Minimize Bruising Rhinoplasty
Bruising after nose surgery
Bruising to some degree is inevitable after most surgical procedures. Blood is released into the tissues around the surgical site due to trauma to the blood vessels during the procedure.
In nose surgery the biggest culprit is the fracturing of the nasal bones that usually accompanies significant reduction of the bridge of the nose.
Each person has a genetically determined ability to control bleeding when they are cut. However, there can be a wide variance in a patient’s ability to clot effectively.
Assuming one’s ability to form a clot is ‘average’ there are a number of things one can do to reduce post operative bruising.
In most surgeon’s offices they will provide you with a list of medications which can promote excessive bleeding and therefore bruising.
Simple avoidance of these substances will go a long way in reducing post operative bruising. Next, there are varying substances that have been found to actively reduce bruising in many, though not all patients.
Arnica Montana, Bromelain and Vitamin K are some of the products I recommend to reduce bruising after surgery. Often overlooked, some simple physical precautions can help reduce bruising. First, keep the head elevated for the first 3 days.
I advise no lifting, straining or bending forward as well. Cold compresses during the first 2-3 days are helpful as well in my experience.
Bruising after nose surgery image
Despite doing everything possible some folks will still have significant bruising. The good news is that most bruising is gone by the second week after surgery. (Jon F. Harrell, DO, Miami Plastic Surgeon)
Also try Bromelain or eat pineapple
You have received a lot of good advice already about how to minimize bruising. Avoid medications and vitamins that make you bleed. You can also take the enzyme in pineapple, Bromelain, which I have found to dramatically improve the amount of bruising seen after cosmetic surgery. After surgery, make sure to use ice on your eyes and elevate your head. Once the bruises are about 5 days out, you can switch to warm compresses. The good news is that all bruising eventually goes away. (Theda C. Kontis, MD, Baltimore Facial Plastic Surgeon)
Minimize bruising after nose surgery
Bruising after nose surgery photo
There are several things that you can do to minimize the bruising. Keep in mind that the amount of surgery you have and your own propensity for bruising are major factors in the bruising that you cannot control.
No aspirin or other products that cause bleeding and bruising for two weeks prior to surgery. No herbal supplements two weeks prior to surgery Icing for the first 48 hours after surgery. (Talmage J. Raine, MD, Champaign Plastic Surgeon)
Minimizing bruising after nose surgery
The bruising seen after a nose surgery is caused by manipulation of nasal bones. If your nose surgery does not require any bony work you should not expect any significant bruising. An expert nose surgery surgeon should have a well designed protocol to minimize bruising. This will include a thorough pre-operative evaluation; avoidance of specific medication, vitamins, nutrients and diet (we give our patients specific written and easy to follow pre-op instructions); expert and gentle intra-operative technique; specific post-operative instruction.
Bruising after nose surgery rhinoplasty
You should find a reputable, experienced and talented surgeon who will guide you through the entire process. (Boris M. Ackerman, MD, Newport Beach Plastic Surgeon)
Several things can be done to minimize your bruising:
- Avoid aspirin, ibuprofen, and similar medications for two weeks prior and after
- Avoid Vitamin E, Vitamin A, Fish Oil, Flax Seed Oil, etc for two weeks prior and after
- Take Arnica and Bromelain for a week prior and two weeks after
- Take a daily multiple vitamin with minerals for two weeks prior and after
- Keep your head elevated above your heart (including sleeping) right after surgery and for the first week
- Avoid strenuous activity, straining, sneezing, etc.
- Apply Ice packs over and between your eyes right after surgery and for 48 hours (Randy J. Buckspan, MD, Austin Plastic Surgeon)
Nose surgery and Bruising
Bruising after nose surgery nose job
The most important factor in bruising following nose surgery relates to techniques that were performed during the surgery. If your nose is broken (termed an osteotomy) as part of the nose surgery, you might experience mild bruising during the first 5-7 days of recovery. In many cases, this can be kept to a minimum by certain precautions that are taken during surgery.
If you do not require osteotomies as part of the nasal reshaping process, it is highly unlikely you will see much bruising at all. Other factors relate to medications and supplements that you might take or not take leading up to the surgery.
