Plastic Surgeon Questions Plastic Surgeon

How much bleeding is too much after a rhinoplasty?

I am a 33 year old female. I want to know how much bleeding is too much after a rhinoplasty?

5 Answers

Depends on extent of procedure and your clotting ability.
Generally, rhinoplasties bleed a decent amount, particularly the more that is done to the nose, such as breaking the bone with osteotomies. However, new medications have helped us plastic surgeons reduce the amount of operative bleeding, including systemic or topical use of TXA (tranexamic acid). Some surgeons also mix a medication called hyaluronidase into their local anesthetic mixture, which can be helpful with the tissue dissection during rhinoplasty.

However, for the most part, operative bleeding should not get to the point of requiring a blood transfusion. If someone loses more than 300 mL (cc) of blood (about one (1) unit), that generally warrants consideration for blood transfusion. If you end up getting transfused during or after a rhinoplasty, I would certainly say that is way too much bleeding!

Short of that, expect a slow ooze of blood from the nares (nostrils) after rhinoplasty for even several days. Afrin decongestant spray can help minimize congestion and nosebleeding. Keeping the head elevated and frequently applying a 'gauze mustache' along the upper lip to capture bloody and mucus drainage is important. Avoid blood thinners postop (including nonsteroidal anti-inflammatory drugs, or 'NSAIDs') unless your plastic surgeon says it's 'ok' to do so. Making sure you are not overexerting, and keeping your blood pressure in the normal range (120/80 mm Hg) will also avoid unnecessary postoperative bleeding.

Finally, always seek a Board-Certified Plastic Surgeon or Facial Plastic Surgeon (Otolaryngology trained) with the knowledge and experience to perform your rhinoplasty. Your surgeon should be able to discuss with you his or her strategies to manage operative bleeding and keep it to an absolute minimum.

Good luck to you with your rhinoplasty journey!

Nirav B. Patel, MD, JD, FACS, FCLM
Board-Certified Plastic Surgeon
Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery

Patel Plastic Surgery, LLC
11459 Johns Creek Parkway
Suite 240
Johns Creek, GA 30097

Office 470-395-6932
Fax 470-395-6951
Cell 203-710-9952
1. If you continue to have blood in the back of your throat or bleeding bright red blood from your nostril overnight.
2. If you are vomiting blood clots all night long after surgery, you could be bleeding too much. Spitting some blood is ok though.
3. Some bruising around the inner aspect of your eyes can be normal, however, if you look like a raccoon eye, you might be bleeding a little more than usual.
4. If you are passing out, vomiting blood, or have a breathing problem, you should go to the emergency room...

Your question does not give details about your bleeding.
If you are soaking the nose pad every hour after surgery then you should call your doctor.
If you are soaking the nose pad every hour after surgery then you should call your doctor.