Rhinoplasty, commonly known as a nose job, is a surgical procedure performed to reshape the nose. This procedure can address various aesthetic concerns, from altering the size and shape of the nasal bridge or tip to refining nostril width. As with any surgical intervention, some degree of bleeding is a normal and expected part of the recovery process. Understanding what constitutes typical bleeding versus what might be a sign of concern can help individuals feel more at ease during their healing journey.
Expected Bleeding After Rhinoplasty
Following rhinoplasty, it is common to experience some light bleeding, particularly during the first 24 to 48 hours. This typically manifests as a pinkish or dark red discharge, often thin and watery, which may also contain small blood clots. This discharge usually appears as light oozing from the nostrils or drains into the back of the throat. The amount of bleeding tends to be minimal, often absorbed by a small piece of gauze placed under the nostrils.
As the initial days pass, the bleeding usually lessens considerably. While the discharge may continue for several days, it often transitions into light spotting or crusting within the nostrils. Nasal dressings or packing, if used, are designed to absorb this drainage, and their appearance will reflect the amount of bleeding occurring. The presence of dried blood and mucus crusts inside the nose is also a common occurrence during the healing period.
Signs of Excessive Bleeding
One such sign is the continuous gushing of bright red blood from the nostrils that does not slow down. Another indication of potential concern is the passage of large or frequent blood clots, especially if they are larger than the size of a quarter. If the bleeding is constant and requires very frequent changes of gauze, or if it feels as though blood is continuously dripping down the back of the throat, it warrants attention. Difficulty breathing that results from blood accumulation within the nasal passages, rather than from typical swelling, can also signal excessive bleeding.
Managing Bleeding and Post-Operative Care
Keeping the head elevated, particularly during the first few days and while sleeping, helps reduce blood pressure in the nasal area and can decrease bleeding. Applying cold compresses to the cheeks or forehead, not directly on the nose, can also aid in reducing swelling and minor bleeding. These measures work by constricting blood vessels in the surrounding tissues.
It is advisable to avoid activities that increase pressure in the head, such as nose blowing, which can dislodge clots and restart bleeding. If a sneeze is unavoidable, it is best to sneeze with an open mouth to release pressure. Strenuous activities, heavy lifting, or bending over should be avoided for several weeks, as these actions can also elevate blood pressure in the face. Gently cleaning the nostrils as instructed by the surgeon, often with saline spray, helps keep the nasal passages clear without causing irritation.
When to Contact Your Surgeon
You should seek medical advice if you experience persistent gushing of bright red blood that cannot be controlled with the recommended home measures. Similarly, if you notice a sudden and significant increase in pain that is not relieved by prescribed medication, this should be reported. Other concerning signs include the development of a fever, significant and rapidly increasing swelling around the eyes or face, or any changes in vision. Signs of infection, such as increased redness, warmth, or pus-like discharge, also warrant prompt communication with your surgical team.