Several methods have been used to decrease the periorbital edema and ecchymosis after rhinoplasty. In this study, we evaluated the efficacy of hirudoid and dexamethasone in reduction of the periorbital edema and ecchymosis. METHODS Sixty patients who underwent primary rhinoplasty were randomly divided into 3 groups. Group H received hirudoid cream, 3 times per day for 5 days from postoperative-day (POD). Group D received 10 mg of dexamethasone IV, immediately before surgery; and group C (control) received neither dexamethasone nor hirudoid. Two surgeons who were unaware of administered medications rated the severity of edema and intensity of ecchymosis, on 2 nd , 5 th , and 7 th POD.