All patients undergoing rhinoplasty or revision rhinoplasty by my office are counseled on how to minimize chances of bruising following surgery. The onset and severity of bruising after cosmetic rhinoplasty is dependent on multiple factors, which can usually be accounted for by careful planning. All patients are instructed to review our list of restricted of medications that is handed out to you and is always on our website for reference. I prefer my patients avoid these potential blood thinners at least 10-14 days prior to their rhinoplasty procedure. I also highly recommend that my patients begin taking Arnica Montana starting two days before and continuing for one week after surgery (see photo below of the exact kit we carry in our office). Arnica is an herbal supplement that can significantly reduce chances of bruising from many plastic surgery procedures. Although scientific evidence of this effect is scant, I can tell you anecdotally that Arnica unequivocally aids in healing from nearly all plastic surgery procedures, including rhinoplasty and revision rhinoplasty. Patients who undergo osteotomies (breaking the bone) as part of their rhinoplasty procedure tend to have more bruising than those undergoing only cartilage and soft tissue reshaping of the nose. When performing osteotomies, rest assured I take extreme caution in my technique to help minimize unwanted bruising. This includes use of a specially formulated solution that I inject in your nose to chemically constrict the blood vessels. Elevating your head following surgery is another helpful step that works by counteracting gravity to decrease blood flow and, therefore, pooling of blood around the nasal bones. I am not a big fan of ice compresses applied directly over the nose as this can sometimes cause unwanted shifting of the cast and underlying bones. Instead, I prefer if patients apply a small packet of frozen peas or similar lightweight cold compress over each eye in a symmetric fashion. In doing so you can minimize chances of shifting the newly positioned bones and maximize control of bruising. Finally, limiting physical activity during the first 1-2 weeks following rhinoplasty further minimizes chances of bruising.
