How bad is the bruising and swelling after a slight dorsal hump shave? I'm male

The bruising after rhinoplasty is mild to moderate.  It depends on the extent of rhinoplasty and on the individuals.  It is very important to not take any fish oil, aspirin, Motrin or related products that can lead to extensive bruising.  The osteotomies and narrowing of the nasal bones will not affect the nasal tip.  Tip plasty is a separate procedure.RegardsDr. J

Hello,Bruising and swelling after rhinoplasty is quite variable.  Typically, bruising occurs in the lower eyelids and not on the nose itself.  Of course the nose has a dressing on it so you wouldn't really know it anyway.  The primary cause of bruising in rhinoplasty is the lateral osteotomies.  These are bone cuts on each side of the nose in the angle where it turns from being a "face" bone to being a "nose" bone.  These cuts are necessary if the dorsum of the nose is reduced enough to open into the hollow inside of the nose.  We call this condition an "open roof" and it must be closed by doing lateral osteotomies and rotating the bones in to make a triangle shape again.  If only a tiny bit of dorsal reduction is done and no lateral osteotomies are needed, you probably won't bruise at all.  If lateral osteotomies are needed, you have something like a 75% of getting bruising under the eyes, at least in my hands.  Often times, the bruising under the eyes is mostly gone by one week.  Since you have a dressing on your for one week, bruising during this time is somewhat irrelevant . . .no matter what, it is obvious you just had surgery.  I will tell you that a rhinoplasty where so little dorsal bone is reduced as to not need lateral osteotomies, is a rhinoplasty where you probably won't notice any difference, at least not in the height of the dorsum.Dorsal work and lateral osteotomies will not narrow the tip the of your nose.Best of Luck.Dr. A

Patients that undergo rhinoplasty have bruising and swelling. Rasping the bone and then performing osteotomies which is common will cause bruising. Even if the tip is not treated, it will swell too.

 A full set of pictures are required to determine the extent of the dorsal hump which is composed of both bone and cartilage. Most patients require osteotomies placed in the nasal bones to close the open roof created from the hump removal. Also important to make sure the tip balances with the new bridge line, so sometimes some minor tip work is also required. The bruising and swelling from the rhinoplasty is usually related to the  osteotomies  placed in the nasal bones. Osteotomies of the nasal bones will only narrow the nasal bones and upper lateral cartilages, and will not narrow the nasal tip at all.

Dear mango9244,

Thank you for your clinical
post. Invariably rhinoplasty involves
manipulation and treatment of the nasal dorsum particularly a bump reduction
results in mild, moderate or significant bruising depending on patient and
nasal factors. Patient factors include
predisposition to bruising or a patient being on anti-coagulates or
anti-platelet medication. Rhinoplasty
surgical factors include degree of bump reduction that is required. There is rarely a bump that is amenable to
just a simple rasping. Rasping results
in flattening of the nasal bridge and the creation of a flat book end
appearance and osteotomies or fractures in the nasal bones need to be performed
to bring the nasal pyramid or bony bridge back into a nice parametable or
triangular shape. The osteotomies or
breaking of the bone creates a tremendous amount of bruising usually in the
under eye region called raccoon eyes.
Generally, much of the bruising is dissipated by one week when the cast
comes off and another week until it turns greenish/yellowish and then
dissipates and disappears. Some patients experience much less
bruising when they’re on Arnica Montana or Bromelain and certainly avoiding any
anti-inflammatory or anti-platelet medications.

I was fortunate to train in both
plastic surgery and ear, nose, throat, head and neck oncology and perform a lot
of cosmetic reduction rhinoplasties.

I hope this information is of some
assistance and best of luck.

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R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto