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鼻骨骨切り（幅寄せ）: Downtime

Name: Nasal Osteotomy Downtime: Swelling, Bruising & Cast Removal
Published: 2026-07-14

Extensive Category: Nose Surgery Last updated: 2026-07-14

Nasal osteotomy (nasal bone narrowing) is a surgical procedure that cuts the nasal bones — the framework of the bridge of the nose — and moves them inward, aiming to narrow a wide nose. Because it is surgery on bone, its downtime is generally considered on the longer end compared with injectables or laser treatments, and a nasal cast is usually required for about a week after surgery. Bruising that spreads around the eyes is also characteristic of this procedure, and major swelling and bruising tend to settle over about 2–4 weeks. It is generally said to take 3–6 months or more for residual puffiness to fully subside and the contour to become defined, and recovery varies from person to person. This page summarizes the typical course from the day of surgery to the final result, along with everyday precautions covering the cast, meals, glasses, and more. The actual technique and course differ depending on your condition, so please make your final decision after being examined by a physician.

DowntimeMajor swelling a…

PainModerate

MakeupThe cast is remo…

Work / social lifeIf you work from…

On this page

Downtime at a glance
Recovery timeline: treatment day to final result
Common symptoms
When can I do what? (Daily-life restrictions)
Pain and anesthesia
Tips for a smoother recovery
Risks and side effects (the honest version)
Spacing and combining with other procedures
Who it may suit / who should be cautious
Frequently asked questions

Downtime at a glance

The cast stays on for about 1 week, and major swelling — including bruising around the eyes — typically lasts 2–4 weeks. Many people feel ready to be seen in public from around 2 weeks, and the final result is generally said to take 3–6 months or more.

Typical downtime is Major swelling and bruising last 2–4 weeks (the cast stays on for about 1 week). Puffiness subsides and the result approaches completion from around 3–6 months onward, and most people feel comfortable being seen in public after If you work from home, many people aim for about 1 week after surgery, once the cast is removed; for jobs that involve being seen in public, around 2 weeks — when the bruising has faded — is said to be a common guideline (this varies by occupation and individual recovery). How much swelling or bruising appears varies from person to person, depending on constitution and the extent of treatment.

Recovery timeline: treatment day to final result

Day of surgery

The procedure is usually performed under general anesthesia (or intravenous sedation plus local anesthesia), and afterward the nose is stabilized with a cast or tape. Gauze or cotton packing may be placed inside the nose to control bleeding. A dull ache tends to appear once the anesthesia wears off, so manage it with the prescribed pain medication. Rest quietly on the day of surgery; keeping your head above heart level while resting is said to help reduce swelling. Blood-tinged nasal discharge may seep out — wipe it away gently without blowing your nose.

Days 1–3

This is considered the peak of the swelling. Not only the nose but also the area around the eyes can swell, and bruising may spread across the lower eyelids and cheeks. Nasal congestion makes mouth breathing more likely, and many people find sleeping with the pillow raised more comfortable. Cool the area around the eyes if instructed. For meals, avoiding hard or very hot foods and choosing things that are easy to swallow is said to be less taxing. Keep outings to a minimum, and follow any instructions for follow-up visits (disinfection, gauze changes, and so on).

1 week after (typical cast removal)

In most cases, stitches are removed (if incisions were made inside the nose) and the cast comes off around days 5–7. Right after the cast is removed, swelling still remains, and quite a few people feel it is hard to see the narrowing effect yet. Some clinics instruct you to continue tape fixation for a further few days to a few weeks. This is also when the bruising begins to fade, turning yellowish.

2 weeks after

Major swelling subsides, and the bruising fades to a level that is easier to cover with makeup. Scheduling appearances in public from around this time onward is said to give you more leeway. The nasal bones are not yet stable, so continue to avoid pressing hard on the nose, bumping it, or sleeping face down. This is a good time to ask your doctor at a checkup whether you can resume light exercise.

1 month after

Visible swelling has largely settled, and daily life has usually returned to near normal by this point. However, puffiness along the bridge remains, and the final slimness and contour have not fully emerged. Because this is an important period for bone healing, still be cautious about blowing your nose hard, wearing glasses for long stretches, and contact-heavy sports. Follow your doctor's instructions on when to resume them.

3 months after

Puffiness subsides further, and this is said to be when the narrowing effect becomes easier to appreciate. Bone stability also progresses, and most daily restrictions are usually lifted; if asymmetry or a step-like feeling concerns you, raising it at a checkup around this time is reassuring.

6 months to 1 year (typical completion)

The fine puffiness clears and the contour becomes defined, approaching the final result. How long completion takes varies from person to person depending on skin thickness and bone condition. If you are weighing whether a revision is needed, it is generally recommended to make that decision from this period onward.

Bars show approximate swelling levels (individual results vary).

