1 year post op and still dealing with a leaky nose - what could be causing this and how can it be corrected?

A runny nose after rhinoplasty is more common than you think. In general, when this happens, we recommend treatment of the symptoms. This may involve a topical nasal antihistamine spray. If the liquid is clear and dripping out of only one nostril like a faucet, a CSF leak should be ruled out. I hope this helps. Sincerely, Dr. Joseph

Although some rhinorrhea (runny nose) after a rhinoplasty is not unusual but continuous running nose of concern. Most likely it is still allergy related but this could in some cases indicate a CSF leak. That is the brain fluid that can leak from base of skull. When we break the bones during a rhinoplasty the fracture can sometimes extend into the roof of the nose which is the base of the skull. That can cause leakage of CSF. This can lead to meningitis in some cases. It is imperative that you get checked for that by a competent Endoscopic Sinus Surgeon who is fellowship trained and knows how to diagnose the CSF leak and repair it as well.
Regards
Dr. J

Thank you Kari for posting your question here!Let me start by stating that my answer is based on the little information provided for a more detailed answer and a bespoke plan please consult with your plastic surgeon.
I am sorry to hear that you are dealing with this issue a year after your surgery. I am alarmed by the symptoms you are describing and I would urge you to contact your surgeon in a more urgent manner especially if the fluid leaking is clear.
Though rare, CSF (cerebrospinal fluid) leaks can happen with rhinoplasties as the brain and the nasal cavity are separated by a thin bone through which the olfactory nerve (nerve that is responsible for the sense of smell ) perforates . If this bone is injured it can lead to a communication between those spaces , through which CSF can leak. This usually presents as a leak of clear fluid which can be positional. This will also provide a route for bacteria to migrate to the areas surrounding the brain and can cause infections such as meningitis.
That being said a simple test can confirm the diagnosis or refute it. You could be having a totally different issue that might not be as urgent or alarming but given the dire consequences should the diagnosis be CSF leak I would urge you to seek medical attention.
I hope this helps , best of luck!

While it is normal to experience a runny or leaky nose for a few weeks following rhinoplasty, persistent leakage beyond the initial recovery period could indicate other underlying factors. One possible cause is vasomotor rhinitis, a condition where the nasal passages become overly reactive to various triggers, such as temperature changes, humidity, or even changes in body position, which can lead to excessive nasal drainage. Unlike allergic rhinitis, vasomotor rhinitis is not triggered by allergens but rather by abnormal nerve responses in the nasal passages.
If vasomotor rhinitis is suspected, treatment options may include nasal sprays (such as anticholinergic or corticosteroid sprays), which can help reduce nasal secretions, or other medications that help manage the symptoms.
Other potential causes of leaky nose may include residual inflammation, changes in the nasal mucosa, or disruptions in the normal nasal drainage pathways. In some cases, conditions such as non-allergic rhinitis or sinus-related issues can also contribute to prolonged nasal drainage.
It would be advisable to consult with your surgeon or an ENT specialist to assess your symptoms thoroughly. They can evaluate your nasal anatomy and function, perform any necessary diagnostic tests, and recommend appropriate treatments based on your specific condition. Management options may range from medical treatments, such as nasal sprays, to surgical interventions if structural issues are identified.
I hope this information helps clarify the potential causes and encourages you to seek a comprehensive evaluation for the best course of action.

There is a nasal spray called atrovent which can be used to deal with nasal drainage. Thus occasional happens folowing rhinoplasty

I runny nose can continue for six months or sometimes longer. Keep track of if this is slowly improving or not and let your surgeon know.
Your best option is to follow up with your provider.
Best,
Mats Hagström MD