Rhinoplasty: Cost, Pics, Reviews, Q&A

How to minimize bruising after rhinoplasty

Significant bruising after rhinoplasty is uncommon. Avoiding medications that affect clotting (aspirin, etc.) is recommended.

Infracturing of the bones during rhinoplasty might leave some bruising under the eyes.

However, an open rhinoplasty is left completely dry by the surgeon so bruising is uncommon unless infracturing is part of the operation. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)

Reducing rhinoplasty bruising and speed your recovery

The best way to reduce bruising and speed your recovery is follow a carefully directed plan provided by your surgeon.

The Maas Clinic provides each patient a flow sheet that describes foods, supplements and medications to avoid one week before surgery.

The program follows with a homeopathic remedy of arnica montana (SinnEcc) for before and after the procedure.

Specific instructions for the patient at home include crushed ice in a glove applied across the eyes and nose for periods of 20 minutes on and 20 minutes off for the first 24 -48 hours.

Also, elevation of your head head during sleep in a lounge chair or with several pillows can substantially reduce swelling and bruising. Get your written plan and stay with it! (Corey S. Maas, MD, San Francisco Facial Plastic Surgeon)

Follow your Surgeon’s Instructions

Most surgeons will have some degree of written pre- and postoperative instructions for you to follow in addition to preoperative counseling. Obviously, part of the outcome relates to the surgeon’s individual techniques.

Part of the outcome relates to preoperative instructions: avoid aspirin, vitamin E, non steroid anti-inflammatory drugs, and/or other meds which promote bruising.

Lastly, part of the outcome relates to postoperative instructions: avoid bending over, avoid lifting heavy objects, avoid sneezing with a closed mouth, and sleep with your head elevated.

All of these factors help insure a more speedy recovery. (Stephen Prendiville, MD, Fort Myers Facial Plastic Surgeon)

Advice to decrease bruising and swelling after rhinoplasty

There are various things that can be done to reduce bruising and swelling.

Some are done by the surgeon and some can be done by the patient.

As a patient, the main things you can do to reduce bruising and swelling is to:

1. Keep your head elevated after surgery
2. Apply ice to your nose area after surgery
3. Avoid activity and get rest during your recovery.

Some of my patients have taken arnica and pineapple juice and have told me this seemed to help. (John Diaz, MD, Beverly Hills Plastic Surgeon)

Avoiding excessive bruising and swelling after Rhinoplasty

Bruising and swelling on the nose are a reflection of the amount of surgical trauma the nose endures during rhinoplasty. The integrity of the lymphatics will also influence the course of swelling postoperatively. I recently had a patient from Beirut, Lebanon who had undergone a rhinoplasty four years ago and had significant swelling and bruising after the surgery. Before her redo Rhinoplasty, I suggested she avoid aspirin, ibuprofen, blood thinners, herbal supplements, and niacin. I also prescribed her a 7 day course of Bruisestick ointment stick to the nasal area.

Bruisestick is a standardized Arnica formula for bruises. After surgery, we placed a nasal splint, continued oral Arnica (BruiseKare), provided a regimented protocol for ice packs every 15 minutes, elevated the head at all times, and placed intranasal splints for 4 days. Needless to say, her revision rhinoplasty resulted in significantly less bruising and swelling when compared to her first rhinoplasty. (Raffy Karamanoukian, MD, FACS, Los Angeles Plastic Surgeon)

1. Follow your surgeon instructions. They will usually include stopping all blood thinning medications and supplements such as aspirin, ibuprofen, vitamin E for two weeks prior to your surgery. Usually, we give our patients a complete list of these medications and supplements at their pre-operative appointment.
2. Surgeon skill matters. You can ask to talk to several recent patients about their bruising. However, remember, in the grand scheme of things, an extra day or two of bruising is nothing compared to the importance of the overall good result.
3. The patient factors: extent of the work required and your skin type. Some patients will bruise more than others, all other things being equal.
4. We use Arnica capsules and Bromelain capsules before and after rhinoplasty, and we found that our patients have minimal bruising. We use Arnica from Sinnech. I had it checked by the homeopathy department of Bastyr University in Seattle, and they confirmed it is much stronger than the stuff you buy at health food stores. (Stella Desyatnikova, MD, Seattle Facial Plastic Surgeon)

The best way to minimize bruising around the eyes is to take preventative measures. Patients must refrain from any aspirin, aspirin-containing compounds, ibuprofen, Vitamin E, blood thinning medications or herbal supplements two weeks prior to the surgery.

