FAQs / Links
FAQs:
Tom asks:
"My nose was cauterised recently, I am still getting nose bleeds. What should I do?"
Raj says:
"This is unusual but not uncommon. For 2 weeks after cauterisation you may still suffer with an occasional nose bleed as the crust matures in your nose. You should keep using the cream that I prescribed you at your appointment, and control your nose bleed in the usual way (thumb and index/forefinger pressure on the soft part of your nose under the bones, head tipped forward). If the bleeds are brisk and worrying, you may need to go to Casualty at your local hospital. If they are smaller and less worrying, contact April and Raj will either call to discuss or will ask you to come back to clinic to discuss the next stage of your treatment."
Sangeeta asks:
"Are there any nasal drops you can recommend which will help prevent me from being ill after being in the cold air?"
Raj says:
"Unfortuantely not. However, there are ways to reduce your exposure to viruses and allergens circulating in the air. If you are really concerned, a barrier such as Vaseline to plug the nostrils may be effective. An FFP3 mask, like the types used during the COVID pandemic, can be very effective at reducing your exposure to viruses and allergens."
Emma asks:
"Dr Raj prescribed me antibiotics, Clarithromycin. I did take these antibiotics for a few weeks over Christmas, no problems but last month, I took one tablet but later I had a funny turn where my pulse was racing and I felt sick/flushed/weak and faint. Today, Dr Raj prescribed this medication and although I remembered what happened the last time, I felt it most likely wasn’t related to the medication as I had taken them over Christmas fine. But about 1.5 hours later I felt sick/flushed and weak with my pulse racing again. So I am unsure if I am having a bad reaction and if I should continue taking them. Is this a possible side effect of this medication? Would it be possible for Dr Raj to prescribe me a different medication instead?"
Raj says:
"Yes, this could be a side effect of the medication. And yes, there are alternatives. I will telephone you or see you again in clinic to discuss your symptoms and to prescribe you an alternative. We can usually post a prescription to you to save a return journey to the hospital."
Dawn asks:
"I’m in a lot of pain in my cheek going up to my head, after the op. I thought it was getting better towards the end of last week but since Monday it’s been awful. Should I ring my own GP about painkillers?"
Raj says:
"This is unusual, to be improving and then to take a turn for the worse again. Your GP will not be able to help. You should contact April to arrange to see me in clinic as you may have developed an infection, or there may be some dressing or crust blocking the opening into your sinus. There is always a solution."
Tia asks:
"My right nostril, where I had stitching on the side, is raised higher than the other one. I was hoping it would start to drop by now but it still hasn’t. Is this going to be permanent?"
Raj says:
"Your surgery was performed less than 2 months ago. At all our conversations prior to surgery I will have advised you that a final result will be seen at 12 months after your operation. In ethnic and Asian patients this can take longer, puffiness in the skin that can take 12 to 24 months to settle completely. Nostril symmetry and height particularly takes almost the entire 12 months to normalise. This is especially the case when nostrils are asymmetric to begin with - complete nostril symmetry is almost impossible to achieve but I will strive towards this for you. So in summary, at less than 2 months after your surgery you should try not to worry too much, keep moisturising and protecting from direct strong sunshine as I asked you to do at your postoperative review."
Beth asks:
"I’ve had a horrible smell in my left nostril for the last couple of weeks and it feels swollen inside. Can I double check if that’s to be expected or if I need to see Mr Bhalla before my appointment at the end of March?"
Raj says:
"Thank you for letting me know, I will ask April to bring you back to clinic sooner so that I can examine the inside of your nose. You had an extensive reconstruction of your nose using grafts and it is important to make sure that these have not become infected. Sometimes, the smell is caused by static mucous in the nose and a simple solution might be saline irrrigations. I can advise you when I see you."
Jennifer asks:
"If I decide to use a donor graft, do I need to stay overnight? I am looking at possibility of doing this to reduce the fee."
Raj says:
"The fee should not really be the reason for you to make this choice. If grafts are needed to reconstruct your nose, particularly if you require revision rhinoplasty or after many injuries to your nose, these grafts can either be taken from you (ear, chest, thigh) or from a donor. If the grafts are taken from you, you may not be able to have your surgery as a day case. And the more grafts that are taken from you, the greater the chance of complications - the law of averages! Unfortunately, your surgery then becomes more complicated and takes longer to perform. All of these factors will incur a greater surgical, anaesthetic and hospital fee. A graft from a donor also incurs a fee if you are self-funding, but your surgery can be performed as a day case. The grafts have been treated so that they do not reject, and have been irradiated so that you are not at risk of infections such as HIV or hepatitis. As a result of the shorter time in surgery your fee will be smaller. However, you should be comfortable with receiving donor material before making this choice and not just base your decision on cost. I will discuss all of this with you over your pre-operative consultations with me and we'll only move ahead when I'm confident you have all the information to make an informed decision and are involved in the decision-making process."
Links:
Courses:
Manchester Sinus, Rhinoplasty and Nasal Plastics Dissection Course, June 2024
Manchester Advanced Endoscopic Sinus and Skull Base Dissection Course, December 2025
Hospitals:
BMI The Alexandra Hospital, Cheadle
HCA The Wilmslow Hospital, Wilmslow
Spire Manchester Hospital, Didsbury
Societies:
The Royal College of Surgeons of England
Teaching:
Manchester Surgical Skills & Simulation Centre