Rhinoplasty: Cost, Pics, Reviews, Q&A

Surgical technique during rhinoplasty is important for minimizing bruising

Minimizing bruising is an important goal in rhinoplasty. I find that surgical technique has a lot to do with it.

For my patients, bruising is much less obvious today than it was earlier in my career due to a number of factors, including increased precision when breaking the bones, more meticulous dissection, and the local anesthetic used.

Icing the swollen area continuously for 8 – 12 hours after surgery is very important.

Medications to improve bruising such as arnica have not been demonstrated in studies to be helpful, but they are safe and many patients use them. (Thomas A. Mustoe, MD, FACS, Chicago Plastic Surgeon)

Bruising Normal With Rhinoplasty

Bruising and swelling is a normal part of rhinoplasty surgery. The type of rhinoplasty performed can make a significant difference if the amount of bruising experienced post procedure.

Avoiding blood thinning vitamins such as advil, tylenol, fish oil, and vitamin E prior to surgery can help to minimize bruising.

I also recommend taking oral Arnica before and after surgery to support the healing process and faster recovery. (Jeffrey W. Hall, MD, Austin Plastic Surgeon)

Tips for Reducing Bruising and Swelling after Rhinoplasty

Bruising after rhinoplasty operation photos

First, the amount of bruising and swelling after rhinoplasty (nose reshaping) will vary based on a few factors:

1. the approach needed (open vs. closed);
2. if the nasal bones were treated (osteotomies);
3. and how long the surgery took.

A fourth consideration is for revision surgery, which in general results in more swelling. In terms of reducing bruising and swelling, this can be though of in two phase: pre-op and post-op.

About 2-3 weeks before surgery (pre-op), you should stop taking any aspirin or NSAIDs (ibuprofen, naproxen, etc.), since these medications increase bleeding/bruising. In addition, certain supplements and vitamins have a similar effect and should be held (vitamin E, ginseng, gingko, etc.)

Bruising after rhinoplasty surgery photos

After surgery (post-op), I recommend that patients take a short course of an inflammation-reducing medicine (medrol) as well as some supplements that have been shown to reduce bruising and swelling (arnica montana, bromelain, etc.). Careful use of cold compresses around the cheeks/eyes and forehead can be useful in the first 24-48 hours, but are less effective after that.

Lastly, it is important to reduce strenuous activity, as increases in your heart rate and blood pressure can lead to increases in bruising and swelling. For most of my patients, this last restriction is the hardest part – though it is important in the two weeks. (Evan Ransom, MD, Bay Area Facial Plastic Surgeon)

Bruising & Swelling Following Rhinoplasty Varies From Patient to Patient

The bruising after rhinoplasty photos

Bruising and swelling following rhinoplasty vary from patient to patient. Several factors may contribute to bruising and these include the surgical techniques, wound healing characteristics of the patient, and the medical management of the patient in the pre and postoperative periods.

The type of rhinoplasty performed may significantly impact bleeding and bruising. Patients who have their nasal bones fractured to narrow the nose are more likely to have postoperative bruising than those who don’t have nasal infracture.

There are also significant differences in wound healing characteristics of individual patients. Some have greater tendencies toward bruising than others. In the preoperative and postoperative periods, several maneuvers have been shown to decrease bruising. It’s important to stop Aspirin, Ibuprofen, Herbal supplements, nonprescription drugs, and vitamins. After surgery, elevation of the head, ice compresses, and splinting all help to minimize bruising and swelling.

It’s also important to avoid activities that will elevate blood pressure and potentially increase bruising. For this reason, strenuous activity should be avoided for at least six weeks. It’s important to realize that swelling and bruising are a normal part of rhinoplasty surgery. Preoperative, intraoperative, and postoperative maneuvers may minimize bruising, but they won’t make it disappear entirely. (Richard J. Bruneteau, MD, Omaha Plastic Surgeon)

Reducing Bruising after Rhinoplasty

Some patients bruise more than others. Some patients who undergo rhinoplasty don’t bruise at all.

We place all patients on Arnica and Bromolain to minimize bruising as much as possible.

If patients do have bruising, we use warm compresses and other methods to be able to have the tissues clear the bruises quickly.

