When Is Bruising the Worst after Rhinoplasty?

When to expect the peak of bruising? 


F, 32, Vermont

Many individuals are fearful of undergoing rhinoplasty not so much because of the pain, but rather the degree of bruising that may occur afterward. Images of post-op patients with extensive bruising found online can be disconcerting for those considering surgery. This is perfectly understandable as the reality of being unable to attend social events or return to one’s everyday activities because of lingering facial bruising can be overwhelming.

While some patients enjoy a speedy recovery with minimal or no bruising around the incision areas or eyes, some bruising and black eyes can be expected for the majority of people. Bruising generally peaks several days after surgery and remains visible for several weeks, sometimes up to a month.

In rare cases, however, bruising may persist longer and 'stain' the skin. Red blood cells have a pigment called hemosiderin in their haemoglobin. During surgery, inadvertent trauma to the blood vessels can cause quantities of this pigment to be deposited. The hemosiderin stains the skin, and these stains can outlast the healing time of normal bruises.

Post-operative bruising is strongly influenced by the rhinoplasty techniques used during surgery. Factors such as if nasal bones were broken, or if soft tissue dissection was included in the procedure, increase the risk of bruising, particularly around the eyes.

Placing yourself in the care of a board-certified facial plastic surgeon will minimize the risk of excessive bruising. A qualified surgeon will inform you of any potential risks or complications involved based on your unique characteristics, and provide you with the information you need to expedite your recovery.

There are several things you can do to diminish the risk of bruising following rhinoplasty. Avoid aspirin, alcohol, and certain herbal supplements for at least one week before and after surgery, as they can thin the blood and increase the risk of bleeding.

Ice packs and cold compresses are essential in the first 48 hours of your recovery, as they minimize bruising and swelling. Some surgeons also recommend foods containing bromelain -- such as pineapple juice or papaya -- as well as Arnica Montana to help with post-op bruising. Your surgeon will provide you with instructions on how best to heal after surgery.

Dr. Robert Brueck has 1 Nose job before & after:

Nose job before image performed by Dr. Robert BrueckNose job after image performed by Dr. Robert Brueck

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Bruising following almost any form of plastic surgery is part of the body's natural response to trauma. Regardless of the skill of the plastic surgeon or how gentle he or she is, rhinoplasty patients will likely experience some bleeding beneath the skin. Bruising occurs when blood cells settle, causing the skin to appear black and blue before changing to a yellow color as they gradually subside.

For most patients, bruising under the eyes and around the nose will peak several days after rhinoplasty and last 7 - 10 days. However, some patients may experience discoloration that lingers for two weeks, occasionally even as long as one month. This isn’t anything to be concerned about, as each individual is unique and the healing process varies from person to person.

Factors such as age figure prominently in the extensiveness of one's bruising. Rhinoplasty patients under age 30 generally experience minimal bruising, while those over 40 experience more substantial bruising that takes longer periods of time to fade. Other factors such as general health, wellbeing, diet prior to surgery, existing health conditions or a genetic propensity to bruise easily will also influence how intensely a person bruises.

There are, however, ways to minimize bruising or help bruises to fade more efficiently. Many  plastic surgeons who specialize in rhinoplasty recommend patients take Arnica Montana or Bromelain supplements before and after surgery, both natural supplements that help to reduce bruising and swelling. Cold compresses -- such as a bag of frozen peas wrapped in a soft cloth -- are also helpful.


Finally, there are cosmetic surgical techniques available that work to dissipate extensive bruising. One recent study demonstrated how vascular filter IPL treatments and specific laser treatments -- such as pulsed dye --  break bruises up more rapidly. If you are considering rhinoplasty and concerned about bruising, talk to your surgeon about what to expect and what can be done to help with your recovery.

Between the 1st week ti the 3rd week. 

Typically the worst time is around 3-5 days right after surgery.  By 7-10 days, most of the bruising is typically gone in our patients. 

Bruising usually peaks at about 72 hours following a Rhinoplasty. After that point the bruising usually begins to subside. Many patients may return to non-strenuous work after about 1 week. 

Swelling and bruising generally peak at 48-72 hours after a rhinoplasty.  We give our patients steroids intraoperatively and have our patients take a medrol dose pack postop to reduce the amount of bruising and swelling.  It is very important to put ice/frozen peas on the eyes for the first 48 hours.  Arnica tablets and LED therapy also reduces bruising and swelling.  

Dr. Gary Breslow has 12 Nose job before & afters:

Nose job before image performed by Dr. Gary D. BreslowNose job after image performed by Dr. Gary D. BreslowNose job before image performed by Dr. Gary D. BreslowNose job after image performed by Dr. Gary D. BreslowNose job before image performed by Dr. Gary D. BreslowNose job after image performed by Dr. Gary D. BreslowNose job before image performed by Dr. Gary D. BreslowNose job after image performed by Dr. Gary D. Breslow

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