Considering Rhinoplasty: Does Surgery Make You Sick?

I am considering Rhinoplasty, and I was wondering how much blood do you lose down your throat during and after surgery, and whether it made you sick feeling after you woke up?

Doctor Answers 11

Blood can be upsetting to the stomach

In most rhinoplasties patients lose 30 to 50 cc of blood, which is equivalent to 3-5 little tubes of blood. Local anesthetic is placed inside the nose while the patients are asleep to prevent most bleeding from occurring. Occasionally, when patients are awake in the postoperative phase, some blood is swallowed. This blood going down the back of the throat can be upsetting to the stomach causing nausea and vomiting. The nausea and vomiting usually subsides once the bleeding stops. Sometimes Afrin nasal spray in the immediate postoperative period will stop the bleeding, helping to alleviate the nausea and vomiting.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty and Bleeding

Thanks for the question -

Typically blood loss for rhinoplasty is typically minor. A throat pack can be used to catch blood that goes down the nasopharynx and patient's can also be suctioned at the end of the procedure to get any additional blood.

In addition, medications to cause vasoconstriction of the blood vessels in the mucosa also significantly lower the amount of bleeding.

As some of the other doctors have mentioned nausea can be caused by many sources including, most commonly, anesthesia. Anti-nausea medications given orally, by IV or topically can be a very effective way to combat this and a careful discussion of nausea prevention should take place with your surgeon and anesthsiologist.

I hope this helps

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

If proper precautions are taken, you should not be sick or swallow blood after your Rhinoplasty

Dear Jesse,

That is a great question. Since Rhinoplasty does cause some bleeding it is easy for the blood to trickle down the back of your throat.

However, proper Rhinoplasty technique involves placing a gauze pack either back in the throat (if you are asleep for the operation), or in the back of the nose (if you have local anesthesia and are awake.)

These gauze packs prevent blood from trickling down the back of your throat and are very helpful at preventing the swallowing of blood during Rhinoplasty.

You are correct , swallowing blood during Rhinoplasty can make you sick.

However, the narcotic analgesics (pain killers), and anesthetics given for general anesthesia can also make you sick if your procedure takes a long time.

We use anti-nausea medications such as Zofran, and a skin patch (Scopolamine patch) placed on your neck that help prevent nausea and vomiting.

If your nose is packed, you are given the proper anti-nausea medications, and your procedure is done quickly, (less than 2 hours), it is very likely that you will not get sick after your Rhinoplasty, in my opinion.

Rhinoplasty is one of the most challenging plastic surgery operations we do. I recommend you consult several doctors and choose a very experienced doctor who can show you excellent results in pictures of patients he/she has operated on in the past.

A more experienced surgeon who is interested in Rhinoplasty will likely give you a better result and your surgery should go more quickly.

Blood loss is minimal

Dear Jesse,

As was said by others, we use a special material to minimize the flow of blood into the back of your throat. We also use nasal packing either temporarily for the surgical procedure or in rare cases for a few days after surgery to stop any bleeding.

Most patients experience minimal pain after a rhinoplasty surgery. If I ever have a complaint about discomfort, it is usually from those patients who have had packing left in their nose after the procedure.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

Need an experienced surgeon AND anesthesiologist

Postoperative nausea after rhinoplasty can be significantly reduced by minimal blood loss during the procedure. Bleeding, a minimal amount is normal during the procedure, from the nose can be swallowed during the procedure which will causes nausea.

In addition, there is a method for predicting postoperative nausea termed the Apfel Score. If you are female, have a history of motion sickness/postoperative nausea, nonsmoker, and postoperative pain medication is planned, you are much more likely to have nausea.

An experienced anesthesiologist will help perform a few measures to decrease the chance of this occuring.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 162 reviews

Nausea is the side effect of anesthesia

Most plastic surgeons use throat packs, and this prevents any blood going down the throat and the amount of bleeding is minimal. You may want to take some medications preop for nausea. Please discuss your concern with your surgeon.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Rhinoplasty Bleeding and Recovery

Rhinoplasty is a surgery that is very well tolerated. Patients usually feel good within a day after surgery and there is little to no pain.

During rhinoplasty there is usually very little bleeding. The things that might create more bleeding are septal surgery, turbinate surgery and more aggressive bone work that is required for very crooked noses.

Certain types of anesthesia may also be associated with less bleeding and post-operative nausea. I prefer twilight or sedation anesthesia for that reason. But you have to have a good anesthesiologist in order to do it right.

Cosmetic healing takes longer than the feeling good healing. Usually patients take 7-10 days before they feel socially acceptable to interact with others.

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 51 reviews

Blood loss is minimal

Jesse06, During rhinoplasty, just as any surgery, you will have minimal bleeding. During the rhinoplasty procedure packs are placed in your nose which help collect the drips of blood from going into your throat. Additionally, at the end of the surgery, your surgeon or anesthesiologist will such any remaining fluid out of your throat. However, after surgery you have some dripping down the back of your throat that goes into your stomach. This is completely normal. You may have mild nausea, but there are medications that help control this. These issues are not a reason to avoid rhinoplasty, they are just a consequence of having surgery. Good luck with your procedure. David Shafer, MD New York City

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

This is rarely any problem for rhinoplasty patients


Rhinoplasty, in general, has very little blood loss when done correctly. Moreover, many surgeons will place some packing in the back of the throat during surgery so any blood loss that does occur does not go into the stomach. Still others will place a small suction at the end of the case to remove any blood that was swallowed during the procedure. So this should not be a real source of concern for you.

Even if none of this is done, in general, most patients do not feel much nausea after this procedure. I hope this helps relieve you of any anxiety. If you have any more specific questions, feel free to let us know.

Warm Regards,

Peyman Solieman, MD

Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Minimal Bleeding From Rhinoplasty

Hi Jesse,

A little blood letting is a good thing; it has been practiced for thousands of years in medicine. Just kidding, we have improved our medical treatments in the past hundred years.

You need not concern yourself with blood going down your throat during rhinoplasty. When performed by a well trained competent experienced rhinoplasty surgeon there is very little bleeding. Once you are under anesthesia, a laryngeal mask airway (LMA) is placed into your mouth. The LMA sits at the base of your tongue (back of your throat) and prevents blood from going into your stomach or larynx. Whatever blood that does accumulate is suctioned from the nasal passages.

The surgeon can minimize bleeding by properly placing local anesthesia with epinephrine causing constriction of blood vessels. Also by operating in the proper surgical plane bleeding is minimized.

Lastly, if there is any doubt, the anesthesiologist can suction your throat and stomach before you wake up. There are also medicines that they can give you to minimize your chances of being sick in the recovery room.

Choose your rhinoplasty surgeon most carefully. It's your nose, in the middle of your face, for the rest of your life.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.