Most bruises are not perceptible with a light amount of coverup. (Richard A. Zoumalan, MD, Los Angeles Facial Plastic Surgeon)

Minimize Bruising After Surgery

The most important step is prevention. For two weeks before surgery you should avoid taking any aspirin or ibuprofen or similar medications if possible.

Also, many natural remedies cause bleeding including garlic, ginseng, and St. John’s wort. Green tea also thins the blood and causes bruising.

During surgery, careful meticulous technique and control of bleeding helps to minimize bruising after surgery. This component is in the hands of your surgeon.

Around surgery there are many supplements that can be taken to try and help minimize bruising and swelling.

In my practice, I recommend the use of GliSODin Pre/Post, which in my experience does diminish both bruising and swelling and speeds recovery time. (Cory Goldberg, MD, Toronto Plastic Surgeon)

Bruising with rhinoplasty

Most of the bruising often seen from a rhinoplasty (nose job) is from the bone fracture (breaking the nasal bones to make them narrower). The bleeding associated with this is not significant but the skin around the lower eyelids is very thin and readily shows off the bruising. To minimize this the plastic surgeon can apply some pressure during surgery, you can keep you blood pressure from being elevated, head elevated, and you can take arnica montana. (Remus Repta, MD, Scottsdale Plastic Surgeon)

How to Minimize Bruising After Rhinoplasty

Avoid taking Aspirin, Motrin, Aleve, Ibuprofen, and certain natural herbs as these can cause blood thinning. Consult with your physician for specific products to avoid as well as medications or vitamins you can take to help with bruising. Use ice packs and keep your head elevated as often as you can to control bruising and swelling. (Carlo Honrado, MD, FACS, Los Angeles Facial Plastic Surgeon)

Minimizing Bruising After Rhinoplasty

As others have discussed. Stay away from medications and herbal/natural supplements that increase your bleeding and bruising risk. Your surgeon should be able to provide you with a list (which is pretty large). Some of my patients also believe in the use of a supplement called Arnica Montana. I’m not sure if it’s held up to scientific scrutiny but there are plenty of believers out there and the supplement is relatively inexpensive.

After surgery you should also adhere to icing instructions and your head of bed should be elevated so the swelling dissipates away from the nose. Your bruising will also largely depend on the technique used and your own anatomy. Noses that require precise bony repositioning (osteotomies) will bruise more than those that do not. (Michael M. Kim, MD, Portland Facial Plastic Surgeon)

Tips for minimizing bruising after rhinoplasty

The biggest thing that you can do to prevent bruising after any surgery is to avoid medications, vitamins or herbal supplements that can cause thinning of the blood and increase your chances for bruising. There is an exhaustive list of medications out there and you should talk to your surgeon at least two weeks before surgery to double check which medications (aspirin, ibuprofen, plavix, coumadin), vitamins (particularly vitamin E) and herbs (ex. gingko, ginger, fish oil) can interact.

The second thing I would recommend is starting bromelain prior to surgery and arnica after surgery. I prescribe a special blend of recovery vitamins and supplements that help to reduce bruising and swelling for all patients undergoing rhinoplasty or facelift surgery. The last tip is to keep your head elevated above your heart (prop some pillows) for the first five days after surgery. This will speed up the healing process if bruising does occur and minimize swelling in the nose. (Kristina Tansavatdi, MD, Los Angeles Facial Plastic Surgeon)

Everyone is different when it comes to bruising from any procedure. Patients will often know if they bruise easily from bumping themselves and know if they have that tendency. Some people bruise with rhinoplasty and some people do not at all. If bruising does occur, it is usually gone by 5-7 days. I usually say allot 10 days, just in case, if you are worried about going back to work with bruises. There are some things you can do to minimize this chance.

1. Limit alcohol intake the week before your surgery.
2. Do not take medications that can increase the risk of bruising, like aspirin, blood thinners or fish oil for the week before your surgery.
3. Applying ice or a bag of frozen peas over your eyes for the first 72 hours after surgery.
4. You can start taking Bromoline 3 days before the surgery and for 1 week after.
5. Oral and topical arnica can be used after the surgery until the bruising goes away.