Common symptoms

Symptom	Likelihood	When it appears	How long it lasts	Notes
Swelling of the nose and surrounding area	High	Immediately after surgery	Major swelling lasts 2–4 weeks; puffiness 3–6 months	Swelling is generally said to peak around days 2–3 and then broadly settle over the following 2–4 weeks. Subtle puffiness can remain for several months.
Bruising around the eyes	High	Same day to a few days after	2–3 weeks	Because the osteotomy sites are close to the eyes, bruising is said to spread easily from the lower eyelids to the cheeks. It fades over time, turning yellowish as it does.
Pain, dull ache, and a feeling of tightness	High	After the anesthesia wears off to a few days after	A few days to 1 week	A dull ache and a feeling of pressure from the cast are common for the first few days, but this is usually said to be manageable with the prescribed pain medication.
Nasal congestion and blood-tinged nasal discharge	High	Same day to a few days after	1–2 weeks	Swelling and discharge inside the nose can make nasal breathing difficult. Gauze or cotton packing may be placed inside the nose for a few days; do not remove it yourself during the instructed period.
Numbness or reduced sensation around the nose and upper jaw	Medium	After surgery to several weeks	Several weeks to several months	The osteotomy can temporarily dull sensation in the nasal tip and the area around the nose. In most cases it is said to recover over time, though the duration varies from person to person.
Asymmetry or a step-like feeling in the bone	Low	As the swelling subsides (1–3 months)	Varies with recovery	You may notice asymmetry or unevenness while the swelling goes down. Most of this is said to be temporary puffiness, but bone displacement or a residual step can occur, so consult your surgeon if it concerns you.

When can I do what? (Daily-life restrictions)

Activity	Typically OK from	Key point
Cast and tape fixation	The cast is removed after about 1 week; tape fixation may continue afterward	This fixation is essential for keeping the repositioned bones stable. Do not remove or shift it on your own, take care to keep it dry, and always follow your clinic's instructions for removal and changes.
Makeup	Areas not touching the cast from the next day; around the nose after cast removal	Covering the bruising with concealer becomes easier from around 1–2 weeks, once it starts to fade. Avoid applying makeup over wounds or the cast.
Face washing	From the same or next day as long as the cast stays dry; normal face washing after cast removal	During the fixation period, substitute a warm towel or wipe-off cleansing, and avoid rubbing the nose.
Shower	From the neck down, often allowed from the next day	Hair washing may be allowed after a few days if done in a position that keeps the face dry (lying back, salon-style). Follow your clinic's instructions first.
Bathing (soaking in the tub)	Around 2 weeks after as a guideline (after cast removal, with your doctor's permission)	Letting the body get too warm can prolong swelling and bruising, so be cautious even with short, lukewarm baths during and right after the fixation period.
Alcohol	Around 2 weeks after as a guideline (at minimum, until the swelling has peaked and passed)	Alcohol boosts circulation and is said to raise the risk of swelling, bruising, and bleeding, so avoid it in the early recovery period. Confirm with your doctor when to resume.
Exercise	Light exercise from about 2 weeks; strenuous exercise from about 1 month	Exercise that raises blood pressure can lead to swelling or bleeding. You may be instructed to avoid sports where a ball or physical contact could hit the face until the bone is stable (several months).
Sauna and hot-stone baths	Around 1 month after as a guideline	Intense heat can bring swelling and puffiness back, so it is safer to wait until things have settled well.
Blowing your nose	Do not blow hard for 2–4 weeks	Blowing hard is said to put pressure on the osteotomy sites and may lead to bleeding or bone displacement. Wipe nasal discharge away gently, or blow one nostril at a time very softly. Sneezing with your mouth open is said to reduce the pressure.
Glasses and sunglasses	For 1–2 months, find ways to keep weight off the nose	Until the nasal bones stabilize, the weight of frames has been noted as a possible strain on the bone. You may be advised to switch to contact lenses, or to support the frames with tape or on the cheeks. Confirm the duration with your doctor.
Sleeping face down / contact with the nose	Avoid for about 1 month	Pressure or bumps during sleep can cause the bone to shift. Sleeping on your back with your head slightly raised is also said to help reduce swelling.
Meals	Soft, easy-to-eat foods for the first several days	Opening the mouth wide or chewing hard foods forcefully can be felt around the nose. Very hot or spicy foods can aggravate swelling, so going easy on them in the early recovery period is the safer choice.

Can you hide it? Concealment difficulty ●●●●● ／ During the fixation period (about a week), the cast makes complete concealment difficult. A realistic approach is a combination: a large, structured face mask to cover part of the nose area, plus a wide-brimmed hat or sunglasses to draw attention away from the bruising around the eyes (choose lightweight sunglasses that put no weight on the nose, wear them only briefly, and check with your doctor whether they are allowed). After the cast comes off, the bruising becomes easier to cover with concealer, but swelling of the nose itself is hard to hide with makeup, so scheduling appearances in public from 2 weeks onward gives you more leeway. How well it can be concealed — and the pace of recovery — varies from person to person.

