Mucus buildup and congestion 3 years after cosmetic rhinoplasty

Question

I had a deformed nose after a car accident. Had a functional surgery and then a cosmetic surgery a year after. After the cosmetic surgery (3 years ago) I started experiencing mucus buildup and congestion in my left nostril. That side was particularly deformed and probably required more work. ENTs say they don’t see a structural issue. I have to blow my nose 50 times a day. Rinsing with neti pot and flonase help to some extent.

Semih Yildiz, MD, FEBOPRAS · Answer

Three years of one-sided mucus and congestion after trauma surgery and cosmetic rhinoplasty deserves a focused nasal-airway work-up, even if a routine examination did not show an obvious problem. Possible contributors include allergic or nonallergic rhinitis, turbinate inflammation, dryness or crusting, a subtle internal or external nasal-valve problem that changes with breathing, mucosal scarring, or less obvious sinus disease. A normal brief examination does not exclude all of these.

I would seek review with a rhinologist or ENT who performs nasal endoscopy while you describe the symptoms, ideally with your previous operative reports and a clear timeline. Ask whether the valve, turbinates, septum, mucosa, and sinus openings have been assessed; allergy testing or CT is sometimes useful when the history or endoscopy supports it. Because Flonase helps, inflammation may be contributing, but use it consistently with correct technique and only as directed. Saline irrigation can help, but use distilled/sterile water or water that has been boiled and cooled, and keep the device clean.

Avoid forceful repeated nose blowing, cotton swabs, and decongestant sprays unless specifically advised. I would not pursue revision rhinoplasty or graft work solely for mucus without identifying the cause, since further surgery can worsen airflow or mucosal symptoms. Seek prompt care for recurrent bleeding, foul or bloody discharge, fever, severe facial pain, or a new rapidly worsening blockage.

Eric M. Joseph, MD · Answer

As one of my teachers used to say, uncommon problems are very common and those people that have them. In general, if there is excessive nasal mucus, the best treatment would be what you were doing. Nasal wash with saline, along with a steroid nasal spray. You may also wish to consider a topical antihistamine nasal spray like AsterPro. Wishing you well and I hope this helps. Sincerely, Dr. Joseph

Mucus buildup and congestion 3 years after cosmetic rhinoplasty

Answers (2)

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