Can Flonase (Fluticasone Propionate Nasal Spray) Actually Cause More Swelling After Rhinoplasty?

My plastic surgeron gave me Flonase (Fluticasone Propionate Nasal Spray) for swelling after my rhinoplasty. I was using it for a month and half and my nose seem to swell worst every week. So i decided to stop using it and my nose seem to not be as swollen. I am confused because i thought the Flonase (Fluticasone Propionate Nasal Spray) suppose to decrease swelling not actually cause it. I also notice even if i use a saline nasal spray my nose swell. Is this common/normal?

Doctor Answers 4

Flonase and saline safe after rhinoplasty

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Flonase is very safe after rhinoplasty, and is not expected to cause swelling.  The active ingredient, fluticasone, is in truth supposed to reverse swelling.  However in less than one percent of patients, the medication can cause irritation or swelling.  That may be your situation, a reaction or intolerance to either the medication, the "vehicle" that helps deliver the drug, or preservatives.  If you feel better off of it, logic should tell you not to use it or look for an alternative.

Saline is more safe, provided it's pH balanced and isotonic, meaning concentrated appropriately for our cellular interations.  If you are responding to store purchased saline, check to see if it is listed as preservative free.  If not, you might be reacting to topical preservatives.  You might also consider making your own saline solution, or purchasing a Sinucleanse/neti pot at your local pharmacy (they include packs of preservative free saline for reconstitution).  That would still provide the soothing, healing properties of saline without the preservative risk. 

Flonase and Saline Causing Nasal Swelling after Rhinoplasty

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Flonase and saline should not cause intra-nasal swelling after rhinoplasty surgery. Consult with your surgeon who can evaluate your nose and determine the cause of your nasal obstruction.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Flonase Should Not Cause Nasal Swelling After Rhinoplasty

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Hi Brown,

Best to address  your concerns to your rhinoplasty surgeon.  Your surgeon can examine your nose with the knowledge of what has been done to it.  It is not normal for the nose to swell after either Flonase or nasal saline spray.  Empirically it seems that not using the sprays is doing better for you than using them.  Good luck, be well, and hope that you love your new nose.

Dr. P

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

Nasal sprays can be irritating immediately post rhinoplasty

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Flonase is a type of nasal steroid that is used to treat swelling inside the nose caused by rhinitis.  One of the side effects, especially if used incorrectly, is to cause irritation inside the nose.  I usually instruct my patients on how to spray it, in an outward manner towards the cheeks rather than in the mid line where it can irritate the septum of your nose.  I like to have my patients wait at least 2 weeks before resuming their Flonase.  I have not heard of using Flonase post operatively to reduce swelling if the person is not allergic.  The fact that Saline irritated your nose tells me that it may still be raw from healing or raw from the Flonase.  Apply Vaseline ointment to your nose 2 to 3 times a day and the irritation will settle down.

Good luck

Ran Y. Rubinstein, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 156 reviews

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