NOSEBLEEDS

John R. Bennett, MD
801-328-2522
1255 East 3900 South #301, Millcreek, Utah 84124
756 East 12200 South, Draper, Utah 84020

22 South 900 East, Salt Lake City, Utah 84102

Updated 7/4/17

NOSEBLEEDS

There are two categories of nosebleeds. “Anterior” bleeds originate in the forward part of the nose and are the most common. Although blood may run down the back of your throat (particularly if you pinch your nose or tip your head back) or even out of both nostrils, anterior bleeds initially bleed on one side and out the front of the nose. The other category of nosebleed is called a “posterior” bleed. These are less common and usually seen in older people, and are more dangerous because they tend to be associated with greater blood loss and are more difficult to control. Posterior bleeds tend to bleed down the back of the throat, although there will be blood coming out the front of the nose as well.

Common causes of nosebleeds include: trauma (punched or picking), dry nose (from dry air or medicines that dry you out such as antihistamines), bleeding problems (blood thinners, excessive aspirin or anti-inflammatory drugs, systemic disease), high blood pressure, infection, twisted septum, septal perforation, overuse of over-the-counter nasal decongestant sprays (more than 3 days in a row can break down the nasal lining), cocaine, etc.

How to Stop the Bleeding

The easiest way to stop a nosebleed is pressure:

  1. Gently blow your nose to clear out all the blood clots (there may be some big ones).
  2. Use a decongestant nasal spray (like Afrin or Neosynephrine), which will quickly squeeze down the blood vessels.
  3. Place tissues under the nose, and pinch your nose by placing your thumb and index finger on either side of the soft lower half of your nose. Feel for the bony step-off and place the pads of your fingers just beneath.
    1. Do not pack tissue into the nose, as this irritates the nasal lining, setting you up for future bleeds. It also rips the clot off the bleeding area when you pull out the tissue plug, re-starting the bleeding.
  4. Apply firm but gentle pressure by squeezing the nostrils together for 10-20 minutes.
  5. An ice pack laid across the bridge of the nose as you pinch the lower nose is helpful.
  6. If this doesn’t fix the problem or the bleeding comes back later, please call us.

Office Procedures to Stop the Bleeding

To stop nosebleeds in the office, we can use silver nitrate chemical “sticks,” an electric cautery, or a variety of nasal packs. The nose is first sprayed with Afrin to squeeze the vessels and Lidocaine to numb the nose. This will drip down the back of the nose, so you will notice a bad taste and a numb throat for about an hour. If we need to use an electric cautery, we will give you a numbing shot as well.

After the Bleeding Stops

If your nose was cauterized:

  1. Take it easy for a few days. Strenuous activity (yard work, lifting, weightlifting) or even just bending over at the waist can increase your chances of bleeding again.
  2. Sneeze with your mouth open so that the air will pass through your mouth instead of your nose. Try not to sneeze through the cauterized side, and don’t blow that side of your nose.
  3. Place Vaseline or an antibiotic ointment such as Bacitracin, Neosporin, or Bactroban just inside the nostril three times a day with a Q-tip or your fingertip for a week. Gently place the ointment just inside the nostrils, not higher. It will melt with your body temperature and coat the lining of your nose.
  4. Spray nasal saline mist in the nostrils every 1-2 hours while awake for about a week.
  5. A humidifier next to the bed at night for a week will help keep your nose moist and help it heal.

If your nose was packed:

  1. Take your antibiotic as directed to avoid sinus infection or even toxic shock syndrome.
  2. Take your pain medicine as needed. Do NOT use aspirin or ibuprofen, as both of these thin the blood.
  3. Come back in 3-4 days and we will remove the packing. Removing the packing before then may result in bleeding again.
  4. Do NOT pull the packing out yourself. If it seems to be slipping out, press it back in place and call our office. If it seems to be slipping backwards, call our office or go to the emergency room.
  5. Please call the office with any fever, visual problems, or headache not relieved with your pain medicine.

One or two brief bleeds after cautery is okay, but if you continue to have significant bleeds, please come back for further treatment.

