Rhinoplasty Q&A
80%
WORTH IT RATING
"Worth It Rating" shows the % of consumer reviewers that stated the procedure was "Worth It" or not. See more RealSelf Worth It Ratings or Add Your Review
1,003 Reviews
Rhinoplastybefore & after photos
View Before and Afters

Average Rhinoplasty Cost: $5,975

Learn about Rhinoplasty

5,053 people and 803 doctors are talking about Rhinoplasty

Get Free Email Updates

Long-term Nose Bleeds Many Years After Rhinoplasty

asked 2 years ago by Juneguy in Los Angeles
Latest answer by Steven Goldman, MD
Question viewed 2,449 times
Tags: nose, nostrils

I've had 2 rhinoplasty surgeries. First one healed and the cartilage was pronounced on the tip and looked "done" and my nose bled and scabbed. 2nd revision a few years after the first made my nose look natural but I still have a scab that bleeds. I've tried saline sprays, neti pots and Polysporin in the nostril. It's been about 8 years and my nostril scab won't heal and i still bleed, every day. I've seen an ENT years ago and he said it's probably my airway is so large that it dries out and never heals. Any suggestions?

28 answers to Long-term Nose Bleeds Many Years After Rhinoplasty

+2

Bleeding After Rhinoplasty Needs Evaluation

There are numerous potentially treatable causes of persistent scabbing after Rhinoplasty, like a foreign body (e.g. a stitch), a bone or cartilage fragment, infected cartilage or bone, a septal perforation, or even dryness and picking fingers. Most importantly, you should seek evaluation and treatment to resolution.
Paul C. Zwiebel, MD

Denver Plastic Surgeon
+2

Long-term bleeding after rhinoplasty: You need a thorough evaluation.

You need a thorough evaluation. Here's some possible causes: 1) Autoimmune or vascular disorder: Crusting/bleeding that is resistant to treatment may indicate conditions that fall under the heading of autoimmune or vasculitis. These conditions generally require a biopsy for diagnosis. It's better to find out sooner than later because they can cause problems in other parts of the body. 2) Septal perforation: This is a hole in the mucous membrane that divides... more
Anand D. Patel, MD

Austin Facial Plastic Surgeon

www.freshfaceaustin.com

+2

Nosebleeds have many causes

The potential problems that can lead to recurrent nosebleeds (epistaxis) are numerous.  Common conditions include dryness, septal deviations, local irritation.  This problem may not be related to the previous surgery.  A competent Otolaryngologist-head and neck surgeon should evaluate your problem, and give you some advice.
Robert Mounsey, MD

Toronto Facial Plastic Surgeon

revesse.ca

+1

Saline gel for nose bleeds.

First, have a qualified otolaryngologist or plastic surgeon well versed in septoplasty and rhinoplasty evaluate your history and examine your nose. Nose bleeds often respond to saline nasal gel, over-the-counter salt-water-based gels for the nose. Use every night on both sides for at least two weeks. You can also use saline nasal spray 2-4 times a day. No picking. Have the doctor scope the inside of the nose (easy to do in the office) to look for a septal perforation or other issues. Hope... more
Steven Goldman, MD

Cleveland Plastic Surgeon

www.drgoldman.com

+1

Causes of Nosebleeds After Rhinoplasy

There are many potential etiologies of nose bleeds after Rhinoplasty.  Careful history and examination are the key to accurate diagnosis.  Some of the most prevalent causes include septal perforations (holes in the nasal septum) and thinning of the nasal lining.  Septal perforations require surgery to close the hole which prevents further crusting and bleeds.  Thinned nasal lining, secondary to multiple nasal surgeries, can dry out causing cracking and bleeding. ... more
Anthony Corrado, DO

Philadelphia Facial Plastic Surgeon
+1

Chronioc bleeding after rhinoplasty

There are so many potential causes for nasal bleeding years after rhinoplasty including thinned nasal lining, dry environments, retained permaneent sutures, small septal perforations, to name a few.  A thorough exam is important.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Frequent nose bleeds

There are several potential reasons for why you may be bleeding. This can be an extensive evaluation and may even involve treatment of high blood pressure. Occasionally, it can be easily treated with cauterization and other times it may require ligation of vessels. I think its time you should be evaluated again to search for treatable causes.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Chronic nosebleeds after rhinoplasty

Nosebleeds years after rhinoplasty probably are due to a thinned, atrophic nasal lining that cracks and bleeds.  If moisturizing doesn't work, then you may consider surgery to control the bleeding either through cautery (I prefer bipolar cautery for this) or by replacing the thinned lining with more lining.  This can be done by a skilled experienced surgeon with knowledge of septal perforation repair. 
Minas Constantinides, MD

