Fast facts

Rhinoplasty


What it is: A plastic surgery procedure to improve the appearance, proportions and structural functionality of the nose.  Rhinoplasty, commonly called a nose job, can enhance facial symmetry and harmony to improve the patient's self-confidence.  Breathing can also be improved as a result.


What it addresses: Specific aspects of the nose, such as:

- Nose size
- Nose width
- Asymmetry
- Nostrils


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Question

After rhinoplasty surgery will I need nasal packing?

Does everyone need nasal packing after a rhinoplasty?  It sounds really uncomfortable.


Asked by: Edna, Great Neck, NY

Answers (3)

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1
June 20, 2008
William A. Portuese, MD
William A. Portuese, MD
Board Certified
Facial Plastic Surgeon

Nasal packing is no longer needed or required after rhinoplasty surgery or septoplasty surgery.  This is a technique that was very common 20 and 30 years ago.  On a rare occasion (1 in 1500 rhinoplasties) a patient will have an uncontrollable nosebleed that is unresponsive to local anesthetics and nasal sprays.   This is the only time nasal packing is would be required.

2
May 15, 2008

Packing is rarely needed with rhinoplasty

Sam Naficy, MD
Sam Naficy, MD
Board Certified
Facial Plastic Surgeon
Answer by Sam Naficy, MD

Routine packing of the nose is not required with modern rhinoplasty techniques.  Any surgeon who performs rhinoplasty on a regular basis should be able to place dissolving sutures inside the nose (called quilting sutures) that make packing unnecessary. 

Over the past 1,000 rhinoplasty procedures that I have performed there was only one patient who required overnight nasal packing due to persistent oozing.

Packing is very uncomfortable when it is inside the nose, and even more uncomfortable when it is being pulled out with you awake!  There are other major risks with nasal packing, such as toxic shock syndrome and obstructive sleep apnea.

3
April 9, 2008

We avoid nasal packing for patient comfort after rhinoplasty

Peyman Solieman, MD
Peyman Solieman, MD
Board Certified
Facial Plastic Surgeon

Want to know the most significant complaint we hear about after Rhinoplasty surgery? It’s not pain, pressure, headache, or even discomfort. In fact, rhinoplasty is rarely very painful. The symptom we hear about most is nasal congestion.

Most surgeons still use some form of packing or splint in the nose after surgery to reduce bleeding. These can either be merocel, ribbon gauze, xeroform or a variety of other forms of packing. The end result unfortunately is more discomfort for the patient.

While not being able to breathe through your nose is not earth-shattering, it is extremely annoying. Think of it like a bad head cold that lasts. So, anything we can do to prevent this symptom is meaningful to you, and therefore important to us. And the biggest thing we can do to help, is to avoid nasal packing altogether.

Packing is routinely used by some to help prevent excessive bleeding or dripping. We find we almost never need it. By handling tissues exceedingly carefully and gently, we find that we can generally keep bleeding, bruising, and swelling to an absolute minimum…and the benefit to you is an earlier return to breathing through your nose, less blockage from the beginning, and no painful removal of crusted packing.

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