The majority of patients agree that even with some bruising, the outcome of rhinoplasty is worth it! Nothing will guarantee there will not be bruising, but these tips can minimize the chance and help it go away faster if it does happen! (Angela Sturm, MD, Houston Facial Plastic Surgeon)

Tips to Reduce Bruising & Swelling Following Rhinoplasty

Whether or not you have significant bruising after a rhinoplasty depends in large part on the surgeon who performed your rhinoplasty.

A skilled rhinoplasty surgeon understands the need to be very careful in the handling of the tissues. This leads to unnecessary trauma and consequently less bruising and swelling postoperatively.

A well-trained and careful rhinoplasty surgeon understands the need to control and minimize bleeding as much as possible in the course of the procedure.

Regardless of who performs the procedure, there are certain things you can do postoperatively to minimize bruising and swelling.

This would include keeping your head above your heart during the postoperative recovery time in order to promote the reduction of swelling in the affected area.

Postoperatively, your surgeon may also recommend some degree of ice packing to your nose.

It is important to follow your surgeon’s directions carefully so as not to do something postoperatively to disturb the postoperative result. (John J. Edney, MD, Omaha Plastic Surgeon)

Minimizing Bruising After Rhinoplasty

There are steps that can be taken both before and after surgery to minimize bruising. Generally you are advised not to take aspirin, alcohol, omega 3 fatty acids almost 1-2 weeks prior to the surgery.

After you are through with the surgery you should keep your head elevated by pillows for the next 2-3 days. You can ice the area for 20 minutes every hour after the surgery.

There are also a number of vitamins that help the bruising resolve faster like vitamin C, vitamin K, folic acid, bromelain, arnica montana etc. which can be started 4-5 days prior to the surgery and continued to be taken daily for up to 2 weeks post surgery. (Jeffrey Weinzweig, MD, Chicago Plastic Surgeon)

Swelling After Rhinoplasty

Icing on and off for 30 minutes during the first 24-48 hours can help reduce swelling. After one week when your splint is removed you can usually use foundation or cover up over the bruising.

At our practice we suggest some patients use Arnica in order to assist them with swelling. Arnica is a homeopathic treatment and can be found at some grocery stores including Whole Foods. (Saeed Marefat, MD, Washington DC Plastic Surgeon)

Minimze bruising after Rhinoplasty Surgery

Bruising is very common with cosmetic surgery and not considered a complication with plastic surgery. I advise my rhinoplasty surgery patients to expect some degree of bruising and swelling after surgery, especially under the eyes.

Skin bruising may even occur with non-surgical cosmetic treatments such as lip enhancement or Botox wrinkle treatment. Most bruising occurs within 24 hours after rhinoplasty surgery, but may occur several days afterward too.

To help reduce bruising, plastic surgeons advise their patients to limit strenuous activity for the early recovery period. The most significant risk factors for bleeding or bruising with cosmetic surgery are the following:

• hypertension or high blood pressure
• men
• blood thinners, including herbal medication, ibuprofen, aspirin, and similar medications
• smoking
• coughing or nausea after surgery
• heavy lifting or activity after surgery.

The following may help reduce the chance of developing bruising or a hematoma:

• take arnica montana tablets before and after
• your procedure minimize pain and nausea after surgery
• avoid smoking before and after surgery
• avoid blood thinners, including herbal medications or teasice on cheeks or forehead, but directly ontop of nose

Most importantly follow the strict cosmetic surgery care instructions of your plastic surgeon. (Houtan Chaboki, MD, Washington DC Facial Plastic Surgeon)

Minimizing Bruising after Rhinoplasty

Patients can help avoid bruising after surgery by discontinuing blood thinners such as Motrin, Aspirin, Fish Oil, Vitamin E, ect. Patients can also start taking homeopathic Arnica before and after surgery to help against bruising as well.

After surgery, patients will want to use an ice compress on forehead and eyes and sleep upright for the first 2 days. (Edward J. Gross, MD, Orlando Facial Plastic Surgeon)

A certain amount of bruising is normal and expected after a rhinoplasty. Some helpful tips to acheive the best result is avoiding any blood thinning medications or vitamins prior to surgery.