In my practice, I have a list of restricted medications that all patients are expected to read and abide by for at least 10 days before the surgery. This list includes multiple prescription and over-the-counter medications/supplements that are known to thin the blood and contribute to more bleeding during surgery.
This translates into more bruising post-operatively. In addition, I have all patients start taking Arnica Montana beginning 2-3 days before surgery. Arnica is a homeopathic supplement that helps further minimize bruising and swelling from a surgical procedure. (John M. Hilinski, MD, San Diego Facial Plastic Surgeon)
Causes of Rhinoplasty Bruising under eyes
Rhinoplasty bruising under eyes depends on a number of factors including the type of rhinoplasty performed, the skill of the surgeon, post-operative patient choices, pre-operative patient choices, and patient genetics.
First off, bruising during a rhinoplasty is almost all from cutting the nasal bones. If your rhinoplasty doesn’t involve cutting the bones, you probably will not bruise at all. Rhinoplasty of the tip only, or ones that involve making the nose larger frequently don’t involve bone cuts. Surgeon skill is also key. On average some surgeons have a lot less bruising than others.
There are ways to cut the bones that produce cleaner cuts with less disruption of the surrounding soft tissues. Surgeons who are careful this way will see, on average, less bruising under eyes. Patients who after surgery keep their heads elevated, stay very calm, ice their face, and avoid blood thinning medications/foods/vitamins will do better.
Patients who before surgery avoid blood thinning medications/vitamins, and start arnica will do better. Lastly, the impossible to control patient genetics. If you bruise easily from other things, you will probably bruise more from rhinoplasty. The same bruise will also be more obvious on fair skinned people as compared to darker skinned people. (Louis W. Apostolakis, MD, Austin Facial Plastic Surgeon)
Several steps to minimize bruising under eyes
While bruising following a rhinoplasty is often related to the steps performed during the rhinoplasty procedure, it is usually out of the control of the patient as well as the surgeon.
However, the following may be beneficial to reduce post-operative bruising after a rhinoplasty: elevation of the head above the heart for a few days, ice application to the nose and eyes, and Arnica Montana. (Roger J. Oldham, MD, Bethesda Plastic Surgeon)
How to minimize bruising after rhinoplasty under eyes
Before Surgery
The important things a patient can do to minimize bruising prior to rhinoplasty are:
- Avoid aspirin, NSAID inflammatories medications such as advil for 10 days prior to surgery.
- Avoid void Vitamin E, fish oil, Ginka Biloba, and other herbal supplements known to cause problems with bleeding.
- Take arnica montana prior to and following your surgery.
During Surgery
Your surgeon’s technique is important – a gentle touch and good technique will minimize trauma
After Surgery
- – plenty of icing is important post operatively.
- – Arnica – Head of bed elevated (Amir M. Karam, MD, San Diego Facial Plastic Surgeon)
The easiest way to minimize bruising under eyes is with three aspects provided by any good experienced rhinoplasty surgeon.
- Keep operative time to a minimum, if possible, and do as atraumatic surgery as possible. An experienced rhinoplasty surgeon can do all but the most demanding rhinoplasties (grafts, extensive suturing, etc ) in less than 1 hour. With experience most good rhinoplasty surgeons learn to handle the tissues with as little trauma as possible.
- The use of epinephrine with the anesthetic Xylocaine certainly helps but the surgeon should wait a minimum of 15 minutes after injection to get the full effect of the hemostasis from the epinephrine
- Last but most important the surgeon should hold pressure on his osteotomie sites (where the bones are broken) for 5 minutes after doing them. This drastically lessens bleeding into the tissues and subsequent black and blue. (Richard Galitz, MD, FACS, Miami Facial Plastic Surgeon)
Minimizng bruising after rhinoplasty under eyes
We give out patients a list of do’s and don’ts. Vit A and E, Aspirin, Garlic, St. Johns Wart, etc. all can precipitate bruising and bleeding. We have them stop this 2 weeks before and after surgery. Ice and elevation also help. Our patients also like Arnica, an herbal supplement. (Jeffrey Roth, MD, Las Vegas Plastic Surgeon)
How to decrease bruising after rhinoplasty under eyes
The most important part of getting a good result from rhinoplasty, or any plastic surgery, is the surgeon that you choose. Years of experience have improved surgical techniques to reduce trauma during the surgery and thereby reduce bruising under eyes from the outset.