The bruising is caused from blood that extravasates out into the skin. Bruising will dissipate in approximately ten days after the surgery. Bruising around the eyes after the rhinoplasty procedure can be quite variable, but also can be controlled by the surgical technique performed by the rhinoplasty surgeon.

We elevate the periosteum off of the nasal bones which is where the blood vessels are located to try to minimize the amount of bleeding and bruising around the eyes.

We also inject both sides( internal and external) of the nasal bones with lidocaine and epinephrine to help minimize the bruising during the procedure (William Portuese, MD, Seattle Facial Plastic Surgeon)

Minimizing bruising around the eyes from rhinoplasty is the surgeon’s job before, during and after rhinoplasty. Before surgery it is important to stop blood thinning medications and vitamins.

No aspirin containing products or anti-inflammatory medications such as ibuprofen should be taken for one week before surgery. Vitamin E, Gingko Baloba, and fish oils should be stopped.

Patients should abstain from alcohol for one week before surgery as well. I start my patients on a homeopathic regimen of Arnica Montanta and Bromelaine three days before surgery. These agents have been shown in medical studies to reduce bruising around the eyes and recovery.

We continue them for one week after surgery. During the surgery, I utilize a minimally invasive approach that I patented called the Quick Recovery Rhinoplasty Technique that minimizes the incision lines for rhinoplasty, does not require the nose to be broken, and reshapes rather than cuts away cartilage.

I also do not pack the nose after surgery minimizing any discomfort. During surgery, we also use music therapy.

According to a study in the March 2006 Journal of Advanced Nursing, the use of music helps lower patient’s blood pressure during surgery, which limits bleeding, and therefore minimizes bruising around the eyes. (Andrew Jacono, MD, Great Neck Facial Plastic Surgeon)

Try Auriderm and Bromelain and the closed approach

Bruising around the eyes following rhinoplasty is rather rare in our practice. We reviewed our last 452 patients who had rhinoplasty and found significant bruising in less than 5%. In addition to making sure patients are off all blood thinners (aspirin, ibuprofen, greater 400 IU per day or Vitamin E, Ginger , Gingko Biloba and Garlic supplements) we have found that the closed rhinoplasty results in much less swelling and bruising then the open approach. Additionally we place all pre operative patients on natural supplements called Cyruta and Mulitzyme from Standard Process. We have found these anecdoctally to reduce bruising around the eyes. Post operatively we have patients concerned with bruising use Auriderm. This is a product that is topically placed over the bruised areas and seems to reduce bruising to half the time. For more information on the open vs. closed approach I refer you to a presentation I gave to the Australian Facial plastic surgery society. I hope this helps. (Steven H. Dayan, MD, Chicago Facial Plastic Surgeon)

This is what I do to minimize bruising around the eyes from Rhinoplasty:

1. Arnica Montana before and after surgery
2. Stop all aspirin, motrin, fish oil, vitamin E, flax seed oil and other blood thinners 2 weeks prior to surgery.
3. Compression splints on your nose after surgery for 7 to 10 days.
4. Ice packs to your nose after surgery.
5. Keeping your head elevated after surgery. (Daniel Reichner, MD, Newport Beach Plastic Surgeon)

There is a product called Auriderm-post op gel which delivers the power of Vitamin K Oxide to help improve the appearance of post procedure bruises. The use of Auriderm helps the body reabsorb the blood more quickly.

Auriderm’s Vitamin K Oxide activates the body’s natural healing process to help eliminate the unsightly discolorations in about half the normal time. For best results the first application should be immediately post-procedure, follow by twice daily till bruise is completely gone.Prior the surgery is it very important to avoid aspirin, product containing aspirin and Vitamin E. Keeping your head elevated should help also reduce swelling and additional bruising as well as using some ice compresses around the eye area. (Gregory Turowski, MD, PhD, FACS, Chicago Plastic Surgeon)

Hints on how to minimize swelling:

1. No blood thiners before – asprin, motrin advil, or other drugs that cause bleeding
2. Use Arnica Montana (a health food) for 2 – 3 days before and after
3. Use iced compresses or frozen peas for the first 48-72 hours post op
4. Keep your head elevated – and sleep on pillows
5. Pick a surgeon who uses gentle technique (William B. Rosenblatt, MD, New York Plastic Surgeon)

Gentle Touch By Your Surgeon

There are several ways to minimize bruising:

1. Gentle touch by your surgeon- Bruising during rhinoplasty can be from several factors including tearing of the perisoteum (covering of the nasal bones) during the procedure. Maintaining this layer can help reduce the incidence of bruising
2. Avoid medications which promote bleeding
3. Avoid herbal medications which promote bleeding
4. Avoid social habits which can promote bleeding such as alcohol and caffeine (2 days before surgery and 2 days after)
5. Ice- Preop, intraop, and postop icing is critical to reducing bruising.
6. Avoid strenuous activity postoperatively (Anil R. Shah, MD, Chicago Facial Plastic Surgeon)

Tips to reduce bruising after rhinoplasty plastic surgery

Aside from all of the other tips that my colleagues have mentioned above, the one other thing that I find helpful is to ice the eyes during the surgery.

Before the work even starts I place ice over the eyes and let it stay there for the majority of the case.

Bruising is usually very minimal since I added this technique. (Jason B. Diamond, MD, Beverly Hills Facial Plastic Surgeon)

Reducing bruising after a rhinoplasty

The most important way to have less bruising is to find a plastic surgeon who is gentle. A heavy-handed surgeon will casue more swelling and black and blue than is necessary. I also advise patients to take 1000 mg. of vitamin C twice a day beginning a week before the operation.

There is no scientific proof, but through my extensive experience, I am convinved that this treatment is very effective. (Howard T. Bellin, MD (retired), Manhattan Plastic Surgeon)

Find a gentle and skilled surgeon to reduce bruising after plastic surgery rhinoplasty

How does bruising occur after rhinoplasty plastic surgery? Actually, it occurs during the rhinoplasty when blood vessels on the sides of the nose are cut or broken during the surgery. The bleeding that occurs seeps under the eyes and is visible through the thin skin of the eyelid.

This bleeding most often occurs when the surgeon performs the osteotomies (breaking the bones). There are certain things the surgeon can do to help reduce this bleeding:

1. be gentle.
2. use a very small and sharp osteotome.
3. apply pressure to the site right after doing the osteotomy.

I think using ice after the surgery can help but it is the critical 5 minutes around the time of performing the osteotomy that is the most important surgeon factor to reduce bruising.

Things the patient can do to help prevent brusing are stopping all medications and supplements that effect the blood’s ability to clot such as aspirin, ibuprofen, fish oil, garlic and vitamin E. (Ivan Wayne, MD, Oklahoma City Facial Plastic Surgeon)

Rhinoplasty Healing – How to Reduce Bruising

Bruising after rhinoplasty does not occur every time rhinoplasty is performed. There are two factors that determine bruising:

1. What is done during surgery and
2. What YOU do after surgery.

Obviously the first is in your surgeon’s hands, but there are steps you should take to reduce this.

• 1) Ice – Applying ice to your nose and under your eyes will reduce the bruising and help it go away faster. This is mainly of help for the first 48 hours after surgery. The sooner this is started, the better. I ice all of my patients before, during, and after surgery.
• 2) Activity – Limit your activity for the first several days. Listen to your body and do not over do it. Also, sleep with your head elevated on several pillows and/or a recliner.
• 3) Supplements – Certain supplements such as Arnica and Bromelain have been touted to help reduce bruising.

The jury is still out as to whether they help or nor. Many of my patients use this and some claim to think it helps. Importantly, they are not bad for yo after surgery if taken properly. Best advise is to listen to your surgeon when it comes to their specific healing instructions. The link below will lead you to a video portal where you can learn all about the recovery from video journey of my patients. (Jacob D. Steiger, MD, Boca Raton Facial Plastic Surgeon)

Minimizing Bruising after a Nose Job (Rhinoplasty)  plastic surgery

Post-surgical bruising can be related to the surgeon’s technique and to the patient’s propensity to bleed.

SURGEON FACTORS – OPEN rhinoplasty allows the surgeon to coagulate bleeding vessels and prevent bruising. Some of the major bruising is related to the way the fracturing of the nose is done. There is evidence to support that if the fracturing is done through the skin, in postage stamp fashion, the artery the is located at the junction of the nose and cheek can be avoided and bruising minimized. This artery and is branches are usually injured when the osteotomies are done continuously through the nose.

PATIENT FACTORS – There is little you can do about genetic diseases associated with bleeding except to get transfusions just before surgery. But – you CAN avoid many drugs and supplements that prolong bleeding (such as Aspirin, Advil, Alleve, Nuprin, Garlic, Ginger, Vit. E etc). Consult with your surgeon. (Peter A. Aldea, MD, Memphis Plastic Surgeon)