Some common blood thinners are Aspirin, Ibuprofen, Fish Oil, and Alcohol. After surgery, follow your physician’s orders, apply ice packs intermittently, supplement with Arnica Montana and fresh pinapple, sleep with your head elevated at least 30 degrees for the first 72 hours, and keep to quiet activities. (Timothy Treece, MD, Columbus Plastic Surgeon)

Reducing post rhinoplasty bruising

Prior to surgery you should make sure you discontinue use of any medicines and supplements that could thin the blood.

These include NSAID’s (i.e. Advil, Motrin) and aspirin containing products. There are many homeopathic and herbal supplements that may increase bruising.

You should ask your physician for a list of these so you know what should be stopped. Even more important is to let your surgeon know of all medicines and supplements that you are on at least several weeks in advance so appropriate advice can be given.

After surgery, using ice-packs on the sides of the nose, at the eye-cheek region, will help control bruising and swelling. I recommend applying ice 20 minutes on and off while awake for the first 2 to 3 days.

Additionally, homeopathic remedies, including arnica, may reduce or speed up resolution of bruising. (Robert Glasgold, MD, East Brunswick Facial Plastic Surgeon)

How Do I Minimize Bruising from a Rhinoplasty?

There are multiple factors that contribute to the bruising after rhinoplasty and many are under the control of the patients and surgeons. While we can reduce the bruising after rhinoplasty it may not be totally avoidable.

If you bruise easily or bleed for a long time after cutting yourself you need to let your surgeon know this. It may mean that you have a coagulation disorder and your clotting may not be totally normal. If you take aspirin or similar medications you need to inform your surgeon to delay the surgery 3 weeks and stop taking these medications immediately.

Most herbal products cause thinning of the blood and result in excessive bruising or bleeding. Additionally, if you have high blood pressure it needs to be controlled before and after surgery and your surgeon should be aware of this.

Even some food product such as red wine, which contains aspirin type products, can cause excessive bruising. Most of us provide the patients a list of medications, vitamin E, herbal and food products that they need to refrain from weeks before surgery. During the surgery gentle handling of the tissues will minimize the swelling and bruising after surgery.

Additionally, some of us use a medication which is called DDAVP if we notice that the patient is bleeding excessively and is like to bruise more than usual. After surgery, avoiding high blood pressure, controlling the pain, application of cold compresses, elevation of the head, controlling the nausea and vomiting can reduce the bruising. Should the bruising occur, use of vitamin K and Arnica cream may resolve the bruising faster. (Bahman Guyuron, MD, Cleveland Plastic Surgeon)

Preventing Bruising After Rhinoplasty…

Bruising is usually a big concern for patients after rhinoplasty because it can prevent them from going back to work. The best thing to do to prevent bruising is to use a lot of cold compresses over the eyes and cheeks for the first two days. That will help limit the extent of the bruising.

Preoperatively, you should avoid NSAIDS like Advil, as well as Aspirin, fish oil, vitamin E, and other things than can “thin” the blood. The skill of the surgeon is also a factor because the less traumatically a rhinoplasty is performed, the less bruising occurs.

Supplements like arnica may help, but no properly performed studies have been published as of yet. (Andrew Miller, MD, Edison Facial Plastic Surgeon)

Reducing bruising after rhinoplasty

Though it is one of the most common concerns, not every patient bruises after rhinoplasty. The type of rhinoplasty, skin type, daily medications, activity post surgery are among a few items that can increase your bruising ability. Ultimately, there are several factors that contribute to this.

Here what I tell my patients to reduce bruising after surgery: keep you head elevated, ice the upper cheeks and under eyes, minimize fluctuations in your heart rate by avoiding heavy lifting, exercizing, bending over, and nose blowing, taking certain herbal supplements such as arnica, bromelain, papaya extract, and topical vit k can help, avoiding all other herbal supplements especially Vit E, fish oil, flax seed, garlic, ginseng, ginger, kava kava, etc., avoiding aspirin and ibuprofen containing products for at least a week before and 1 week after surgery, avoid smoking for 2 weeks before and 2 weeks after, treat any new coughing or sneezing that may increase risk of bleeding, and tell your doctor if you have any bleeding tendencies such as very heavy periods or are chronically anemic. (Mike Majmundar, MD, Atlanta Facial Plastic Surgeon)

Bruising after rhinoplasty occurs if there are changes made to the bony framework of the nasal dorsum

Bruising after a rhinoplasty generally only occurs if there are changes made to the bony framework of the nasal dorsum. If the corrections made are confined to the nasal tip or inside of the nose, visible bruising may be avoided altogether.

