Am I Unable to Have a Rhinoplasty? Or Should I Look for a Different Surgeon?

I am concerned my surgeon is not qualified for my surgery. I had a septoplasty done last year but the surgeon was unable to do the rhinoplasty because he said I bled too much during surgery. He said he is willing to give it another try after I got tests done to show that I had no types of bleeding disorders. He said if I bled the same as last time he would have to stop. He said he doesn't know why it happened and doesn't know if it will happen again. Won't I get the same result?

Doctor Answers 9

Bleeding disorders

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If your surgeon is concerned about bleeding then it sounds like they are a prudent surgeon. Get the blood workup and meet with three board certified plastic surgeons in your area--that should help you make a confident decision. Good luck! dr K

Bleeding During Surgery

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Your safety should always be the top priority.  Your surgeon will likely request blood tests to determine your bleeding and clotting system.  If you are confident in your surgeon, then get the blood tests before proceeding.  If you have lost confidence, you might want to seek another opinion.  Please discuss with your surgeon.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Bleeding During Rhinoplasty

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If you have confidence in your surgeon get the blood tests to study your clotting system. If your not comfortable with him get a second opinion. Another surgeon will probably get blood tests and review your diet and any medications taken before the last operation.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Excessive bleeding issues

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It sounds like your doctor did the right thing. If you have a bleeding disorder, this can be disastrous for rhinoplasty surgery. Sounds like you need this to be worked up.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Excessive bleeding deserves investigation, but may be encountered occasionally, and be quite normal, in nose surgery.

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Your concern is very understandable.  You probably do not have a history of a bleeding disorder or you would have already mentioned that.  Regardless, it does make sense to have blood tests and possibly see a hematologist.  If your results are normal, that would suggest that your surgeon simply got into some significant bleeders during surgery (probably during the bony work).  Even so, it is very unusual not to go ahead with the rhinoplasty as planned at the same operation.  Did the septoplasty improve your airway?

I think you should get a second opinion, and maybe a third (another surgeon can also verify the quality of the septoplasty).  There is also the financial part to consider because another surgeon will charge you full price for the rhinoplasty.  But safety and quality come before money (it is no bargain when you need additional operations).  I have a rule of 10:  If you view 10 before and after photos that you personally would accept, that is a good sign that your surgeon can achieve what you are looking for.  I have attached some examples from my own website.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

Excessive Bleeding During First Rhinoplasty

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Your experience is very uncommon and does raise the question as to whether you have some type of bleeding disorder or whether this was an intraoperative issue. If you have ever had prior surgery and did not a bleeding issue suggests that there is not a problem. But given this event you need to get a coagulation/bleeding profile done first. If those tests show normal coagulation, then get another consultation and compare notes to the first one before undergoing further rhinoplasty surgery. 

Abnormal bleeding during rhinoplasty

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The first place to start is with your family physician. Describe the situation and have him review the records from your septal procedure, and evaluate a possible bleeding cause. If you do indeed pass the work up for bleeding and no problems are found, look for another surgeon.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Bleeding Problems and Elective Surgery

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Qualifications of your surgeon should be based on training, appropriate board certification and practice experience.  Given your past experience, your physician's recommendation to order pre-operative bloodwork prior to elective surgery is appropriate.  If you have had no issues prior or since, your bleeding experience is likely an isolated incident but if there is a specific cause, bloodwork will help to identify it.   Excessive bleeding during a rhinoplasty not only makes the procedure more difficult but can lead to complications and an undesirable cosmetic outcome.  Ultimately, it is important to know if a bleeding disorder exists whether you proceed with the surgery or not.   If it is normal, you can feel more comfortable to move forward with the qualified surgeon of your choosing.

Pamela Henderson, MD
Phoenix Facial Plastic Surgeon
4.8 out of 5 stars 20 reviews

Abnormal Bleeding during surgery is a problem

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It is hard to say what happened the first time but with your surgeon's experience it is a good idea to have some basic lab tests to see if you are normal.  You would want to do this no matter who does the next surgery.  Have you ever had any other surgical procedure?  If you have never had any bleeding problems with other procedures then the technique may have been off. 

Make sure your surgeon is board certified in plastic surgery and this should help you get a safe result.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

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.