Postoperative bruising and facial swelling is one of the main concerns of rhinoplasty patients. There is sustained controversy on the surgical manoeuvres, medication and postoperative measures to reduce it, and many published papers address this topic. The authors of this manuscript have done a thorough review of the literature, grouping the papers into different categories such as use of corticosteroids, type of approach, postoperative care, herbal supplements or surgical techniques, in order to separately evaluate the effectiveness of the recommendations provided in each of them. Corticosteroid use, low intraoperative blood pressure, intraoperative cooling, head elevation, absence of nasal packing and periosteal elevation were all related to decreased postoperative oedemas. No clear evidence was found between type of approach, herbal supplements or internal or external osteotomies, but Arnica Montana may be helpful with ecchymosis and swelling although further studies are needed to fully prove it. Surgical downtime is a big issue for patients. Evolution of facial plastic surgery procedures in the last decade shows a clear trend towards minimally invasive procedures so as to reduce this period to a minimum; patients demand fast recovery and quick return to their normal life. This paper provides valuable information on how to achieve these goals in the highly competitive professional and social environment where patient and surgeon interact. A very interesting article for rhinoplasty surgeons.

Interventions to decrease postoperative edema and ecchymosis after rhinoplasty: a systematic review of the literature.
Ong AA, Farhood Z, Kyle AR, Patel KG.
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Eduardo Morera Serna

Hospital Universitario Son Espases, Palma de Mallorca, Spain.

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