How Do I Minimize Bruising from a Rhinoplasty?

Hi,At my office, we use a product called Ocumend by Cearna.  They are patches that have high concentrations of Arnica and really work to reduce the bruising significantly.  Usually at the one week follow up, most of the bruising is gone.Best,Dr. Nima

Thank you for your question.  In my experience, most of my patients have very minimal bruising, although this is not the case for everyone.  Surgeon technique, patient medical history (bleeding tendency), patient age, need to fracture nasal bones and patient medications can all contribute to the presence and severity of bruising post-operatively.  To help minimize bruising risks, I typically recommend that my patients stop taking all non-necessary medications (including multivitamins, vitamin e, aspirin, ibuprofen, anti-inflammatories, herbal supplements, etc...) that can thin the blood.  I also recommend that patients take arnica and bromelin, which can provide patients with some bruise limiting benefits.  In the immediate post-operative period head elevation and ice packs are also helpful.  I would definitely recommend following up with your chosen board-certified operating plastic surgeon to discuss their specific pre- and post-operative protocols and any bruise reducing tips.  I hope this helps and best of luck!

The only nonsurgical option that reliably helps is fairly continuous icing for up to 8 hours after surgery. Careful attention surgically to precise osteotomies also helps. Discuss your concerns with your surgeon. In my experience in the last several years, there is only trace bruising after a week which can easily be hidden by makeup. This contrasts to my training, and early years in practice when bruising was more extensive, due to less attention to minimizing soft tissue injury with the osteotomy.

Hi from Istanbul, thanks for this question. Bruising after a nose job is influenced by various factors, including the surgeon's expertise and the patient's unique anatomy. To significantly reduce the risk of bruising, we focus on five key aspects during surgery:
1. Applying an effective local anesthesia is crucial for minimizing bruising.
2. We strive to maintain the patient's blood pressure at the lowest safe level during the procedure.
3. The dissection of the nose is performed at the deep plane with precision instruments to ensure minimal tissue trauma.
4. In shaping the nasal bones, we employ extremely delicate and precise tools to prevent excessive bruising.
5. Throughout the surgery, cold irrigation is used to constrict blood vessels, significantly reducing the likelihood of bruising.
These strategies combined can prevent bruising for the most part. However, if post-op bruising does still occur, its progression can be effectively managed with cold compresses and by keeping the head elevated. Additionally, for patients with hypertension, continuing their blood pressure medication is advised to aid in reducing bruising. Discontinuing the use of certain medications, supplements and herbal teas before and after surgery may be required, so it is also paramount to share this information with your surgeon. Best of luck to you!

Hello and thank you for your question. I always advise my patients to take arnica and bromelain 10 days before and 10 days after surgery for a total of 20 days. This is not a miracle cure, but it can help. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thank you for your question. With the latest Piezo technique, we expect minimal bruising after rhinoplasty surgery. However, some patients with sensitive skin still get bruised after their operation. I recommend keeping your head elevated for 4-5 days after the surgery which significantly helps reduce swelling and bruising. Eating pineapple, drinking pineapple juice, and applying ice also help with bruising and swelling. I ask my patients to stop taking blood thinning medication such as aspirin and stop drinking herbal teas including green tea 10 days before their surgeries to eliminate bruising as well. Make sure you listen to the directions your surgeon gives you carefully. This will help your recovery process. Good luck.

Bruising is a common concern after rhinoplasty. The extent of the bruising often depends on the type of surgical approach your surgeon chooses to take for your rhinoplasty. Oral arnica is a supplement that may help reduce the amount of bruising, and I usually advise my patients who are interested in trying this to take it for a week after surgery. Avoiding alcohol the week prior to surgery can also help reduce bruising. Additionally, I advise my patients to avoid medications that can thin the blood such as NSAIDs (ibuprofen, also known as Advil, and naproxen, also known as Aleve), aspirin, and Excedrin (which contains aspirin) for 2 weeks before and 2 weeks after surgery to decrease the risk of bruising. 

Gary Linkov, MD
Rhinoplasty Specialist
Manhattan

Depending on the amount of work being performed, bruising and swelling are an inevitable part of rhinoplasty surgery.  I recommend several things to my patients to minimize the amount of bruising and edema:1. Start taking Arnica tabs 2 days prior to surgery and continue for 5 days after2. Use ice packs to minimize swelling every 20 minutes while awake for the first 48 hours after surgery3. Sleep with head elevated at 30 degrees while sleeping on your back4. For persistent bruising, an IPL can often be used to help "break up" the stubborn purple pigment

thank you for your question,
*It is important that you stop taking multivitamins or aspirin two weeks before surgery* After the surgery you can apply ice packs* at the time of sleeping the position is also important, try to use several pillows to elevate your head * you can apply arnica cream three times a day* Vitamins like, Bromelain, Quecetin and vitamin C will help to reduce bruising

The extent of bruising after rhinoplasty surgery depends on a number of factors including the techniques used by the surgeon, if the patient was taking any medications or supplements before surgery, and what restrictions the patient follows after surgery. If bony osteotomies are performed at the time of surgery I tell patients to expect some level of bruising for the week after surgery. Rarely this can extend to two weeks following surgery. Icing around the nose, head elevation and even some post-operative supplements and lasering may help to minimize the visibility.Be sure to have a thorough discussion with your surgeon to strategize the most effective way(s) to minimize bruising after surgery. Good luck!