How Do I Minimize Bruising from a Rhinoplasty?

Hi,At my office, we use a product called Ocumend by Cearna.  They are patches that have high concentrations of Arnica and really work to reduce the bruising significantly.  Usually at the one week follow up, most of the bruising is gone.Best,Dr. Nima

Many things can be done to try to reduce the bruising and swelling after a Rhinoplasty, but nothing can completely eliminate it. Frequent application of cold packs, 20 minutes on - 20 minutes off, immediately after surgery and for the first 3 days post-operatively should be your first line of defense. Not laying completely flat when sleeping will help the inevitable bruising to dissipate more quickly. Many patients seem to experience less bruising when they take Arnica just before and after surgery.

So it depends on 3 things1. What you do before surgery.  Dont take meds that will thin your blood like anti inflammatorys or Aspirin.  Also avoid suppliments like fish oil and flax seed.2. What you do after.  Keep your head elevated, ice and herbals like arnica and bromolin.  A note about these products.  Weak science as to whether or not they help.  If you plan on taking them you should start before surgery3. Genetic.  Some people are bruisers.  Hope that helpsRR

Bruising is usually a big concern for patients after rhinoplasty because it can prevent them from going back to work. The best thing to do to prevent bruising is to use a lot of cold compresses over the eyes and cheeks for the first two days. That will help limit the extent of the bruising. Preoperatively, you should avoid NSAIDS like Advil, as well as Aspirin, fish oil, vitamin E, and other things than can "thin" the blood. The skill of the surgeon is also a factor because the less traumatically a rhinoplasty is performed, the less bruising occurs. Supplements like arnica may help, but no properly performed studies have been published as of yet.

Hello and thank you for your question. I always advise my patients to take arnica and bromelain 10 days before and 10 days after surgery for a total of 20 days. This is not a miracle cure, but it can help. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hi from Istanbul, thanks for this question. Bruising after a nose job is influenced by various factors, including the surgeon's expertise and the patient's unique anatomy. To significantly reduce the risk of bruising, we focus on five key aspects during surgery:
1. Applying an effective local anesthesia is crucial for minimizing bruising.
2. We strive to maintain the patient's blood pressure at the lowest safe level during the procedure.
3. The dissection of the nose is performed at the deep plane with precision instruments to ensure minimal tissue trauma.
4. In shaping the nasal bones, we employ extremely delicate and precise tools to prevent excessive bruising.
5. Throughout the surgery, cold irrigation is used to constrict blood vessels, significantly reducing the likelihood of bruising.
These strategies combined can prevent bruising for the most part. However, if post-op bruising does still occur, its progression can be effectively managed with cold compresses and by keeping the head elevated. Additionally, for patients with hypertension, continuing their blood pressure medication is advised to aid in reducing bruising. Discontinuing the use of certain medications, supplements and herbal teas before and after surgery may be required, so it is also paramount to share this information with your surgeon. Best of luck to you!

Thank you for your question. With the latest Piezo technique, we expect minimal bruising after rhinoplasty surgery. However, some patients with sensitive skin still get bruised after their operation. I recommend keeping your head elevated for 4-5 days after the surgery which significantly helps reduce swelling and bruising. Eating pineapple, drinking pineapple juice, and applying ice also help with bruising and swelling. I ask my patients to stop taking blood thinning medication such as aspirin and stop drinking herbal teas including green tea 10 days before their surgeries to eliminate bruising as well. Make sure you listen to the directions your surgeon gives you carefully. This will help your recovery process. Good luck.

Bruising is a common concern after rhinoplasty. The extent of the bruising often depends on the type of surgical approach your surgeon chooses to take for your rhinoplasty. Oral arnica is a supplement that may help reduce the amount of bruising, and I usually advise my patients who are interested in trying this to take it for a week after surgery. Avoiding alcohol the week prior to surgery can also help reduce bruising. Additionally, I advise my patients to avoid medications that can thin the blood such as NSAIDs (ibuprofen, also known as Advil, and naproxen, also known as Aleve), aspirin, and Excedrin (which contains aspirin) for 2 weeks before and 2 weeks after surgery to decrease the risk of bruising. 

Gary Linkov, MD
Rhinoplasty Specialist
Manhattan

Depending on the amount of work being performed, bruising and swelling are an inevitable part of rhinoplasty surgery.  I recommend several things to my patients to minimize the amount of bruising and edema:1. Start taking Arnica tabs 2 days prior to surgery and continue for 5 days after2. Use ice packs to minimize swelling every 20 minutes while awake for the first 48 hours after surgery3. Sleep with head elevated at 30 degrees while sleeping on your back4. For persistent bruising, an IPL can often be used to help "break up" the stubborn purple pigment

After your rhinoplasty procedure, you will have a splint protecting your result for approximately one week. Because I prefer to file bones rather than breaking them, bruising is kept at a minimum.  By the time the splint is removed, the majority of my patients are able to go out in public immediately without looking as if they have had any surgery. Certain supplements and medications can also increase your risk of bruising and bleeding, and my staff will provide a comprehensive list of medication and supplements to avoid, ensuring a safe and quick recovery. Please consult with a board certified plastic surgeon who has formidable experience in rhinoplasty. Thank you for your question and best of luck to you!