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The Effectiveness of Bromelain on Oedema, Subconjunctival Haemorrhage, and Ecchymosis After Rhinoplasty: A Randomised, Double-Blind, Placebo-Controlled Trial Publisher



Rahmaty B1, 8 ; Naraghi M2, 3 ; Mesbahi A4 ; Mohebbi A5 ; Sadeghi B6 ; Zadeh AR7 ; Almasi A6
Authors
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Authors Affiliations
  1. 1. Head and Neck Surgery Department, Arak University of Medical Sciences, Arak, Iran
  2. 2. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Rhinology Research Society, Orphans Worldwide, Jacksonville, FL, United States
  4. 4. Shiraz, Iran
  5. 5. ENT and Head and Neck Research Center and Department, School of Medicine, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Clinical Pharmacy, Iran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Epidemiology, Student Research Committee, Arak University of Medical Sciences, Arak, Iran
  8. 8. Otolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Northern Saadi Ave, District 12, Tehran, Iran

Source: Aesthetic Plastic Surgery Published:2025


Abstract

Objective: To evaluate the effectiveness of bromelain on periorbital oedema, subconjunctival haemorrhage, and ecchymosis after preservation rhinoplasty. Study Design: Randomised, double-blind, placebo-controlled trial Setting: Tertiary referral centre Methods: In this double-blind clinical trial, participants aged 18–45 who were scheduled for open preservation rhinoplasty using the push-down technique and lateral osteotomy were recruited. Twenty-three cases were assigned to the placebo group and twenty-three to the experimental group Bromelain. Results: Regarding gender, 17.39% (8 cases) were male, and 82.61% (38 cases) were female. Comparing the severity of left and right eye ecchymosis between groups at different times showed that bromelain was significantly effective on both sides on the 7th day (p = 0.012). Like ecchymosis, the results demonstrated that bromelain was also considerably effective on subconjunctival haemorrhage on the seventh day post-operatively (p = 0.015). However, the intensity of oedema between groups at different times did not significantly differ. Conclusion: Bromelain increases serum fibrinolytic activity and decreases plasma fibrinogen levels. It is significantly more effective on subconjunctival haemorrhage and ecchymosis compared with the placebo on the seventh day in both eyes after rhinoplasty. Hence, this study indicates that bromelain is remarkably more effective than a placebo in reducing subconjunctival haemorrhage and ecchymosis. Trial registration: Iranian Registry of Clinical Trials ID: IRCT20180519039720N2 Level of Evidence I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2025.
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