2026-06-04
Nosebleeds and Bloody Phlegm After Zygoma Reduction: Causes and Precautions Explained
Many patients are surprised by unexpected nosebleeds, nasal congestion, and bloody phlegm after zygoma reduction surgery. This is a natural part of the recovery process due to the anatomical relationship between the facial bones and the paranasal sinuses. In this article, we provide an expert guide on the causes of these symptoms, recovery precautions, and the proper ways to prevent 'emphysema'.
Anatomical Reasons for Nosebleeds and Nasal Congestion After Zygoma Reduction
Experiencing nasal congestion or nosebleeds after zygoma reduction is a very common clinical symptom. This is closely related to the air-filled cavities in our facial structure known as the 'paranasal sinuses'.
The paranasal sinuses located around the cheekbones are connected to the nasal cavity. During the surgery, the upper part (roof) of these sinuses is temporarily opened. At this time, minor bleeding from the procedure or the antiseptic solution used for irrigation can flow into the sinuses. After surgery, as these pooled liquids drain out through the nose, they can appear as nosebleeds or cause nasal congestion.
Should You Worry About Bloody Phlegm in Your Throat?
Coughing up bloody phlegm into the mouth shares the same cause. Blood that has entered the sinuses or nasal cavity drips down the back of the throat and mixes with phlegm before being expelled. You can rest assured, as this does not mean there is direct bleeding inside your throat.
This phenomenon typically occurs gradually between 1 to 10 days post-surgery. Once all the pooled residue is expelled, it will naturally resolve as you progress through a healthy recovery.
Recovery Precautions: Preventing Emphysema
Even if your nose feels stuffy after surgery, blowing your nose forcefully is strictly prohibited. Forcefully blowing your nose causes a sudden spike in nasal pressure, which can force air into the gaps of the surgical site that have not yet fully healed.
- Emphysema: This refers to a condition where air enters the tissues beneath the skin, causing swelling and a crackling sensation, which can delay recovery.
- How to handle sneezing: When you need to sneeze, do not cover your mouth or nose. Instead, open your mouth wide and sneeze out loud to disperse the pressure outward.
Please take special care to avoid applying excessive pressure to your nose for about a month following zygoma reduction surgery.
Other Temporary Symptoms That May Occur
In addition to pain and swelling at the surgical site, you may occasionally experience bruising in the conjunctiva or the whites of the eyes (sclera). This occurs when bleeding around the bones spreads through the tissues toward the eyes. It does not affect your vision and will naturally be absorbed over time.
These changes during the recovery process generally correspond to normal healing stages. However, if the symptoms suddenly worsen or the pain becomes severe, it is highly recommended to visit the clinic where you had the surgery for a check-up.
Frequently Asked Questions
Why do I get nosebleeds after zygoma reduction surgery?
Yes, it is because fluid that has flowed into the sinuses is being discharged. The sinuses around the cheekbones may temporarily open during surgery, allowing minor bleeding or disinfectant solution to enter. These accumulated fluids exit through the nose, causing nosebleeds or nasal congestion.
Is it okay if I swallow phlegm mixed with blood?
Yes, you can rest assured. It is a natural phenomenon where blood that has entered the sinuses or nasal cavity goes down the back of the throat and is discharged mixed with phlegm. It is not direct bleeding from inside the throat, and once all the accumulated residue is discharged, it will disappear through a good recovery process.
When will nosebleeds and bloody phlegm symptoms disappear?
They usually disappear gradually between 1 and 10 days after surgery. Once all the accumulated blood and disinfectant solution residue inside the sinuses are discharged through the nose and throat, the symptoms will naturally improve, so you don't need to worry too much.
Can I blow my nose if it's stuffy after surgery?
No, blowing your nose hard is absolutely forbidden. Blowing your nose hard can increase pressure inside the nasal cavity, leading to emphysema where air enters through the unhealed surgical site. For about a month after surgery, care must be taken not to apply excessive pressure to the nose.
What should I do if I sneeze during the recovery period?
You should open your mouth wide to disperse the pressure outwards. If you cover your mouth or nose when sneezing, strong pressure will be applied to the surgical site, which can hinder recovery. Therefore, it is safe to make a sound like "achoo" and naturally release the pressure through your mouth.