Please call our office immediately at 801-328-2522 or proceed to the emergency room if you have sudden, severe bleeding, or notice excessive bleeding down the back of your throat. Nosebleeds can cause a large volume of blood to be lost in a relatively short amount of time. Some people even need a transfusion if the bleeding is heavy enough or goes on for a prolonged period of time. If you feel lightheaded or faint when you sit up or stand, please contact the office or proceed to the emergency room for evaluation.

What is Rhinoplasty?

What is Rhinoplasty?

Nasal surgery or nose surgery is called Rhinoplasty. But you probably know the more common name for nose surgery: a nose job.

Through nose surgery, noses can be made smaller or larger, narrowed or straightened. Our Utah ENT doctors have vast experience enhancing the appearance of noses and correcting nasal deformities. We’ve prepared a set of articles to help answer questions you may have about nose jobs or rhinoplasty.

    • What is a Rhinoplasty?

 

 

 

  • What Happens During a Rhinoplasty?
  • How Can I Prepare for Nose Surgery?
  • How Long Does it Take to Recover from Nose Surgery?
  • How Is a Broken Nose Set and Repaired?

3 Reasons to Get a Nose Job

Celebrities aren’t the only people who pursue nose jobs. Chances are good you know someone who has had nose surgery or rhinoplasty. That’s because a well-performed nose job can improve the shape, appearance and proportion of your nose. That, in turn, can improve your looks and enhance self-confidence.
No nose is perfect and there are three major reasons people get a nose job.

  1. Your nose is repaired for medical reasons, for instance, to repair a deviated septum and help improve breathing
  2. Your nose is damaged in an accident
  3. You choose a nose job for cosmetic reasons

Read: 3 Reasons to Get a Nose Job

Open and Closed Rhinoplasty Surgeries

Before any nose surgery, your surgeon will examine your nose, the skin on your nose, the features of your face, and will discuss your goals and reasons for rhinoplasty with you. Once you commit to a nose job, there are two types of rhinoplasty surgeries: closed rhinoplasty and open rhinoplasty.

Small nasal humps or minor fullness in the tip of the nose can be performed in what is called a “closed” rhinoplasty. All skin incisions are done inside the nostrils, leaving no visible scars. A splint is worn for about a week afterwards. If the septum (the inside part that divides the two halves of the nose) needs straightening, this is usually done at the same time, and the internal splints usually stay in your nose for approximately one week.

More challenging nose surgeries (and most revision nose surgeries) are done with an “open” technique. A small zig-zag cut is made between the two nostrils, and is joined to cuts inside the nostrils that allow the skin of the nose to be lifted up. The cartilage and bone of the nose is exposed, allowing us to make major changes in the tip, the sides and the top of the nose.

Noses can be made smaller or larger, narrowed or straightened. Tips can be made more refined or prominent, raised or lowered. If more fullness is needed, your own cartilage can usually be harvested from your nasal septum, your ear, or even from a rib. Collapsed noses can be corrected using similar techniques.

A Natural Look is Our Goal

We’ve all seen pictures of celebrities with bad nose jobs. Our philosophy is that a nose must look “natural” after surgery. An operated appearance is to be avoided.
Cosmetic nose surgery can correct major deformities, or can correct subtle problems that detract from the overall appearance of the face. The good news is that our Utah rhinoplasty patients are satisfied with their nose surgery.

Contact the Ear, Nose and Throat Center with Rhinoplasty Questions

Call the Ear, Nose and Throat Center at 801-328-2522 to set an appointment with our Utah ENT doctors to discuss if a nose job is right for you.

Read: How Can I Prepare for Nose Surgery?
Read: How Long Does it Take to Recover from Nose Surgery?
Read: How Is a Broken Nose Set and Repaired?
Read: 3 Reasons to Get a Nose Job

Fix a Broken Nose

Repairing a Broken Nose

Nasal fractures and broken noses in Utah are common. Noses can be injured while playing sports—
baseball, football, rugby, skiing, wrestling and many other activities are common causes of broken noses.
Noses can also become fractured in accidents. And noses can be broken as part of rhinoplasty to help
enhance the look of a patient through cosmetic nasal surgery or the nose.

