5 HOURS OF EXCESSIVE CONSTANT BLEEDING 10 days after Rhinoplasty. My surgeon doesn't know what's going on - please help!

Question

I had closed rhinoplasty 11 days ago. Since having the splint removed 5 days ago my nose has been bleeding every day in small amounts. When I woke up today my nose was bleeding heavily, fresh running blood & clots, it was also dripping into my throat. I went straight to the hospital to see nurse & wait for surgeon to arrive. Bleed continued for 5 HOURS, heavy flow with clots. I now have a pack up my nose and given Tranexamic Acid to stop bleeding. I can feel it is still bleeding.

Tanveer Janjua, MD · Answer

Significant nose bleed after a rhinoplasty usually happens from turbinate area and is located in the back part of the nose.  A posterior nasal pack certainly we'll stop that bleeding.  Within 2-3 days the area can heal and removing the nasal pack at that time is safe in most cases.  It is imperative to control the blood pressure and pain at that time to avoid recurrence of the epistaxis.  Any medication that can increase the chance of bleeding such as NSAIDs (aspirin, Motrin, Aleve), fish oil or vitamin E must be avoided.If possibly should see an otolaryngologist for nasal endoscopy under anesthesia for cauterization of the blood vessel that has been causing the bleed.RegardsDr. J

Stephen Prendiville, MD · Answer

This happens occasionally after Rhinoplasty, but can only be addressed by your operating Surgeon.  Some possible explanations include: any form of inferior turbinate reduction, a subtle coagulation disorder, excessive activity, or medications that affect platelet or clotting activity.  The timeline is suggestive of a clot or scab becoming dislodged in your nasal interior.  This is most common with turbinate reduction and can be controlled by cauterization of the sight and/or repacking the nose. However, this is not an internet diagnosis and it is always best to see your Surgeon for acute or subacute postoperative problems.

Grady B. Core, MD · Answer

It sounds like you had more than a closed rhinoplasty and likely had septal work as well. While it is common for a little bleeding to occur, when you have clots, and it is going on for 11 days, that's more than usual. However, 99% of the time the pack is successful. If you are continuing to have significant bleeding episodes,  it would be helpful to do an exam under anesthesia and see if the focus can be located and cauterized. The work up of a coagulation disorder is in order to rule out Von Willibrands and other types of such underlying issues. I assure you that your surgeon may not know exactly where the bleeding focus is at this time as this is unusual, but he does know "what's going on" and can handle it so just stay in close touch with your surgeon and you will be fine.

Darryl J. Blinski, MD · Answer

Sounds like a posterior arterial injury in the nose that needs posterior nasal pack and possible ICU observation....

Michael Bublik, MD · Answer

It is best to have close follow up with your surgeon regarding this matter, however this happens on occasion especially if a septoplasty and turbinate reduction was performed at the same time.  It is usually from a small piece of scar tissue or crust falling off from being too dry and underneath it there are blood vessels that have a tendency to bleed.  This will rarely affect your rhinoplasty result, but can be uncomfortable and frightening.

5 HOURS OF EXCESSIVE CONSTANT BLEEDING 10 days after Rhinoplasty. My surgeon doesn't know what's going on - please help!

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Answer: 5 HOURS OF EXCESSIVE CONSTANT BLEEDING 10 days after Rhinoplasty. My surgeon doesn't know what's going on - please help!

Answer: 5 HOURS OF EXCESSIVE CONSTANT BLEEDING 10 days after Rhinoplasty. My surgeon doesn't know what's going on - please help!

Answer: Bleeding after rhinoplasty

Answer: Bleeding after rhinoplasty

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5 HOURS OF EXCESSIVE CONSTANT BLEEDING 10 days after Rhinoplasty. My surgeon doesn't know what's going on - please help!

Answers (7)

Answer: 5 HOURS OF EXCESSIVE CONSTANT BLEEDING 10 days after Rhinoplasty. My surgeon doesn't know what's going on - please help!

Answer: 5 HOURS OF EXCESSIVE CONSTANT BLEEDING 10 days after Rhinoplasty. My surgeon doesn't know what's going on - please help!

Answer: Bleeding after rhinoplasty

Answer: Bleeding after rhinoplasty

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