Pain and anesthesia

The typical pain level is Moderate. The procedure is generally performed under general anesthesia, or intravenous sedation combined with local anesthesia. The anesthesia method affects how you spend the day of surgery (whether you need an escort, how you get home, dietary restrictions, and so on), so confirm with your doctor in advance. During surgery you generally feel no pain because of the anesthesia. Once it wears off, a dull ache around the nose and a feeling of pressure from the cast are common, and pain and discomfort tend to be strongest in the first 2–3 days. This is usually said to be manageable with the prescribed pain medication, though how it feels varies from person to person. Pain you cannot tolerate or a sudden worsening of swelling can be a sign of bleeding or another problem, so contact the medical institution where you had the procedure promptly.

Tips for a smoother recovery

Cooling the area around the eyes as instructed for the first 48–72 hours and resting with your head above heart level are said to help reduce swelling and bruising (take care not to get the cast wet).
Avoiding alcohol, strenuous exercise, long baths, saunas, and other activities that strongly boost circulation in the early recovery period is considered important for keeping swelling and bruising from dragging on.
If you take blood-thinning medications or supplements (such as EPA or vitamin E), they can affect the risk of bleeding and bruising — always tell your doctor in advance and confirm whether they need to be paused.
Strictly keeping pressure off the nose — no nose blowing, no touching, no sleeping face down — is said to support bone stability and a steady recovery.
If you have an important event such as a wedding or photo shoot, allow time for the bruising and swelling to subside: having the procedure at least 1–2 months in advance — or 3 months or more if the finished appearance matters most — gives you peace of mind.

Risks and side effects (the honest version)

Postoperative bleeding, hematoma, or infection can occur. If you notice a sudden worsening of swelling, severe pain, fever, or a nosebleed that will not stop, contact the medical institution where you had the procedure promptly.
The cut bone may shift, a step may remain, or asymmetry may develop. To distinguish these from temporary asymmetry caused by swelling, evaluation is generally done at the completion stage (3–6 months or later).
It has been noted that the width may relapse slightly as the bone heals. Depending on the outcome, revision surgery may be considered.
Numbness or reduced sensation in and around the nose can continue for several weeks to several months. Most cases are said to move toward recovery, but in rare cases it can be prolonged.
Swelling inside the nose or structural changes can cause nasal congestion or difficulty breathing through the nose — usually temporarily, and in rare cases over the long term.
General anesthesia and intravenous sedation carry risks such as nausea, allergic reactions, and effects on breathing. Always disclose any medical conditions, medications, and allergy history in advance.
The final appearance varies from person to person, and the degree of change depends on bone structure and skin thickness. Results are not guaranteed, so be sure to discuss the technique, risks, and conditions for revision with a physician at a consultation.

If a symptom lingers or gets worse, do not try to judge it yourself — contact the medical institution where you had the procedure.

Spacing and combining with other procedures

If you have an important event such as a wedding or photo shoot, allow for the cast period and the time swelling and bruising take to subside: having the procedure at least 1–2 months in advance — or 3–6 months or more if the finished appearance matters most — gives you peace of mind. Even when considering a revision for bone displacement, a step, or insufficient change, the general guideline is to wait 6 months to 1 year or more so that bone healing and the resolution of puffiness can be confirmed. Early reoperation may carry higher risks, so always discuss the timing with your surgeon.

Combined procedure	Timing	Wait time	Reason
Other nasal surgeries such as Nasal Tip Plasty or Septal Extension	Same day OK	These are often performed at the same time	Combining the osteotomy with nasal tip surgery in a single operation to balance the nose as a whole is considered common. It has the advantage of consolidating downtime, but swelling can be stronger than with the osteotomy alone. Suitability is determined by the doctor based on your bone structure and goals.
Nasal Implant (Augmentation Rhinoplasty; Silicone Implant / Cartilage Graft)	Same day OK	Sometimes performed together on the same day	This combination is sometimes performed at the same time as the osteotomy to make the nasal bridge look slimmer and higher. Whether to do them together or in stages depends on the condition of your nose and your desired result, so discuss it thoroughly with your doctor.
Hyaluronic Acid Filler (nose)	Wait required	If done after the osteotomy, wait until completion (3–6 months or later) as a guideline	Injecting while swelling remains makes the result hard to judge, and consideration for infection risk is also said to be necessary. If you already have hyaluronic acid filler in your nose, check with your doctor whether it needs to be dissolved before surgery.
Double Eyelid Surgery (Buried Suture or Incision Method)	Wait required	If done on a separate day, wait until the swelling settles — about 1 month or later as a guideline	Nasal osteotomy causes significant swelling and bruising around the eyes, so if its timing overlaps with eyelid surgery, assessing the recovery of each can become difficult. Some clinics perform both on the same day, but feasibility and order are up to the doctor's judgment.
Energy-based treatments such as HIFU (High-Intensity Focused Ultrasound) and Radiofrequency (RF)	Wait required	1–3 months or later as a guideline (for the area around the nose, check with your doctor)	Heat stimulation while swelling remains may bring puffiness back, and care regarding its effect on the osteotomy sites is also said to be needed. The treatment area and timing are decided by the doctor after assessing your surgical recovery.