While a broken nose is painful and produces swelling, our Utah ENT doctors are expert at setting and
treating broken noses. We’ve written this article to help you understand what you can expect following a
broken nose.

Setting a Broken Nose

Broken noses with crooked nasal bones can often be set right in the office after numbing the nose, and this
is not a particularly painful procedure. It must be done within two weeks of the injury, before the bones
begin to set in their new position. If more than two weeks have passed since the injury, we usually have
to wait at least six months to let the bones completely set in their new position, and then perform a formal
rhinoplasty.

What to Expect Following a Broken Nose

If it is necessary to break the nasal bones to straighten the nose or reduce the size, you can expect to have
black eyes for one to two weeks. Fortunately, the swelling in the nose and face starts to go down after about
three days. However, your ENT doctor may prescribe painkillers for the first week.

Read: Recovery from Nose Surgery

We recommend our patients lie low for a week or so to enable their nose to heal. That means you may want
to schedule a few weeks off work to provide time for bruising and swelling to decrease.

Contact the Ear, Nose and Throat Center for Questions about a Broken Nose

If you have a fractured nose or wonder if nose surgery is right for you, please contact the Ear, Nose and
Throat Center at 801-328-2522 for a consultation and treatment. We’ll work with you to diagnose and treat
your condition in the most effective manner that helps you once again breathe easy following a broken
nose.

Recovery from Rhinoplasty

Each year we regularly perform rhinoplasty surgery in Utah. Prior to surgery, ENT doctors will provide specific post-operative instructions that include directions that will help you care for your nose, as well as explain what to expect as you recover.

What to Expect Following a Nose Surgery

Once your cosmetic nose surgery is complete, internal tubes and packing will be placed inside your nose. A splint or bandages to help your nose heal are typically used on the outside of your nose to provide support.

For the first days following surgery, you can expect slight bleeding and mucus to drain from your nose or when the dressing is removed. We commonly use a drip pad under your nose to absorb drainage. This drip pad is a small piece of gauze that is held in place with tape and is easy to remove and replace as needed. Your ENT doctor will provide directions on how often to change the gauze.

If it is necessary to break the nasal bones to straighten the nose or reduce the size, you can expect to have black eyes for one to two weeks. The swelling in the nose and face starts to decrease after about three days.

Read: How Is a Broken Nose Set and Repaired?

Swelling and Resting Following Nose Surgery

After surgery, most people “lie low” for a week or more. To minimize bleeding and swelling and improve your comfort, we recommend bed rest for our patients. We also suggest you rest with your head at a higher elevation than your chest.

All patients react differently to surgery, but gauze and dressings are typically used for one to seven days following surgery. The splint or cast on your nose will also remain in place for about one week.

Pain killers are usually necessary for the first week following nose surgery.

Temporary swelling and black-and-blue discoloration of your eyelids and numbness is common following nose surgery. In most cases, the swelling and numbness will last for two to three weeks. Some people go back to work after one week when the bruising has turned a yellowish color and is fading. Others take two weeks off of work.

In rare instances, swelling can last between six months to a year. We advise our Utah rhinoplasty patients to use ice packs or cold compresses to minimize swelling and pain. Your doctor will provide additional direction and instructions following surgery and at a follow-up appointment.

The nose itself, particularly the tip may remain swollen for several months. It may take a full year before the nose completely settles down, but most of the healing takes place in the first two months.

Contact the Ear, Nose and Throat Center with Rhinoplasty Questions

Our ENT doctors in Salt Lake City, Park City and Draper, Utah are expert at cosmetic nose surgery. Contact the Ear, Nose and Throat Center at 801-328-2522 to set an appointment with one of our board-certified physicians to discuss questions about nose jobs and nasal surgery.

