Profuse Nose Bleeding After Rhinoplasty

Hi, I had my rhinoplasty done 3 years ago. I remember having profuse bleeding the 4th day after surgery and the doctor told that the healing did not happen properly and packed my nose again. After 3 days he applied silver nitrate on the bleeding site. Every once year I do get mild nose bleeding. Is this cause of the surgery or some other factors such as dry nose etc. Thanks

Doctor Answers 10

Severe bleeding after rhinoplasty

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Some bleeding is expected after nasal surgery for the first few days. Excessive bleeding occurs when the mustache dressing is soaked through with blood every few minutes. This happens about 1% of surgeries. Severe bleeding is when blood is pouring out or down the throat and is very rare. Bleeding usually happens within the first two days but is possible for the first few weeks. Bleeding of this degree requires professional help and a trip to the emergency. Usually further surgery isn't necessary. Rather complete cleaning of all blood clots and copious decongestant nasal drops will resolve the bleeding. The two commonest areas are the turbinates and the very back of the nose where the large arteries enter the nasal cavities.

Bleeding after Rhinoplasty

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Bleeding months and year after rhinoplasty is likely due to dryness of your nose.  There may have been some trauma to the mucocilliary transport mechanism that is inherent to the internal structures of your nose.

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Is a Serious Nose Bleeding After Rhinoplasty RELATED to recurrent yearly nose bleeds?

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There are many reasons for profuse bleeding during and after nose surgery related to either an anatomical anomaly, unrecognized or poorly controlled intraoperative bleeding or surgical technique. Serious bleeding does not stop by itself and needs to be stopped. The fact that you have not bled continuously since your surgery and have yearly bleeding episodes suggests it is not caused by original surgery. I would be examined endososcopically by a good ENT surgeon to asses the location of the bleeding and look for potential causes of the bleeding.

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Recurrent nosebleeds

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I agree that you need an endoscopic nasal exam by an ENT or facial plastic surgeon to identify a possible source

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Bleeding was severe after Rhinoplasty

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  It's possible that one of the blood vessels supplying the nasal septum was the cause of your severe nose bleed during the 4th post op Rhinoplasty day.  Silver nitrate is a chemical cautery device, on a thin stick, that's used to cauterize vessels that cause nose bleeds.

 You should have a consultation, examination with an ENT surgeon to see if there is evidence of a prominent or exposed vessel that needs treatment or attention.  Not sure this would be a result of your prior Rhinoplasty but rather if you had a prominent vessel along the anteriro septum, this may have been more vulnerable to the nasal packing causing it to bleed.  IMHO, this is one reason that I quit using nasal packing 20 years ago for Rhinoplasty surgery.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Bleeding after Rhinoplasty surgery

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Have you ever had a blood work up or check any bleeding disorder problems? The only case that I have seen in my practice over the past thirty years where there has been excessive postoperative bleeding after a few days was on a patient who took motrin following her procedure. Patients are instructed to stay away from many medications including aspirin and aspirin containing compounds, vitamins, herbs and other known blood thinning medications. I have also seen many patients that come in to my office who are not post rhinoplasty patients who come in simply due to nose bleeds. In these cases the patient's were either on motrin or aspirin and eliminating these medications led to a resolution of their problems. I hope this is helpful if you have any questions please feel free to contact me via my website or email. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Bleeding after Rhinoplasty

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Profuse bleeding after rhinoplasty is rare, but can happen.  Bleeding several years after a rhinoplasty that only occurs a few times each year or once a year is likely unrelated.  However, it would be best for you to see a qualified ENT surgeon so examine and do a video endoscopy to visualize that tissue that is bleeding.


Good Luck.

Profuse Nose Bleeding After Rhinoplasty

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Best to seek ENT evaluation in person for this possible sequelae of your rhinoplasty. It could be a arterial deformity in Kesselbach's triangle: Kiesselbach's area, also Kiesselbach's plexus, Kiesselbach's triangle, and Little's area, is a region in the anteroinferior part of the nasal septum, where four arteries anastomose to form a vascular plexus called Kiesselbach's plexus. The arteries are 

Anterior ethmoidal artery (from the ophthalmic artery)
Sphenopalatine artery (from the maxillary artery)
Greater palatine artery (from the maxillary artery)
Septal branch of the superior labial artery (from the facial artery).

Seek treatment. 

A certified, reputable ENT specialist would be the best source of advice regarding your nose bleeds.

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I read your concern. If you're having frequent nasal bleeding, please consult a reputable ENT for evaluation and management. You may get an endoscopic examination of your nose to pinpoint the source of bleeding. Depending on your history, blood work may be necessary to exclude a bleeding disorder.

If you're currently having mild bleeding only once a year, you may just need a minor, in-office cauterization procedure.

I hope this is helpful for you.

Regards from NJ.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Bleeding after rhinoplasty

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Profuse bleeding immediately after rhinoplasty is rare. I have only seen this once in 30 years . Your current situation may be totally unrelated to your surgery . Sometimes a goo septoplasty will stop recurrent nose bleeds

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

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.