Other standard measures are ice compresses around the eyes and head elevation. (Darrick E. Antell, MD, Manhattan Plastic Surgeon)
Nasal surgery, nasal swelling, bruising after surgery
Minimizing nasal swelling may be more difficult than in dealing with surgery in other parts of the body. Facial surgery in all of its forms involve longer and more noticeable swelling because of the increased circulation to the face in general.
All of the traditional recommendations made to help with bruising reduction should be followed- do not use aspirin or antiinflammatory medications for two weeks before and after surgery, don’t take vitamin E for the same period of time, and don’t exercise for at least four weeks after surgery, because this raises the blood pressure which will increasing the bleeding tendencies.
The use of Arnica and Bromelain before and after surgery will also help, as well as to apply ice compresses properly to the face when necessary. (Francis (Frank) William Rieger, MD, Tampa Plastic Surgeon)
Bruising after rhinoplasty
An ounce of prevention is worth a pound of cure.
Before surgery : avoid any asprin or asprin containing medications, Nasids, alcohol, high doses of vitamin A, Ginko Baloba.
After surgery: ice packs; frozen peas, a glove of crushed ice or some cooling devise is helpful for 48-72 hours. Elevation of head for sleeping and avoiding anything that might cause an increase in blood pressure can also be helpful.
Please read the physician from Florida’s analysis of bruise releaving medications, he might be onto something.
No matter, if you do get some brusing; which is a reflection of blood under the skin, it can be covered up with make up, even in a manly way. My patients have instructed me to use a green base make up then a normal skin tone to cover any brusing. (Jon Sattler, MD, Glendora Plastic Surgeon)
Controlling bruising after rhinoplasty
Bruising after rhinoplasty typically is black/purple at days 1-3, brown by days 3-5, yellow by days 6-8 and gone by days 9-10. Swelling is at its worst at day 3-4. Bruising is best controlled by an atraumatic rhinoplasty that causes little bleeding. Usually the most bleeding may occur during nasal bony work (osteotomies), and eventually this blood collection may spread below the lower eyelids and upper cheeks to cause the bruising you fear.
Your surgeon should be skilled enough to avoid major bleeding from bony work and should also prevent bleeding tendencies by making sure you discontinue blood thinning products (aspirin, ibuprofen, NSAIDS, certain vitamins, fish oils, etc) 7-10 days before surgery.
After surgery, icing to the eyes is helpful, but too much ice can be harmful.
Arnica and Bromelain have not been found in placebo controlled trials to help with the bruising, although many surgeons and patients swear that it helps. (Thomas T. Le, MD, Baltimore Facial Plastic Surgeon)
Rhinoplasty bruising
First thing to consider is to be well hydrated before surgery.avoid aspirin and ibuprofen 7-10 days beforehand and avoid alcohol for 2 days pre op. Arnica Montana is a wonderful supplement that you can begin taking up to a week before surgery and eating fresh pineapple before and after helps many patients keep bruising to a minimum. Post operatively keep cold compresses and elevation on your mind to reduce discomfort and swelling. (Marshall T. Partington, MD, FACS, Seattle Plastic Surgeon)
There should be little or no bruising after rhinoplasty
Bruising occurs when blood gets into the soft tissues of the nose, such as skin. During rhinoplasty, the nasal bones are cut to reshape the upper part of the nose. In order to stop bleeding, we all know to apply pressure directly to the site for at least 5 minutes.
