Severe bleeding a week after rhinoplasty, how can it be fixed and what are the risks of future bleeding? (photo)

Question

The night after my cast got removed my nose started bleeding severely. I called my doc, but had to call ambulance as I was losing too much blood. I've been told it's due to a dissolving stitch coming out causing the artery to bleed severely. Now I am stuffed with interior balloon tampon. ER doc told me to remove it in 3 days, as my doc told me to wait 6 days. What should I do? Also, what is the chance of me bleeding again after balloon is removed? (Also I had no blood thinner meds).

Matthew Bridges, MD, FACS · Answer

Personally, i would not want any of my rhinoplasty patients to have a ballon pack in their nose for 6 minutes, much less 6 days.  Please go see your surgeon.  In a young healthy patient who is not on blood thinners, there are few times when a nasal tampon/balloon is necessary or appropriate. If your surgeon's advice was to leave the pack in for 6 days without seeing you, i would question this advice.  If your surgeon is an ENT/facial plastic surgeon and they gave this advice, then shame on them.  A competent facial plastic surgeon should be able to get the pack out, find the bleeding vessel, and cauterize it if needed.  If your surgeon is a general plastic surgeon, you might ask for a referral.  Sorry to rant, but I (obviously) disagree with the advice you've been given.

Laxmeesh Mike Nayak, MD · Answer

While it is extremely uncommon, bleeding can happen in the first 2-3 weeks after rhinoplasty. 
There are many different options to manage active bleeding. Which one is best depends on how brisk the bleeding is, (trickles vs gushing)  where in the nose the bleeding source is (visible or not), and what type of doctor/facility is close enough to safely get to before too much blood loss. 
Generally, once a nose has been packed with successful resolution of bleeding, the safest route is to allow the pack to remain in place while the bleeding area heals, and then remove it several days later. 
Chances of rebleeding are extremely low at that point.

Anup Dhir, MD · Answer

Hello. Sorry to know that you had problem with bleeding. This is an uncommon complication after rhinoplasty surgery.  Anything between 3 to 6 days should be ok but I think it may be best to follow the advice of your surgeon. It is very unlikely to bleed again so do not worry.All the best.

Robert E. Zaworski, MD (retired) · Answer

So sorry you had this complication.  While it is highly unusual, there are always risk with surgery.  Follow your surgeons instructions and follow up with him for an evaluation.

Severe bleeding a week after rhinoplasty, how can it be fixed and what are the risks of future bleeding? (photo)

Answers (4)

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