Read: How Can I Prepare for Nose Surgery?
Read: How Long Does it Take to Recover from Nose Surgery?
Read: How Is a Broken Nose Set and Repaired?
Read: 3 Reasons to Get a Nose Job

Read: What is a Rhinoplasty?
Read: Recovery from Rhinoplasty
Read: 3 Reasons to Get a Nose Job

Read: Repairing a Broken Nose

Read: What Happens During a Rhinoplasty?
Read: How Can I Prepare for Nose Surgery?
Read: How Is a Broken Nose Set and Repaired?

About Rhinoplasty Surgery

Our Salt Lake City rhinoplasty patients expect positive outcomes and the Ear, Nose and Throat Center delivers. However, before you choose to have a nose job, it’s important for you to understand what you can expect during nose surgery.

Rhinoplasty is usually performed within the nose. The ENT surgeon will adjust the bone and cartilage beneath your skin. In an closed rhinoplasty, the surgeon makes small incisions inside the nostrils. In an open rhinoplasty, the surgeon will make cuts in the septum between the nostrils. At this point, the surgeon will separate the skin from the underlying bone or cartilage and mucous membranes. This allows your surgeon to cut, trim or augment nasal bone and cartilage.

The size of a nose can be both reduced or increased and shaped and molded during rhinoplasty. The surgeon may use small bits of cartilage harvested from inside your nose or your ear for small procedures. For more complex changes and enhancements, the surgeon may graft bone material into an existing nasal bone to enhance the size and shape of the nasal bone.

Read: What is Rhinoplasty and Reconstructive Nasal Surgery?

Anesthesia Used During Rhinoplasty Procedures

Nose jobs are performed in conjunction with local or general anesthesia. Your doctor will discuss your options before surgery. The following information details the difference between local and general anesthesia.

  • Local anesthesia. You’re probably familiar with local anesthesia from trips to the dentist. With local anesthesia, the doctor will inject medication that numbs pain directly into your nasal tissues. This allows the doctor to focus on your nose without numbing your entire body. The doctor may also use an intravenous line to sedate you during the procedure. Using an IV will make you feel sleepy but will not make you fully go to sleep.
  • General anesthesia. With general anesthesia, medication is administered either through your nose or through an IV placed in a vein in your body with the intention of inducing a state of unconsciousness. The Ear, Nose and Throat Center works directly with licensed anesthesiologists who will constantly monitor your condition and work directly with the ENT doctor to ensure your comfort and safety.

Following nose surgery, you will immediately wheeled into a recovery room where the nursing staff will monitor your condition. In many cases, patients will leave the hospital or surgery center a few hours after surgery (a friend or family member will drive you home). In other cases where the rhinoplasty is performed in a hospital, the patient may spend the evening in the hospital.

Read: Recovery from Rhinoplasty

Contact the Ear, Nose and Throat Center with Rhinoplasty Questions

A rhinoplasty or nose job is a common cosmetic surgery that can correct breathing problems and improve the appearance of your nose. Call the Ear, Nose and Throat Center to learn more about rhinoplasty in Salt Lake City and Draper, Utah.

Read: What is a Rhinoplasty?

Read: Recovery from Rhinoplasty


Read: 3 Reasons to Get a Nose Job

How to Prepare for Nose Surgery

Rhinoplasty can enhance your appearance and help improve medical issues, which can make it easier to breathe easily through your nose. However, before the Ear, Nose and Throat Center schedules a rhinoplasty, we will meet with you to discuss your expectations and conduct a thorough physical examination. During this meeting we will:

  • Discuss your medical history: We want to understand the medications you are taking, medical conditions you currently have or have had in the past, and any information that can help us determine if a rhinoplasty is a good fit for your needs.
  • Conduct a physical examination: We will perform a thorough medical examination, which may include blood and lab tests. Your ENT doctor will also closely inspect the skin inside and outside your nose to determine if you are a good candidate for rhinoplasty.
  • Shoot photographs of your nose: We will take photos of your nose from a variety of different angles. Your doctor will reference these photos prior to surgery and may use them during surgery for additional guidance and reference. We will also shoot before and after photographs so that you can easily see the nose job results.
  • Discuss your expectations: This is an important discussion because it’s critical for you and your surgeon to understand what is and is not possible in a rhinoplasty. We want to be sure that we understand your motivation for surgery and set clear expectations for the surgical outcome. Consider this candid discussion the roadmap for nose surgery success.