Manhattan Facial Plastic Surgeon
+1

Suggestions for Post-Rhinoplasty Nosebleeds

Yes - mucopirocin (Bactroban®) ointment applied twice a day for a week will usually take care of this.
Jeffrey Epstein MD, FACS

Miami Facial Plastic Surgeon

www.plasticsurgeryoftheface.com

+1

Chronic scabbing and bleeding after Rhinoplasty

If this problem only appeared after you had nasal surgery then a thorough nasal exam should reveal the problem. Is the crusting and bleeding always located in the same spot - then look for retained permanent suture or partially exposed cartilage. Is it on the turbinate or the septum? Then look for prominences that dry out and lead to crusting and bleeding. Is it you? Sometimes chronic manipulation and trauma to the internal nose can cause the same symptoms. Bottom line - find an... more
Jon F. Harrell, DO

Miami Plastic Surgeon

www.westonsurgery.com

+1

Bleeding following rhinoplasty

Every time surgery is performed on the nose (whether primary or secondary) your normal tissue may be replaced by scar tissue.  Nasal blood vessels may be very close to the mucosal surface causing bleeding.  Additionally, if you underwent a turbinate resection, this impairs your nasal ability to humidify air upon inspiration.  This may cause mucosal bleeding and scabbing.  I would first return to your rhinoplasty surgeon.  He/she may be able to advise how to... more
Jason R. Hess, MD

San Diego Plastic Surgeon
+1

Bleeding after revision rhinoplasty

Whenever a patient says that they are having bleeding long after a rhinoplasty, it can send up red flags.  There a few very common reasons, and some uncommon reasons for bleeding.  The most likely scenario is as follows.  The lining of your nose is very much like your lips.  We all know that our lips can chap and bleed in dry weather.  Similarly if there is a knuckle of cartilage sticking out or a prominent vessel, this area can dry out and bleed.  The... more
Raghu Athre, MD

Houston Facial Plastic Surgeon

www.athresurgical.com

+1

Bleeding after rhinoplasty

  Bleeding after rhinoplasty can occur because of prominent blood vessels and or deflected septum.  The one thing that worries me is that you are also having crusting. I would suggest you get another evaluation and get a biopsy to make sure that you are not having an inflammatory problem and or fungal infections. While this is probably not the cause it is worth evaluating.
Carlos Wolf, MD

Miami Facial Plastic Surgeon
+1

Bleeding After a Rhinoplasty

Bleeding after a rhinoplasty from many years ago has several potential causes including but not limited to: prominent blood vessel deviation of septum- turbulent airflow can cause areas of dryness which can create bleeding septal perforation thinned mucosal lining- dissection in wrong plane can lead to abnormal thinning of septal lining. dry air- humidification of air and application of nasal lubricant can help allergies or sinus- blood can be found... more
Anil R. Shah, MD

Chicago Facial Plastic Surgeon
+1

Bleeding after rhinoplasty

I suggest you obtain another consultation from another ENT. The most likely cause is small dilated vessles on your septum. However, a thorough examination should be performed before a diagnosis of " a large airway" is given.
Andres Bustillo, MD

Miami Facial Plastic Surgeon

www.drbustillo.com

+1

Post Rhinoplasty nose bleeds

It is abnormal to have frequent nose bleeds after a rhinoplasty.  If you did not have this problem before surgery, then a congenital nose bleeding disorder can be ruled out.  There are some other causes for a nose bleeds, such as excess dryness, retained permanent suture, abnormal cartilage nidus, other foreign body, abnormal musculature, etc.  Make sure you are examined by an experienced and expert nasal surgeon.  You might have had excess turbinate resection, might have... more
Boris M. Ackerman, MD

Newport Beach Plastic Surgeon

www.doctorackerman.com

+1

Nose Bleeding Following Revision Rhinoplasty

Continued bleeding following prior nose surgery (rhinoplasty, revision rhinoplasty, and even septoplasty) should be evaluated by a nose specialist, particularly if it is this far out from surgery. Simple explanations for something like this include a prominent blood vessel involving the inner lining of the nose (called the mucosa). The nose is richly supplied with blood, therefore, any bleeding can be quite dramatic. Conservative treatment for this type of issue includes topical... more
John M. Hilinski, MD

San Diego Facial Plastic Surgeon

www.drhilinski.com

+1

Correction of the nose bleeds is possible after rhinoplasty

Correction of the nose bleeds is possible after rhinoplasty. Based on what you said, the ENT doctor might have diagnosed what is called Ozena which is when the nostril passages are so open, the mucosa dries out which can lead to crust formation, bacterial overgrowth and bleeding.  You would need a thorough exam to evaluate why you are bleeding.  You could have prominent vessels that is causing the bleeding that could be taken care of.  If it is ozena, you can reconstruct your... more
Philip Young, MD

