Profuse Nose Bleeding After Rhinoplasty

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.

Although rare, post-operative bleeding is a well-known complication following rhinoplasty surgery. In the immediate post-operative period this bleeding is usually related to surgical trauma. When significant bleeding occurs, the nose is usually re-packed. In some cases endoscopic evaluation is necessary to determine the cause of bleeding. Under these circumstances, direct control of the bleeding site may be necessary.
                Bleeding that occurs three years after surgery, probably isn’t related to your rhinoplasty. Under these circumstances environmental factors such as dry air are more likely causes. 

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

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.

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.

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

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. 

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

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.

  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.