Is dark green mucus with blood tinged a normal symptom 2 weeks after rhinoplasty?

Dark Green Mucus with Blood Tinges 2 Weeks After Rhinoplasty

Dark green mucus with blood tinges 2 weeks after rhinoplasty is not normal and warrants prompt evaluation by your surgeon, as it may indicate an infection or other complication requiring treatment.

Evaluation of Post-Rhinoplasty Nasal Discharge

When evaluating colored mucus with blood after rhinoplasty, it's important to understand the normal healing process versus signs of complications:

Normal Post-Rhinoplasty Findings:

• Mild clear or white mucus
• Minimal blood-tinged discharge in the first week
• Gradual resolution of crusting by 2 weeks

Concerning Findings at 2 Weeks Post-Op:

• Dark green mucus (suggests infection)
• Persistent blood in secretions
• Foul smell or taste
• Associated symptoms like pain, swelling, or fever

Potential Causes of Green Mucus with Blood at 2 Weeks

1. Sinus Infection (Sinusitis)

   • Green mucus is a classic sign of bacterial infection
   • May occur in 2-5% of cases following nasal surgery 1
   • Can be exacerbated by pre-existing conditions or surgical complications

2. Retained Secretions

   • Inspissated (thickened) mucus can become colonized with bacteria
   • May appear dark green to almost black 1
   • Can trigger local inflammation and bleeding

3. Surgical Complications

   • Synechiae (scar tissue formation) may obstruct normal drainage 1
   • Crusting along surgical sites can lead to bleeding and infection
   • Recirculation of mucus due to altered nasal anatomy 1

Management Approach

Immediate Steps:

1. Contact your rhinoplasty surgeon for evaluation
2. Nasal endoscopy should be performed to:
   • Identify the site of bleeding 1
   • Assess for infection or other pathology
   • Evaluate surgical healing and potential complications

Treatment Options:

• If infection is confirmed:

  • Appropriate antibiotics (typically amoxicillin/clavulanic acid or levofloxacin) 1
  • Duration typically 7-10 days for sinus infections
  • Nasal saline irrigations to clear secretions

• If structural issues are identified:

  • Removal of crusts or debris under endoscopic guidance
  • Management of synechiae if present
  • Possible revision of surgical areas causing problems

Important Considerations

When to Seek Urgent Care:

• Fever or increasing pain
• Profuse bleeding
• Worsening swelling
• Visual changes or severe headache

Prevention of Further Complications:

• Continue nasal saline irrigations as directed
• Avoid blowing nose forcefully
• Complete full course of any prescribed antibiotics
• Attend all follow-up appointments

Conclusion

Dark green mucus with blood tinges at 2 weeks post-rhinoplasty is abnormal and requires prompt medical attention. While infections after rhinoplasty are relatively uncommon (less than 1% of cases) 2, the presence of green mucus strongly suggests bacterial infection that needs appropriate treatment to prevent more serious complications and ensure optimal surgical outcomes.