Read: Rhinoplasty and Reconstructive Nasal Surgery

Before your nose job we will encourage you to:

  • Avoid certain medications. For up to two weeks before and after surgery, we will recommend you avoid medications that contain aspirin or ibuprofen (Advil, Motrin IB, others) because these medications may increase bleeding. Your ear, nose and throat doctor will provide more detail and direction regarding medications before and after nose surgery.
  • Arrange for help on the day of your surgery. In most cases, a rhinoplasty is an outpatient treatment. That means you will go home within a few hours after your surgery. However, this means that you need to arrange transportation from the surgical center to your home. We also suggest that you ask a friend or family member to stay with you for a few days following surgery to provide assistance. It is not uncommon for patients to experience memory lapses, impaired judgment and slowed reaction time within the first 24 hours following surgery and sedation. A friend or family member can help you during this transition period and increase your comfort as you recover.
  • Stop smoking. Smoking is a bad idea at all times. However, smoking can slow healing following surgery, and we want you to recover quickly from rhinoplasty.

 

Contact the Ear, Nose and Throat Center for Rhinoplasty in Utah

Rhinoplasty is a common plastic surgery procedure and one we regularly perform. Contact the Ear, Nose and Throat Center to schedule rhinoplasty in Utah today. We’ll work with you to assess your situation and, if appropriate, develop a treatment and surgical plan that helps you get the nose you’ve always wanted.

Read: Recovery from Rhinoplasty and Nose Surgery

Read: What is a Rhinoplasty?


Read: 3 Reasons to Get a Nose Job

What is Image Guided Sinus Surgery?

Sinus infections and sinusitis affect millions of people each year. Estimates top 30 million Americans or more.

If you suffer from sinusitis (regularly occurring sinus infections), your ear, nose and throat doctor may suggest image-guided sinus surgery or minimally invasive sinus surgery.

It sounds high-tech and it is. The good news is that minimally invasive sinus surgery is a more effective way to treat sinus infections and sinusitis and offers real benefits to patients.

Read: 5 Benefits of Minimally Invasive Sinus Surgery [LINK TO NEWARTICLE]

A GPS System for the Sinuses

You’ve likely used a GPS navigation system like Google Maps while driving. These systems help navigate complex roadways and point you in the right direction.

An image-guided surgery system works much like a GPS system for your sinuses. The surgeon inserts an endoscope (similar to a telescope) into the nose. A camera lens is located at one END of the scope while the other end is linked to a computer monitor.

The system helps the surgeon create a detailed surgical plan by viewing a three-dimensional map of the twisting nasal passageways on the computer screen. This plan includes the ideal locations to make any incisions, critical areas within the nose to avoid and the best path to the infected area.

Best of all, this map returns information in real time, so a surgeon can react and adjust as needed to help ensure a successful outcome.

Prior to the procedure, Ear, Nose and Throat Center may perform a CT scan of the sinuses on our in-house CT scanner located in our downtown Salt Lake City office. A special mask may be placed on your head that provides information that serves as reference points during the scan and surgery. The CT technician may also place temporary marks on your face to indicate key reference points.

This data is loaded into the image-guided system to create a pre-surgery map and then consulted during surgery.

Why Choose Image-Guided Sinus Surgery?

Our ENT doctors in Salt Lake City and Draper, Utah regularly recommend and perform image-guided sinus surgery because it offers key advantages, including greater accuracy and precision, minimal or no scarring and faster recovery times.

Most people who experience image-guided sinus surgery can return to work within a few days. Recovery symptoms are often compared to the feeling of congestion that accompanies a head cold or sinus infection.

Learn More about Minimally Invasive Sinus Surgery

Regular sinus infections can be diagnosed and treated by a trained ear, nose and throat doctor. Our board-certified ENT doctors in Salt Lake City and Draper, Utah are happy to answer questions about minimally invasive sinus surgery and determine if that treatment approach makes sense for your conditions.