Unfortunately, after osteotomy ( Cutting bones ), no pressure is applied to the cut areas and bleeding from these sites continue into the skin causing the racoon eyes etc. Application of direct pressure to the cut areas of the nasal bones for at least 5 minutes will decrease the bruising down 95% of the time. There are those patients who bruise easily due to several factors such vessel fragility or high blood pressure, who are exceptions. (Mohsen Tavoussi, MD, DO, Huntington Beach Facial Plastic Surgeon)
Some homeopathic remedies may work
Ice is your friend. Continuously for the firs 48 hours as cold compresses or chopped ice in a non-latex glove. We also like pineapple juice, 1 large glass daily, starting 1 week before surgery and continuing for 10 days afterwards.
It contains bromelain. Some of our patients also like to take arnica. There are not a lot of studies on these compounds, but they cannot hurt.
Of course, no aspirin, ibuprofen or other so-called NSAID drugs, high doses of vitamin E, St John’s wart, ginko, garlic or ginseng too for 10 days before and 10 days afterwards. (Stuart H. Bentkover, MD, Boston Facial Plastic Surgeon)
Perioperative measures to minimize bruising following nose job.
The amount of bruising and swelling that one experiences following nose job is determined by several factors. Surgical trauma – the degree of injury the soft tissues around the nose undergo during the procedure.
This can be minimized with careful technique and dissection. Skin quality – in general, thin loose skin will bruise more than thick dense skin. Older patients also tend to bruise more due to the increased fragility of their blood vessels.
Pre-existing bleeding disorders – these should be managed and the clotting ability of the patients blood should be normalized as best as possible before proceding with surgery. Preoperative use of medications known to retard clotting and promote bleeding.
The list is long and contains both presecription medications, over the counter medications and homeopathic agents. Consult with your surgeon for details. Perioperative use of agents such as arnica, bromelain, Vitamin K oxide, etc. There is no definitive evidence supporting these measures but many surgeons and medications use these substances.
Perioperative use of systemic steroids such as prednisone – most surgeons agree that this plays a minor to moderate role in limiting swelling. Postoperative cold compress application and head elevation for 3 to 4 days – these measures play a significant role. Postoperative avoidance of stress, physical or emotional exertion. (Mario J. Imola, DDS, MD, Denver Facial Plastic Surgeon)
How Do I Minimize Bruising from a nose job
Preoperatively, one should not have any aspirin or NSAID compounds prior to surgery for at least 7-10 days. Postoperatively, arnica and pineapple, and ice packs can help with bruising. Bruising is a normal part of nose job and may be minimal in some patients. (Paul Vitenas, Jr., MD, Houston Plastic Surgeon)
There are several ways to reduce bruising and swelling after nose job.
Bruising and swelling after surgery are a normal part of nose job. Because the nose is a midline structure, it will take longer to decongest and lose its swelling after surgery. In my rhinoplasty practice I ask patients to make sure that they take care of several things to ensure the quickest recovery possible:
- I ask that their blood pressure be under normal control
- I ask them to refrain from alcohol usage for some time after surgery
- I ask that they add extra protein to their diet before and after surgery
- I ask them to start Vitamin C and Vitamin K supplementation before surgery and continue it into the early postoperative state
- I really encourage aggressive icing after surgery
- I restrict blowing of the nose and ask for open mouth sneezing after surgery, and avoid swallowing any blood after surgery
- I do not allow the use of Aspirin or Aspirin-like products for two weeks before and after surgery to reduce bruising
- I also recommend the use of Arnica Montana and Bromelain, supplements that can be found in most health food stores.
However, the science on these two products is still up in the air, so my recommendation would be to use with caution and only after consulting with your surgeon. It certainly has helped my patients. (Manish H. Shah, MD, FACS, Denver Plastic Surgeon)
Minimize bruising and recovery time by technique
It is true that if the nasal bones are broken bruising is more likely. And of course, all the common tips of avoiding ibuprofen, red wine, vitamin supplements not approved by your surgeon etc. make a difference.
However, in any surgical procedure where the nose is manipulated gently, the natural fusion planes of tissue are respected, and the dissection for surgery is limited as much as possible, the outcome will be quicker healing with less bruising.
These things often happen with a surgeon who works efficiently but allows for plenty of time to perform an elegant operation. (Pramit Malhotra, MD, Ann Arbor Plastic Surgeon)