Although there are not any recommendations on this from all makers of influenza intranasal vaccine, I do not recommend the use of a live virus in the nose immediately after a rhinoplasty or septoplasty. First of all, immediately after rhinoplasty, the nose is healing and spraying an irritant in the nose is not recommended. The manufacturers of the vaccine note that nasal congestion, nasal irritation, and runny nose are common adverse effects. This leads me to believe that the vaccine or more likely the solution that carries that vaccine is irritating to the nasal passageway, not a good idea after a nasal procedure. In addition, after a septorhinoplasty, it takes several weeks for the cilia and structure of the nose to return to function. This may mean that the vaccine could be less effective than desired. Finally, the CDC suggests that the vaccine not be used in the presence of nasal congestion as it may limit the effectiveness of the vaccine. After a rhinoplasty, there is typically intranasal swelling.