Rhinoplasty: Q&A
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Why Do Some Doctors Use Packing of the Nose and Others Don't?
I've had surgery on my nose and had packing. I am needing a revision rhinoplasty and this doctor is stating he does not need to pack my nose. That this does not need to be done anymore. Is this true? Why do some doctors pack and others don't?
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17 Doctor Answers |
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Sharpie
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Packing the Nose: Sometimes Necessary, Sometimes Not
There is certainly nothing wrong with placing packing in the nose if it is deemed necessary; in fact there are times when it is to the patient's benefit. The concept behind packing is to minimize bleeding or prevent a severe nose bleed. If major septal work is performed, I will use some form of packing. However, what causes discomfort is the type and quantity of packing. The variety I use most commonly is a folded non-stick gauze (Telfa) which slides out easily the next...
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Packing after nose surgery not necessary
Packing of the nose is an antiquated way of performing a rhinoplasty that was discarded over 20 years ago. Packing in the nose creates lots of pain and pressure because the nasal tissues swell against it. Extensive pain medication will be needed if packing is placed. Many inexperienced rhinoplasty surgeons continue to pack noses. In our 20 years of private practice we have not used packing after nasal surgeries.
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Nasal Packing after Rhinoplasty
Although there is nothing wrong with packing after rhinoplasty, I think it is fair to say few surgeons do this any more. Although this was the standard of care many years ago, normally it is not necessary. I use a single piece of telfa overnight to keep the nasal lining in proper position.
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Why Do Some Doctors Use Packing of the Nose and Others Don't?
Not all Rhinoplasty surgeons pack the noses. Some patients required packing some do not .For example, if I performed a Rhinoplasty with septum grafts. I often do not pack the nose on these patients . Instead ,I use a nasal sepal splint to immobilized the septum but not nasal packing.
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Nasal packing after rhinoplasty
There are different approaches to ensuring a smooth post-operative course after rhinoplasty, and packing the nose may be indicated in certain cases but not others. Sometimes after septoplasty sutures are placed inside the nose to obviate the need for packing.
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No Packing Necessary
Sometimes in medicine we do things because "that is the way I learned it and it has worked for a long time." With nasal packing, this is unfortunately the case. Thankfully, most are going away from it. Anyone who has had nasal packing realizes that it is torture to have it in place for any period of time and worse when removing it. The only historical benefit is that the bleeding is worse without the packing. After surgery my patients...
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Nose packing after surgery
Nasal surgeons have used packing of the nose after rhinoplasty and septoplasty procedures for years...the thought being that the compression applied by the packing gauze prevented the dreaded complication of bleeding.
I have not used nasal packing for all of my routine primary rhino/septoplasties for years and occasionally place a septal splint (plastic with holes to breathe thru) with major septal reconstructions. Literature and my personal experience shows that patients who are not pack
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Nasal packing is not routinely used after Rhinoplasty Surgery any more.
During my ENT residency, nearly all patients that underwent nasal surgery were given packing for 1-3 days. During my fellowship in facial plastic surgery (1998), my mentor convinced me it was not necessary. If septal work is performed, a septal quilting stitch is placed: this reduces or eliminates the possibility of a septal hematoma.
Nasal packing breeds infection, causes patient discomfort, and is largely unnecessary for the vast majority of my patients. I don't use it...
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Nasal packing
I occasionally use packing in side the nose. This may because I am concerned about bleeding or I want the packing to bolster some of the internal work I have done.
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Nasal packing with Rhinoplasty
Packing is not usually necessary if the surgeon uses certain techniques to re-approximate the internal tissues. However, occasionally it is needed for a short time depending on the specific problem and particular nose. Frequently a surgeon will learn one way and never consider another.
Highlands Plastic Surgeon
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Some Doctors Use Packing of the Nose and Others Don't
Very personally opinion and training of the plastic surgeon. Most use some degree of packing, like me. 30 years ago I use a good amount of nasal packing. Today I use very little amounts.
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Packing after rhinoplasty.
This depends on the doctor. We use a strip of paper like product and others use packing. It is for oozing after surgery.
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Packing is not usually necessary after rhinoplasty but it helps with comfort after the first 24 hours
That being said, I still usually use a very light packing over night for most rhinoplasties. This is not absolutely necessary and can be avoided if the patient really does't want packing. The reason I use packing is to absorb the oozing (aka light bleeding) that may last for a few hours after surgery. Another reason is ta ht I use cartilage grafts in the vast majority of rhinoplasties for long lasting support. These grafts are often taken from the septum. A light packing against the...
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Depends on the doctor
I have been doing noses over 40 years and almost never pack. In my experience, I use sutures and other tricks to avoid packing a nose. It is very yucky for the patient and annoying to remove.
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Nasal packing is often not necessary in rhinoplasty
We generally do not pack the nose after nasal shaping, and we feel that the trend is away from packing for most rhinoplasty procedures. The purpose of the packing is to support the septum after it has been straightened, and to reduce the risk of bleeding in the first few days after the rhinoplasty procedure. Bleeding seems to be less a problem today, and there are more comfortable ways to secure the septum.
Best of luck,
peterejohnsonmd
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Nose Packing is NOT always necessary
To be able to work on the septum between the nasal passages, its lining needs to be carefully dissected off. The septum is then modified, harvested, straightened, or a variety of other techniques are done on it. To assure the survival of the remaining septum cartilage and bone, its mucosa lining, which carries the blood vessels, must be applied back to it AND the space between the lining and the septum must be obliterated to prevent fluid or blood collections which could ulcerate the lining....
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The need for nasal packing after nose job
When the lining of the septum is elevated and the cartllage is removed, a space that has the potential to collect blood can occur. Packing decreases the tendency by pushing together the seperated linings allowing them to stick together and obliterate the space. If no cartilage is harvested, then the lining will not be separated and no packing is required. Alternatively, the two separate linings can be sewn together like the layers of a quilt blanket and this will eliminate the potential...
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