Bruise/discoloration/redness on nasal bridge? Please help, I don't have access to my surgeon. (photos)

Question

I had an open rhinoplasty done over four weeks ago abroad. When my cast was removed on day 12, there was bruising on nasal bridge where I think graft was used. Doctor prescribed antibiotics for 5 days and triamcinolone ointment to apply to the area once a day and tape the nose for 6 weeks. bruising is much less now but still some redness there. I don't have access to my doctor and he doesn't answer my emails. What is this due to and what should I do? should I continue using triamcinolone, thanks

David Gilpin, MD · Answer

Thank you for your question.  At 4 weeks post-operatively, it is not uncommon to have swelling and bruising/redness, especially in the areas where a graft was placed.  This should resolve with time, and all swelling can last anywhere from 6 months to 1 year to fully resolve.  I would continue to follow the post-operative instructions from your surgeon.  If you are unable to contact your surgeon, I would suggest meeting with a board-certified facial plastic or plastic surgeon who specializes in rhinoplasty, if this redness does not fully resolve. I hope that this helps!-David Gilpin

Ira D. Papel, MD · Answer

Four weeks is still a short time after your surgery. Bruising or redness may persist for several weeks, so don't panic yet. Give it some time to settle down. If after a few months the coloration is still present consult with an experienced rhinoplasty surgeon and see what can be done to help. laser treatments can be used to reduce redness or purple persistence.

Michael M. Omidi, MD, FACS · Answer

Thank you for the question! It is difficult to fully evaluate your situation without an in-person exam. In all likelihood, you are still experiencing swelling, which is not uncommon after rhinoplasty. Typically, it takes 2-3 weeks for most bruising and post-operative discomfort to resolve, and 6-12 months for swelling to completely subside. Until this process is over, you may observe some discoloration and other irregularities. The fact that your bruising is subsiding is a great sign. 
At 12 days post-op, it's much too early to observe final results of your procedure.  I'd advise giving it some more time for your nose to "settle" and alert your plastic surgeon if you experience increase in swelling.   
An in-person exam with a board-certified plastic surgeon would be the best way to assess your situation and guarantee an individualized medical advice. Best of luck!

Summit Kundaria, MD · Answer

from Nz,
Thanks for the question and pictures.  I think that the best course of action is to give this time.  Your surgery was not very long ago (in terms of rhinoplasty recovery), and if you had grafting to the area in question, you may have had a little blood in that area that is just slow to resolve.  The safest thing is to not manipulate this, and to give it time.  There is no intervention that is safer than giving this a few more weeks to recover.  Good luck!

Darryl J. Hodgkinson, MD, FACS, FRCSC (retired) · Answer

Bruising after 4 weeks is a little longer than expected.However you said it is resolving so continue to follow the instructions.You should also continue to try and contact your surgeon or his office for advice and support..Redness is the inflammatory phase of healing and usually takes approximately 6 weeks to resolve.

Juris Bunkis, MD, FACS - Account Suspended · Answer

Sorry to hear that you are having problems and cannot reach your surgeon.    That is a not uncommon problem with procedures done abroad - not worth the savings, in my mind.    But what you have this soon after a major procedure is pretty normal.   I would not use the triamcinolone any more - it can thin your tissues and actually delay healing.    The bruises will go eventually.    And the swelling will take a half a year to get down to normal.    Go see a local surgeon, pay him or her something to be fair, and have them follow you.

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