If bony changes are included as part of the surgery, bruising will be minimized by avoiding any aspirin or aspirin-like products for at least 7-10 days prior to surgery as well as Omega-3 fatty acids or any other blood-thinning over-the-counter or prescription products.

I recommend high doses of vitamin C prior to and for the 1st 2 weeks after surgery as well as homeopathic Arnica and Bromaline taken by mouth, to speed up the resolution of any bruising. (Michael R. Macdonald, MD, Bay Area Facial Plastic Surgeon)

Bruising after rhinoplasty?

I find that significant bruising after rhinoplasty is the exception not the rule. When it does occur it usually lasts for about 1 week and is much improved by the time the splint comes off. (Dustin L. Reid, MD, Austin Plastic Surgeon)

How to minimize big black eyes post-rhinoplasty

Post-rhinoplasty raccoon-type of peri-orbital bruising is common, especially if your surgeon performed an osteotomy (breaking the nasal bones). Many things should be avoided before surgery for 10-14 days: aspirin, advil, anti-inflammatory, vitamin E oil, fish oil, omega-3 oil, ginseng, ginkgo biloba, ginger, garlic pill.

Avoid alcohol for 3 days pre-surgery. Post-operatively, eating pineapple and kiwi daily helps the bruise to resorb (they both contain bromelain, an enzyme that helps bruising to disappear). (Marc DuPere, MD, Toronto Plastic Surgeon)

Tips for reducing bruising after rhinoplasty

The most important factor in minimizing post-operative bruising and swelling is surgical technique. That said, here are a few tips for reducing your bruising after surgery: keep your head elevatedsleep on 2 pillows and on your backuse ice packs frequently, especially in the first 48 hoursavoid taking aspirin, ibuprofen, advil, and other NSAIDS, which increase risk of bleedingfollow your plastic surgeon’s protocol for post-operative activity; do not rush to exercise too soonkeep your nasal splint and tape in place until removed by your plastic surgeon (Lara Devgan, MD, MPH, New York Plastic Surgeon)

Bruising after rhinoplasty

Bruising should be anticipated with rhinoplasty surgery. Ways to minimize bruising include

1. ensure that any medications or supplements that thin the blood are stopped at least 10 days before surgery,
2. consult your physician about taking supplements such as Arnica Montana and Bromelain,
3. use cold packs intermittently for the first 12 hours after surgery,
4. stay very sedentary for several days after surgery.

After surgery if a particular bruise is darker and seems to be taking a long time to go away treatment with a special vascular laser can result in near immediate lightening and faster clearing. (J. David Holcomb, MD, Sarasota Facial Plastic Surgeon)

Bruising from a Rhinoplasty

Some swelling and bruising after a rhinoplasty is to be expected. Elevation of the head of bed may help in more quickly resolving swelling and bruising. Cold compress and arnica montana after surgery may also be beneficial. (Anand G. Shah, MD, San Antonio Facial Plastic Surgeon)

I recommend for my patients to take Arnika Forte to help with minimizing the bruising and swelling. This natural supplement will help speed up your recovery process after surgery. (Leonard Hochstein, MD, Miami Plastic Surgeon)

Minimizing bruising after rhinoplasty

I agree with the answers below. Most important is the surgeon’s technique. Most surgeons for the last 15 -20 years have been trained to do external osteotomies which creates a discontinuous fracture of the nasal bones and much less bruising.

Gone are the days when people would be bruised for a month after a rhinoplasty. Elevation, ice and Arnica are all helpful. Generally, most patients are presentable by 5-6 days post operatively. (Paul E. Chasan, MD, Del Mar Plastic Surgeon)