Q: Dr. Eppley, For the past year, I have been having frequent sometimes heavy nose bleeds three to five times a week. I wanted to mention this to you. Is this a cause for concern going into rhinoplasty surgery? It usually stops easily if I pinch the bridge of my nose. I’ve noticed it is somewhat related to stress in my life.

A: Having a history of nosebleeds before undergoing a rhinoplasty does not preclude you from having one. Having them at the frequency of three to five times a week and being heavy in nature is a cause for some concern about what would happen after a rhinoplasty and having to manipulate your nose to stop the bleeding. This may have adverse consequences on the ultimate aesthetic outcome of the rhinoplasty.

Stress is not really a reason or cause of nosebleeds, there would have to be a more anatomic explanation. I would recommend that you have an evaluation by an ENT specialist to try and determine their source. You may or may not be able to do find a cause but it would be prudent to have that evaluation before undergoing any form of nasal surgery.

Dr. Barry Eppley
Indianapolis, Indiana