Nasal dripping is a common and expected part of rhinoplasty recovery. This natural physiological response occurs as the nose heals and adapts to its new structure. Understanding this drainage helps patients manage expectations during the initial post-operative period. In most cases, nasal dripping is a normal and temporary symptom.
Immediate Post-Operative Dripping
Immediately after rhinoplasty, patients can expect significant nasal dripping, which often involves blood-tinged discharge. This drainage is most pronounced during the first 24 to 48 hours. During this initial period, a drip pad placed under the nose may require frequent changes, sometimes every 10 to 20 minutes.
The volume and consistency of this discharge decrease over subsequent days. By the end of the first week, active bleeding usually subsides significantly, though some light spotting or pinkish discharge might still be present as tissues heal. While noticeable dripping typically resolves within the first few days to a week, some patients may experience a runny nose for a few weeks, and in rare instances, for several months.
Causes and Characteristics of Nasal Discharge
Nasal discharge after rhinoplasty results from several physiological responses to the surgical procedure. The delicate lining inside the nose, known as the mucosa, experiences irritation and inflammation from the manipulation of nasal tissues and bone during surgery. This irritation stimulates the mucosa to produce increased mucus as part of the healing process.
The discharge initially appears reddish or bloody due to residual blood from the surgical site and oozing. As healing progresses, the discharge typically transitions to a clear, watery consistency, or a mixture of blood and phlegm. Swelling within the nasal passages, both internal and external, also contributes to increased mucus production and can make the nose feel congested, leading to further drainage.
Coping with Post-Rhinoplasty Dripping
Managing nasal dripping after rhinoplasty involves several practical strategies to enhance comfort and support the healing process. Patients are advised to use a drip pad, often referred to as a “moustache dressing,” to absorb drainage. This pad should be changed regularly, especially during initial days when drainage is heaviest. Applying a thick layer of Vaseline or antibiotic ointment to the gauze can help lubricate the nostrils and prevent dryness.
Avoid blowing the nose forcefully for at least one to two weeks following surgery, as this can disrupt healing tissues and potentially cause further bleeding. Instead, gently dab the nose with a soft tissue. Keeping the head elevated, particularly while resting or sleeping, can help minimize swelling and reduce drainage. Saline nasal sprays or rinses, if approved by the surgeon, can help keep nasal passages moist and clear, assisting with mucus and crusting removal.
Signs Requiring Medical Attention
While some nasal dripping is normal after rhinoplasty, certain signs warrant immediate medical attention from your surgeon. Persistent or heavy bleeding that soaks through dressings quickly and does not slow down, or the presence of large blood clots, could indicate a complication. Foul-smelling discharge, along with increased redness, warmth, or swelling around the nose, may signal an infection.
A sudden increase in pain not relieved by prescribed medication, or the development of a fever (100.4°F or 38°C or higher), are concerning symptoms. Although rare, a clear, gin-like fluid draining from the nostrils should be reported immediately, as it could indicate a cerebrospinal fluid leak. Prompt communication with your surgical team about any unusual or worsening symptoms is important for a safe and effective recovery.