6 Months Post Rhinoplasty with Osteotomies - Still Bleeding and Cannot Breathe

Question

I am exactly 6 months post-op from a closed Rhinoplasty. My surgeon took down the dorsal hump, removed cartilage from the tip and performed lateral osteotomies. Since the surgery, my nose bleeds everyday - not a lot but enough to be annoying. Mostly when I blow my nose or feel like I have to clean it out. Also, when I lay down at night, I cannot breathe out of my left nostril. Is this normal? I cannot post my pictures b/c I work for a plastic surgeon.

Babak Azizzadeh, MD, FACS · Answer

Make sure your nose is lubricated appropriately with Vaseline and saline rinse. Still should wait a full year but your breathing issues may persist. You can also email me pictures privately.

Michael L. Schwartz, MD · Answer

Changes in airflow direction after rhinoplasty can cause dryness and stuffiness. At six months though you need to be checked to be sure you don't have some nasal vestibulitiis. This is a localized bacterial colonization which acts like a low grade infection with persistent crusting, bleeding and stuffiness. share your concerns with your surgeon and if necessary see an otolaryngologist that he/she works with.

Peter E. Johnson, MD · Answer

The typical congestion after rhinoplasty will clear after several weeks. Breathing problems after six months have to be fully assessed. A poor airway is a risk of the procedure, and generally the issue can be tracked down to specific causes such as persistent deviation of the septum, or compromise of the nasal valve with in-fracture or tip reduction. You can start with your surgeon if you have confidence.
	Best of luck,
	peterejohnsonmd

Richard W. Fleming, MD (retired) · Answer

Daily bleeding 6 months after rhinoplasty is never normal. Consult with your surgeon or get get a second opinion. Your breathing obstruction can be evaluated at the same time.

Francis R. Palmer, III, MD (retired) · Answer

Blowing your nose and other maneuvers to clean out your nose is most likely creating continuous irritation and swelling to the nasal mucosa (inside linning). Have your Rhinoplasty surgeon examine the inside of your nose or refer you to an ENT surgeon for examination and recommendations. What you describe is not a normal thing after Rhinoplasty, IMHO.

Michael Elam, MD (retired) · Answer

Sometimes after having the nose reduced especially with osteotomies the nose is narrowed. While you may not start out with breathing difficulties the surgeon needs to address the turbinates and/or septum to allow proper breather after the thinning of the nose caused by the rhinoplasty. You still have swelling that may be adding to this problem. You should not still be having bleeding this far post op and I would discuss this with your surgeon. You may have some dryness which could be helped with a saline nasal spray and I would discuss this with your surgeon as well. It  is important when fixing the nose cosmetically that you also make sure that the breathing functions are fixed at the same time to avoid this after surgery. I am 
not sure how you are cleaning your nose out...I would have your surgeon do that and make 
sure you are not aggravating the situation by possibly putting cutips in your nose. Best regards and hopefully time will help dissipate your current problems.

6 Months Post Rhinoplasty with Osteotomies - Still Bleeding and Cannot Breathe

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