Bellevue Facial Plastic Surgeon
+1

Chronic nosebleeds after rhinoplasty

Although uncommon, a possible risk after rhinoplasty is to have a nosebleed. In your case, you would best be served by being evaluated by a board-certified plastic surgeon with a great deal of experience in rhinoplasty and septoplasty. It is possible that you may be having some difficulty healing on the inside of the nose which can be creating some of the drainage and bleeding. An experienced plastic surgeon will be able to examine the inside and outside of your nose and help determine what... more
B. Pat Pazmino, MD

Miami Plastic Surgeon
+1

Nosebleeds years after rhinoplasty

Your scabbing and bleeding could be due to an area of chronic dryness, exposed piece of cartilage, or a permanent stitch that is eroding through. A review of your operative note would be helpful. An experienced surgeon should be able to tell what is going on.
Randy J. Buckspan, MD

Austin Plastic Surgeon
+1

Empty nose syndrome?

Crusting with or without nasal bleeding isn't common after rhinoplasty. When it occurs it usually means there were changes to the interior of the nose when the rhinoplasty was done. In other words a Septoplasty and possibly a partial turbinectomy were also done. There are several possible explanations. The septum may still be crooked or deviated. There may be too much space in the nasal channels. There may be a hole or perforation of the septum. Conservative treatment like what you... more
Oakley Smith, MD

Toronto Facial Plastic Surgeon

www.droakleysmithrhinoplasty.com

+1

Nose bleeds long after nasal surgery

Nosebleeds can be related to a nose that does dry out too much. There are many factors that cause a nosebleed and can be all addressed by an ear, nose, and throat surgeon. Acute bleeding is stopped with silver nitrate and packing if it is severe. If the nasal airway is so large that it dries out and never heals and continues to crust, this is related to some type of over aggressive turbinate surgery and septoplasty, not a rhinoplasty surgery. Abnormally enlarged nasal airways can cause... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Nose scabs and bleeding after Rhinoplasty Surgery could be from a septal perforation or nasal vestibulitis.

If you acquired a septal perforation after your Rhinoplasty Surgery, this will often lead to nasal dryness, crusting and bleeding. If you're experiencing painful scabs along the hair-bearing skin inside your nostrils that bleed with manipulation, then this may be a common condition called nasal vestibulitis. Vestibulitis is easily treated with topical hydrocortisone cream. You should consult a board-certified ENT for definitive evaluation and management. I hope this is helpful for you. more
Eric M. Joseph, MD

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

+1

Recurrent nosebleeds after rhinoplasty

You could try using a humidifier, but its obvious you have tried several methods that should clear up any minor issues that would cause the bleeding. I would have your nose re-examined with a board certified plastic surgeon who specializes in the nose and an ENT physician to figure out what can be done. It should definitely not take this long for a scab to heal. Best regards, Dr. Speron
Sam Speron, MD

Chicago Plastic Surgeon
+1

Dry nose treatment after rhinoplasty.

 Humidification and vaseline on the septum will improve this. You might see another ENT to make sure you don't have part of the septum sticking out into your airway inside your nose. Using a vaporizer in your bedroom can do wonders.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

Recurrent nosebleeds should be evauated by a doctor

Nosebleeds that persist following rhinoplasty, septoplasty or even without prior surgery should always be checked by a doctor. If you had surgery, see your surgeon. There are a number of ways to treat nosebleeds, from humidifiers to ointments to cauterization. A deviated septum can be a cause for nosebleeds as well as a number of diseases. Nosebleeds can rarely be the first sign of a more serious medical problem. So, if your nose continues to bleed despite simple measures, seek out an ENT... more
Steven J. Pearlman, MD

New York Facial Plastic Surgeon
+1

Recurrent Nose Bleeds (Epistasis) After Rhinoplasty

Hi Juneguy, You should be examined by a nose physician (ENT, facial plastic surgeon, or plastic surgeon familiar with the internal nose). Most common cause of chronic recurrent epistasis following rhinoplasty is a superficial blood vessel that will likely need to be cauterized. Your physician must make sure that there is no other problem causing your bleeding. You must keep your fingers and anything else smaller that your elbow out of your nose for your nose to heal without further... more
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+1

Bleeding after rhinoplasty

This sounds like something that needs to be re-evaluated and biopsied.  It's unusual to have a wound that won't heal after such a long period of time.  I suggest seeing another surgeon if your initial surgeon is not able to see you or cannot determine the cause of your bleeding.  Best wishes and good luck, /nsn.
Nina S. Naidu, MD

New York Plastic Surgeon

Ask a question