What should I do to remove/prevent blood clots and coagulated blood in my nose after Rhinoplasty? (Photo)

Question

I had a rhinoplasty a 8 days ago, and the bandages were removed 2 days ago. Last night, I woke up feeling like I was drowning. It turns out, I had a blood clot in the back of my nose, and blood was just pouring out of my nose. I kept swallowing and the next morning, the effects of drinking blood definitely hit me. I pulled this out of my nose, and controlled the bleeding with Afrin. Today, I can feel the blood hardening at the side of my nose. What should I do to prevent a relapse?

Stephen P. Smith, Jr., MD · Answer

Certainly,
any vigorous bleeding beyond an ooze deserves your surgeon's attention. In
order to remove clotted blood in the nose, I recommend gentle nasal saline
irrigation using saline irrigation devices that are available over the counter.
You may use this multiple times daily. This will help soften and displace nasal
crusting and will provide moisture to your nasal mucosa (this has the added
benefit of reducing the risk of subsequent nose bleeds). In order to prevent
further episodes of epistaxis I recommend keeping a humidifier in your bedroom,
applying a small amount of coconut oil or aquaphor to your anterior nares twice
daily, and avoid blowing your nose too harshly.

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

Congratulations on your procedure and thanks
for sharing your question. I can appreciate your concern.
Some times bleeding is the result of very dry mucosa. Keeping
a vaporizer in your room may help. Irrigations with Normal saline before going
to sleep and Vaseline or bacitracin might keep the moisture inside your nose
for longer periods of time.
Finally, make sure that your doctor is
aware of your process. She/He should be able to guide you best in your care.

Wishing you the best in your journey

Arfat Jawaid, MBBS, FCPS · Answer

Hi. Let me answer your question in two parts.What to do if there is a nose bleed after rhinoplasty? It's rare to have nasal bleeding episodes after a rhinoplasty. With better surgical techniques we can even avoid putting uncomfortable nasal packs inside the nose. However just in case, if such an episode happens one should sit upright and pinch the nose with thumb and index finger. Sitting upright will prevent blood going into the trachea/airway and manual pressure will prevent bleeding. If it doesn't stop the bleeding in ten mins then rush to the nearest hospital and keep your nose pinched on the way to prevent blood loss.What to do to prevent hardening of clots/crust formation in nose and prevent further bleeding episodes? You are right in that the blood clotted inside the nasal cavity will become hard and it may bleed again when clot is removed. To break this viscous cycle we need to moisten the clots/crusts by frequent irrigation of nasal cavities with plain water or saline. In this way clots can be removed gently without further bleeding. I hope it proves helpful for you. Regards

What should I do to remove/prevent blood clots and coagulated blood in my nose after Rhinoplasty? (Photo)

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What should I do to remove/prevent blood clots and coagulated blood in my nose after Rhinoplasty? (Photo)

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