▶ Check the interval between 鼻骨骨切り（幅寄せ） and another procedure in the simulator

Who it may suit / who should be cautious

May suit you

Those concerned that the bridge of their nose looks wide (a wide nose)
Those told that hyaluronic acid or an implant alone is unlikely to change the impression of width
Those who want a substantial change at the skeletal level
Those who can set aside a solid downtime period of about 1–2 weeks
Those who want to consider the procedure with a full understanding of the swelling, bruising, and fixation involved

Consider carefully

Those who cannot take time off for downtime, or who have an important event within the next 1–2 months
Those with conditions that make them prone to bleeding, or who cannot pause blood-thinning medication
Those with an infection or inflammation at the treatment site
Those who are pregnant or breastfeeding
Those whose bone structure or skin condition leads the doctor to judge that the expected change is unlikely or the procedure unsuitable

Frequently asked questions

How much time do I need to take off work or school?

Because the cast stays on for about a week, many people whose work or school involves seeing others are said to take about a week off, until the cast is removed. Allowing until the bruising around the eyes fades — about 2 weeks — gives you extra leeway. Some people who work from home resume within a few days to a week. It differs by condition and occupation, so plan together with your doctor.

When does the cast come off? Is fixation still needed afterward?

It is generally said to be removed around days 5–7 after surgery. Swelling still remains right after removal, and some clinics instruct you to continue tape fixation — for example, at night only — for a further few days to a few weeks. Fixation is an important step for keeping the repositioned bones stable, so do not remove it on your own judgment; follow the instructions.

When will people stop noticing?

Up to about a week after surgery, while the cast is on, it is inevitably noticeable. From around 2 weeks — when the bruising fades and becomes easier to cover with makeup — more people tend to feel they go unnoticed. Subtle puffiness remains for several months, so people you see often may notice the change in contour. Recovery varies from person to person.

How long does the pain last?

You generally feel no pain during surgery thanks to the anesthesia. A dull ache and a feeling of pressure are common for the first 2–3 days after surgery, but this is usually said to be manageable with the prescribed pain medication. Pain tends to ease after the first week. Pain you cannot tolerate or a sudden worsening can be a sign of a complication, so contact your medical institution promptly.

When can I wear glasses again?

Until the nasal bones stabilize — about 1–2 months — the weight of frames has been noted as a possible strain on the bone. During this period you may be advised to switch to contact lenses, wear lightweight frames only for short stretches, or use tape to spread the weight. The exact period and method differ by clinic, so be sure to confirm with your doctor.

Is it true I can't blow my nose? What should I do about congestion?

For about 2–4 weeks after surgery, blowing your nose hard is said to put pressure on the osteotomy sites and may lead to bleeding or bone displacement. Wipe nasal discharge away gently, and sneezing with your mouth open is said to reduce the pressure. If the congestion is hard to bear, do not use over-the-counter medication on your own judgment — consult your doctor.

The swelling has gone down but the width doesn't seem to have changed. Did it fail?

At 1–2 months after surgery, puffiness is often said to still remain, and the final slimness has not yet emerged. The general benchmark for evaluation is 3–6 months or later. If asymmetry, a step, or a lack of change still concerns you, first have your surgeon examine the condition of the bone. Whether and when a revision is needed depends on your condition, so consult rather than judging on your own.

Can it be reversed? Is there any relapse?

Because this surgery cuts and moves bone, it cannot be easily reversed the way injectable treatments can. On the other hand, it has also been noted that the width may relapse slightly as the bone heals. The degree of change, the risk of relapse, and the conditions for revision differ depending on bone structure and technique, so we recommend confirming them thoroughly at a consultation before going ahead.

This article was written and is kept up to date by our editorial team, based on general knowledge in cosmetic surgery and aesthetic dermatology, the package inserts of the products and medical devices involved, and publicly available information from government agencies and medical societies. It is not an advertisement for any specific medical institution. Editorial policy

This article is for general informational purposes only and is not an advertisement for any specific medical institution. All figures are typical guidelines; results and recovery vary from person to person. Please see a physician before making any final decision. The information on this site is provided for general informational purposes only and is not a substitute for diagnosis, treatment, or medical advice. Final decisions about a procedure's suitability, risks, combinations, and intervals must always be made after being examined by a physician.