After Rhinoplasty Surgery Will I Need Nasal Packing?

Nasal packing is uncomfortable, and may lead to more bruising and possibly infection. In our practice, nasal packing has not been used for over 17 years. Hope this helps. Dr Joseph

It’s important to realize that post-operative care and the use of nasal packs varies from patient to patient and depends upon a multitude of variables.  Although nasal packing is commonly used in both rhinoplasty and septoplasty patients, it’s not used in every case.

            A large variety of nasal packs are utilized following rhinoplasty surgery.  These include the use of ribbon gauze, merocel and xeroform gauze.  These materials are utilized when excessive bleeding or drainage is anticipated following rhinoplasty surgery.

            Unfortunately, nasal packing can cause significant nasal congestion with resultant post-operative discomfort.  For this reason, packing isn’t always utilized when patients undergo rhinoplasty.  Instead packing is utilized when the potential for bleeding and drainage exists. 

            If you’re concerned about nasal packing it’s important to discuss this issue with your plastic surgeon.  Your surgeon can discuss this issue and the probability of your needing packing following rhinoplasty surgery.

With traditional rhinoplasty surgery the use of packing or a splint was used inside the
nostrils to reduce bleeding. However patients found packing of the nose very
uncomfortable as it causes symptoms of congestion, discomfort and sometimes
pain. The feelings of packing in the nose can be similar to those of the
congestion caused by a bad head cold. Dr. De Silva avoids packing the nose for
these reasons, and utilises alternative more modern techniques such as the use
of special stitches in the nose, as a consequence most patients are able to breath through their
nose soon after surgery.

In almost all cases of rhinoplasty you can avoid packing the nose, which translates into a much more comfortable recovery for the patient. I have not 'packed' the nose in over 7 years now. In the past, this was done commonly to help minimize chances of bleeding the early recovery phase and to help encourage the internal lining of the nose to heal quicker. In most cases of septoplasty and rhinoplasty, an absorbable suture can be used inside of the nose to accomplish the same goal - obviating the need for packing.

As with any rule though, there are those exceptions. If the surgeon encounters bleeding unresponsive to normal techniques, it needs to be controlled with placement of packing. Fortunately, this is quite rare.

   Its been at least 5 years since i used nasal packing!  I used to pack all my noses because that was what I was taught in training. I found my patients were uncomfortable and were very frightened by what all their friends told them about packing. Since I have stopped using packing I have not had any more bleeding than  when I used packing. If i do need to put something in the nose it is usually a small amount of material that stops minor bleeding. This material I use usually dissolves by itself.. If on a rare patient I have more bleeding than i anticipate I would not hesitate to use packing. Its all about patient safety!
Good Luck

Packing is used mostly to prevent bleeding.  In most cases, I do not find there to be significant bleeding by the time I am completing surgery.  I will place thin splints inside the nose if I do work on the septum during surgery.  But patients can breath around these spints and they do not cause discomfort.

 Placing packing in the nose depends on the surgeon's preference. While the term "packing" often reminds patients of  a long string placed in the nose after surgery as done in the "old days" and often told stories of removing large amounts of gauze.
However, surgeons sometimes place small pieces of cotton in the nostrils that are not uncomfortable and barely felt. Removal is often easy and painless. The purpose of the small cotton ball is to prevent any drainage during the first night. This is usually worthwhile for the patient.

Typically, we don't use nasal packing unless there's an absolute need. It all depends on the amount of work your septum is getting and that is determined at teh time of surgery. Every rhinoplasty is different so you never really know what you're going to end up with when you're talking about details like this one.
Best Wishes,
DoctorMeade

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.

The decision to pack your nose after Rhinoplasty will depend on the surgeon's preference. In my opinion nasal packing is very uncomfortable for patients and not necessary. For this reason I NEVER pack my noses after rhinoplasty whether it be a comsetic rhinoplasty, functional nose surgery, or a combination. Instead I use dissolvable sutures on the septum that you will never notice.