Our surgical outcomes are excellent and we welcome your call at 801-328-2522 to schedule an appointment.

Nose ring issues

Your Nose: To Pierce or not to Pierce?

Nose piercing in the U.S. have increased dramatically. But is it the same as getting your ear pierced? NO! Compared to piercings in the ear lobe, nose piercings can become infected more easily and the sensitive tissue may be damaged.

When considering a nose piercing the first thing you should do is to consult your ENT doctor, as any of our specialists will be able to give you some advice on if such a piercing is going to be right for you. If you already have a pre-existing health condition, a piercing can quickly lead to complications, so seeking medical advice is a must.

Oh, you say you already have a nose ring? Taking care of your piercing is important and you must keep it clean. Ideally, you should wash the area at least twice each day with an antiseptic solution. A tougher admonition is refraining from touching your nose or the jewelry as a habit — a prime cause for harmful infection. If you do not want the piercing anymore, simply take it out and the hole will not take too long to completely heal; and usually no scar will be left behind. Just make sure to keep the hole filled or you will have to get the piercing all over again.

Here are a few things to keep in mind while caring for your nasal jewelry. Ensure the stud doesn’t fall out when you are asleep and get lodged int he nasal passages. Without proper care, the hole can easily become infected, causing pain, disfigurement and bleeding. When first wearing a new nose ring or stud, simple actions such as blowing your nose and sneezing with a nose ring can be a new experience.

guy picking his nose

Be Careful when You Pick Your Nose or Pluck Your Nose Hairs

Everybody picks their nose, right?

You need to pick now and then. Maybe something is hangin’ out or it itches like crazy. However, if you pick too frequently, or really get into it, then you could cause cuts or irritations, as well as infections. Tears of the nasal septum, the partition separating the nostrils, are common among people who mine their nostrils for 15-30 minutes or more a day, according to a study from Wisconsin’s Dean Foundation. The less time you spend picking and more care you take to extract those little piece of dry mucus, the better.

You also pluck your nose hairs.

Keep in mind, those hairs are there for a reason. At the same time, no one likes to look at tufts of hair descending from the nostrils of friends or co-workers. Experts say these hairs keep contaminants and harmful microorganisms from entering your brain and respiratory system. But when they aren’t even in your nose? Trim the tips but keep the bases embedded in the nostrils. If you pluck them out, you create tiny open wounds in the skin inside your nose and you become susceptible to infection from all those same microorganisms caught in the protective, surrounding hairs.

Nose bleeds

What To Do Prevent Nosebleeds and Stop Them When They Occur

  1. Don’t pick your nose. That may have started it or will make it worse once you are bleeding.
  2. Don’t stop it with wadded tissues up your nose. Depending on how soft your tissue is, it could be just further scraping your nostril lining.
  3. Pinch your nostrils. Most nosebleeds happen near the front of your nose so firmly hold your nostrils together for five or ten minutes. Don’t rub or twist.
  4. Keep your house air moist. Many nosebleeds start because dry air irritates your tine blood vessels in your nasal lining and breaks them open.
  5. Leave the bridge of your nose alone. The blood vessels that usually bleed are not on the bridge of your nose. That just irritates the bone.
  6. Don’t tip your head back. That just causes the blood to run down your throat and can irritate your stomach. Instead lean slightly forward.
  7. Saline or Vaseline® may help. If you regularly spray some saline into your nose when it feels dry or gently apply a bit of petroleum jelly, you can avoid drying out the lining of your nose.
  8. Don’t put pressure on your neck or apply cold to your nose. Some say their grandma told them to put a cold compress on their nose or pressure the back of their neck. Doesn’t really help. Sorry, grandma.
  9. Use nasal decongestant if need to stop the bleeding. If your nose hasn’t stopped bleeding after 10 minutes, applying nasal decongestant may help because it restricts the blood vessels.
  10. If bleeding still won’t stop, get help. A nosebleed that exceeds 20 or 30 minutes needs a doctor or emergency room care. Or if the bleeding is so heavy, you feel dizzy then you’ve lost too much blood.