How is bleeding controlled during rhinoplasty?

Bleeding the enemy of the surgeon during a rhinoplasty.  I take steps before going to surgery to prevent bleeding.  I have a list of medications and foods I have all of my patients stop taking 2 weeks before surgery.  Before going back to surgery, I have patients ice their nose to slow the blood flow to the nose.  

 

In surgery, the throat is packed with gauze to prevent blood from running down into the stomach or in the trachea.  At the end of the case, the stomach and throat is suctioned cleaned to remove any blood that may be in that location.

 

During surgery, the nose is injected with medication to prevent bleeding and I keep the blood pressure low during the surgery.  With these maneuvers  I typically have very little bleeding during a rhinoplasty in my office in Charlotte.  

The answer to this question really depends on what type of anesthesia that is used to perform your rhinoplasty.  I typically use general anesthesia and we place a packing in your mouth and throat to prevent you from swallowing any blood.   We also pass a tube into your stomach while your asleep to remove any additional blood.  If you are not having general anesthesia, the packing is not used although the tube in the stomach may be passed depending upon your surgeon and anesthesiologist.

Other than that bleeding is controlled as it would be in any other surgery through cauterization and use of medicines that cause the blood vessels to clamp down preventing blood from leaking. 


Best of luck with your surgery.

Aspiration is typically not a risk because it is something that a rhinoplasty surgeon carefully controls. The first step is to prevent bleeding from occurring. This is achieved by proper injection of local anesthetic containing epinephrine which minimizes bleeding. The second step is to operate in the proper tissue planes which are typically bloodless. The final step is to use careful cautery to stop any bleeding that does occur. We also typically place small cotton pads in the nose to soak up any bleeding before it reaches your airway. Rhinoplasty is very safe in experienced hands.Stephen Weber MD, FACS