Could Drainage PO Be Necrosis or From Smoking?

Hi. I stopped smoking 2.5 weeks before surgery, and "cheated" here and there. The Park Ave. DR knew all about this and cleared me for surgery. I bled a bit more than I would have expected after the surgery, and the bleeding only stopped today (so 48 hrs later). I saw the nurse and she said I am fine, but I am scared that this bleeding could be a sign of necrosis. Even though it has stopped it has gathered in one nostril, and I am nervous to clean it out.

Doctor Answers 6

Bleeding post rhinoplasty

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Bleeding is not a sign of necrosis. Nostrils need to be cleaned to avoid infection. Smoking can be very dangerous so please hold off till you are out of the woods with your surgery.


Dr. J

Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Come on now!

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You knew how important stopping smoking was, but decided to "cheat" and now you want reassurance? It's too late for you now, but for other patients who read this and think it's OK for them to "cheat" because the Dr. "knew about this and cleared me for surgery," should learn a lesson.

Sure, I know how difficult it is to stop such an addictive habit, but you requested and paid Park Avenue prices for ELECTIVE surgery, and expected your surgeon to bring his "A" game in terms or skill, training, attention to detail, and expertise to the operating room for YOUR operation, didn't you? I'll bet you even wanted him well-rested, not distracted, and certainly not impaired or even hung over!

Was it unreasonable for your surgeon to expect you to follow simple and direct guidelines for safe surgery? DId you perhaps take an aspirin even though that was specifically prohibited as well? Maybe that's what caused your bleeding, or maybe it was simply your elevated blood pressure once you started worrying about not following directions.

It's not considered politically correct for surgeons to "chew out" our patients, even when they think paying us allows them to do really stupid things, and of course we are expected to "fix" the problem(s) if/when they occur. Usually for free. Or with an indignant patient threatening a lawsuit. Shame on you!

But enough ranting. At least you were honest (anonymously, online); but you owe your surgeon that honesty in person. Knowing that we too are imperfect human beings, I suspect that it will go better than perhaps you worry about.

And no, as others have said, your nose is probably "fine." Fortunately, the blood supply to the face and nose is quite good. Not so much so for a facelift, breast lift, or tummy tuck. Had you undergone one of these procedures, you might have given yourself a 15-20% risk of dead skin! But your nose is probably all right. DO NOT remove your nasal splint to "find out" if things are OK. You could wreck your result in another completely different way! No kidding!

For everyone else; please follow your surgeon's directions. It's your nose/breast/belly button, or cheek that will end up with dead skin. And that's not a very good cosmetic result, even after the wound care, debridements, and possible skin grafts or scar revisions.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Rhinoplasty questions about healing

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Bleeding after a rhinoplasty is normal and is not a sign of necrosis.  Necrosis is very unusual following a rhinoplasty.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

You do not have necrosis after rhinoplasty.

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It would be extremely rare for rhinoplasty to generate soft tissue necrosis even in a heavily active smoker. Keep your follow-up appointments and everything should be fine.

Rhinoplasty and bleeding

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Some blood in the nostrils can be normal after rhinoplasty. It is best for you to be seen by your surgeon to be evaluated.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Eventually the Smoking Will Cause Issues

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Only an examination can define your problem. I would advise you to stop smoking before you definitely because a complication secondary to tissue loss. It is in your control.

Dr. ES

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.