mariana's surgery day on Instagram. She shared it in collaboration with our practice.
If you're preparing for rhinoplasty in San Francisco, knowing what happens on the day makes it much less intimidating. Here's what to expect, step by step.
The Night Before and the Morning Of
Your care team gives you specific instructions before surgery. They typically cover:
- Eating and drinking: when to stop before anesthesia.
- Medications and supplements: which to pause beforehand, because some increase bleeding.
- What to wear: comfortable clothes, ideally a top that buttons or zips so nothing goes over your face afterward.
- What to leave at home: jewelry, contact lenses and makeup.
- A ride home: an adult must drive you home and ideally stay with you the first night.
Follow your own instructions exactly. They are tailored to you and your procedure. Our patient information page has more on preparing for your visit.
Check-In and Final Plan Review
When you arrive, the team checks you in, confirms your health details and gets you ready. Dr. Macdonald meets with you before surgery to review the plan one more time and answer any last questions. It's normal to feel nervous; Mariana did too. This is a good moment to say so.
Anesthesia
You'll meet the anesthesia provider, who explains how you'll be kept comfortable and asleep during the procedure and answers your questions.
What Happens During Surgery
Every rhinoplasty is planned for the individual, so the details vary. In general terms:
- Approach: surgery is done through an open approach (a small incision across the skin between the nostrils) or a closed approach (incisions inside the nose). Dr. Macdonald recommends one based on the changes planned.
- Reshaping: cartilage and bone are refined to change the shape, such as smoothing a bump or refining the tip, while keeping the nose's support.
- Breathing: when there is a deviated septum, as in Mariana's case, septoplasty straightens it during the same operation to open the airway.
Because Dr. Macdonald is double board-certified in facial plastic surgery and ENT, he plans the shape of the nose and how it breathes together.
Waking Up
After surgery you wake up in recovery, where the team monitors you. You'll have a splint on the outside of your nose to protect it, and your nose will feel congested. That's expected, especially when septoplasty was done. Once you're awake and comfortable and meet the discharge criteria, you go home, usually the same day.
The First 48 Hours at Home
The first two days are about rest:
- Keep your head elevated, including while sleeping.
- Use cold compresses around the eyes and cheeks if your care team recommends them.
- Breathe through your mouth if your nose feels blocked; that's normal at this stage.
- Avoid blowing your nose, bending over and strenuous activity.
- Take medications exactly as prescribed.
- Call the office if anything worries you.
Mariana also shared her first days after surgery. Watch her early recovery on Instagram.
Frequently Asked Questions
Will I be awake during rhinoplasty?
No. You'll be asleep and comfortable during the procedure. The anesthesia provider explains the plan before surgery.
How long does rhinoplasty take?
It depends on the plan, including whether septoplasty or other breathing work is included. Dr. Macdonald will give you an estimate for your specific surgery.
Can I go home the same day?
Most patients go home the same day once they're awake, comfortable and cleared by the team. You'll need an adult to drive you.
When is the splint removed?
The external splint is usually removed at a follow-up visit about a week after surgery.
Ready to Plan Your Own Surgery Day?
Mariana's journey started with a consultation. Yours can too. Dr. Michael Macdonald sees patients at Aesthetic Surgery Center, 500 Sutter St, Suite 430, San Francisco. See his work in the rhinoplasty gallery, then book a consultation or call (415) 956-3223.
Mariana shared her experience in collaboration with Aesthetic Surgery Center. Individual experiences and results vary.
