Why isn't my cast straight? Will it affect how my nose will look like? (Photo)

Question

I had a rhinoplasty + septoplasty on monday and I am trying not to freak out but I just thought I would ask, is my cast not put correctly? One side is not "sticking" on the side of my nose but the other side is and it just doesn't look straight at all... I am getting it removed tomorrow and obviously I am a bit scared, I know it takes time before seeing the final result and for the swelling to go down but if my nose is not right in the middle of my face I will see it straight away, wouldn't I?

Sirius K. Yoo, MD · Answer

Thank you for your question and photo.  I try to make sure the splint is on straight at the end of the rhinoplasty operation because of this exact reason.  If I were the patient, I would naturally think that it couldn't be good that the splint is crooked, right?  Don't worry or get too worked up.  The split is mostly there to keep the nose from swelling too much after surgery, keep the skin envelope "stuck down" and to a lesser degree protect it.  When the splint is not on symmetrically which is definitely your case, it should not make a difference in your long term outcome as long as the underlying bone and cartilage structure is sound.  Similarly, a splint that is put on straight will not improve a rhinoplasty outcome if the bone and cartilage is positioned ideally.  The only thing a crooked splint is likely to do is make you worry while it is on and worry for a few days after it comes off.  When the splint comes off, the shape of the nose (because of swelling) looks like the splint, so in your case, it may look a little crooked.  Once the splint comes off, it will swell back up and ablate any asymmetries due to the splint.  As the swelling goes down in the weeks afterwards, you will be introduced to the real shape of your nose.  I hope this helps.  All the best!

Kenneth Yu, MD · Answer

It's natural to be concerned since the cast is what you see in the mirror.  The cast is not the critical step in a rhinoplasty.  Rather, it's meant to stabilize the bones (if osteotomies were performed) and to act as a splint to minimize edema.  It's less likely that a cast will shift the nasal bones on its own during the recovery period.  Though it's concerning to you, try not to be too scared.  When the cast is removed by your surgeon, you and he/she can examine the immediate results together.  At that time, a better determination of your results can be made.  Best wishes.

Oakley Smith, MD, FRCSC · Answer

Having a cast on your nose after rhinoplasty is like motherhood: it's expected. Patients just naturally assume there will  be one. It's like peanuts at the ballgame or complimenting the cook after dinner. The cast has changed over the years. Initially surgeons favoured large plaster of Paris casts which spread over the face and on to the forehead and cheeks. Presently smaller thermoplastic casts are popular.The purpose of course is to protect the fragile nose immediately after surgery. Some surgeon feel it also helps control the post operative swelling in a similar fashion as taping. As far as helping to keep a nose straight, I feel if you're relying on a cast, you're likely in trouble.But does it make a difference? Over the years, I've begun to wonder. It may contribute to keeping the swelling in check to some degree, but I now doubt it really protects a nose. People are very, very careful after surgery. A nose not uncommonly is bumped or pressure is placed on it during the first week following surgery. A common worry is sleeping, although this is very rarely as issue.In spite of the nose being in a fragile state, it still takes a significant blow to truly cause a problem. I believe no cast would protect a nose from a blow of that degree. This is heresy to many I expect, but it's my conclusion after many years dealing with post rhinoplasty injuries.So my belief is surgeons, whether they realize it or not, are placing a cast to avoid having to explain to each and every patient why it's unnecessary. Plus it avoids the possibility of having a patient feel their less than expected result was caused by their surgeon not using a cast like every other doctor.So does a cast that's not straight very likely will have no effect on the outcome. If the result is less than expected, then it was going to be anyway.

Why isn't my cast straight? Will it affect how my nose will look like? (Photo)

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Why isn't my cast straight? Will it affect how my nose will look like? (Photo)

Answers (3)

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.