What to Do with Scabs Inside the Nostrils After Rhinoplasty?

I had Rhinoplasty one month ago. I have scabs on the inside of my nostrils and they are very uncomfortable. I was told to use peroxide and q-tips but it does not help. I feel stuffy because the scabs make it hard to breath. Is this normal?

Doctor Answers 28

Intranasal Scabs

We recommend using saline rinses and vaseline at night.  Some scab may require manual removal by the surgeon. If the nose is at night, using vaseline with help minimize scabs and nose bleeds

Los Angeles Plastic Surgeon
4.5 out of 5 stars 312 reviews

Healing Post Rhinoplasty

It is not uncommon to have some internal swelling and even some scab formation for 3-4 weeks after rhinoplasty. You should carefully remove this with hydrogen peroxide. One should use an antibiotic ointment and nasal saline spray and it will eventually go away.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 61 reviews

Scabs after rhinoplasty.

If you still have scabs a month out from your surgery, there is still probably an open area in the nasal lining that has yet to close.  Depending on the amount of re-arranging of tissue, this can happen.  The answer to your question is do what your surgeon told you to do.  Only he/she knows what was done to the nose and what to expect for healing.  My post op instructions are at the attached link near the bottom of the page.  Sounds like what you were told.  My patients also use a salt water spray called Simply Saline.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
4.5 out of 5 stars 25 reviews

Rhinoplasty scabs should be improved with cleansing

The hydrogen peroxide can help break up the crusts. But you could also be doing some nasal saline rinses to keep things moist and allow the crusting to break down. Your surgeon can also help take some of the crusting away with instruments. Sometimes depending on what was done, your airway may be too open and this can cause a dry nose syndrome where the inspired air is too easily passing through your nose causing it to dry and also possibly get infected. Your surgeon could help in determining this possibility.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Scabbing Following Rhinoplasty Surgery

It’s not uncommon to develop crusting and scabbing following nasal surgery. This is especially common when rhinoplasty surgery is performed in combination with septoplasty and the use of nasal splints. This crusting can result in nasal airway obstruction and postoperative discomfort.

For these reasons, it’s not unusual for patients to express concern about this problem.

In an effort to minimize crusting and scabbing, plastic surgeons frequently recommend nasal saline rinses or hydrogen peroxide rinses. Vaseline can be used to soften scabs and occasionally scabs can be removed with Q-tips and instrumentation.

If this issue represents a major problem for you then consultation with your plastic surgeon will prove helpful. Your surgeon will be able to recommend a treatment plan that will address this issue.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Visit your doctor

 If you are one month postop, your incisions are healed and your doctor can be more aggressive in removing the scabs that aren't responding to peroxide.  They will be happy to help ou out!

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Post rhinoplasty care

Every doctor has their own regimen. After the 1st week, mine is as follows:

1. Each day put head under the shower head and cup your hands over your nose to setup a 'steam box" breathe in steam for 1 to2 mins.

2. Spray wit h AYR or OCEAN MIST 5 times during the day

3. Coat inside of nose with Vasoline each night

This should loosen most crusts .If not have your M.D. look at it.

Barry H. Dolich, MD (Retired)
Bronx Plastic Surgeon
4.0 out of 5 stars 1 review

Most likely normal crusting after Rhinoplasty


Most likely you are feeling normal crust, sutures or stitches following your rhinoplasty surgery.

Many surgeons place silicone sheet inside the nose to temporarily support the nasal septum in the healing period. This splint is usually removed within 2 weeks. It is less likely you have an exposed septum or raw surface, even though it may feel like it. Small areas of exposed septum heal very well normally.

Many surgeons ask patients to use ointments (Bactroban for example) and saline nasal rinses during the healing period. Ointments and saline help loosen scabs and keep the nose moist and clean. Large scabs or crust can block the nasal passages, making it difficult to breathe. Sometimes these need to be cleaned out by the surgeon.

Always follow your postoperative surgery instructions and speak to you plastic surgeon if you have any concerns.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Scabs after rhinoplasty

Scabs in your nose after rhinoplasty are very normal. Often, we plastic surgeons use dissolving sutures to close the incisions and they may take that long too dissolve. Old blood may also take a while to soften up and go away.

The advice you were given sounds reasonable. You probably have a visit with your surgeon in the next couple of weeks and you can ask him or her to evaluate this if they haven't resolved.

Daryl K. Hoffman, MD
San Jose Plastic Surgeon
4.6 out of 5 stars 16 reviews

Scabbing and crusting in nostrils following rhinoplasty

There can be a build up of crust and old blood especially in the first few weeks after surgery that causes congestion and can be uncomfortable. Crusted blood in the nostrils can be softened and removed quite easily. Make a solution of half hydrogen peroxide with half saline and using a Q-tip moistened in this solution to dab onto the crusted blood. This will help to dissolve and remove the crusted blood. In addition, the use of saline nasal spray can help to soften crust and mucous that is further back in the nasal cavity. If you are uncomfortable doing this, you should ask your surgeon to show you how to clean your nostrils.

Jamil Ahmad, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 28 reviews

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.