Question About Splints and Packing After Rhinoplasty?

Surgeons typically will use splints or packing whenever work is done on the septum.  If no work is done on the septum, then neither of those two things is necessary.  The benefit is the same benefit as the splint or cast that goes on the top of your nose after rhinoplasty - it limits the amount of swelling and it provides some support to the septum as it is healing.  The question of packing vs. splints relates more to the surgeon's personal preference.  

To answer your question: no, not all surgeons will use splints and
packing when performing a rhinoplasty. It all depends on the
circumstances and how invasive the nose job is. As you suggested, a
rhinoplasty often involves breaking the nasal bones. A splint is useful
in making sure that the re-molding of the bones is in line with the
cosmetic intentions of the nose job. In a sense, the splint and packing
serves to protect the new nose from harm as it can be very sensitive
during recovery time. However, there is also increased swelling with the
use of packing and for this reason, I do not usually use packing after
surgery.

    If a rhinoplasty is performed and the bones are broken, a splint is placed for presumed stabilization.  If the septum is altered, packing or internal nasal splints can be used to prevent bleeding and septal hematoma.

It is rarely necessary to utilize packing following rhinoplasty. Bleeding after rhinoplasty is exceedingly rare, and internal sutures are sufficiently effective in preventing hematoma (blood clot) formation. 

Internal splints serve several purposes and are especially useful when turbinate reduction is concomitantly performed during rhinoplasty. They prevent formation of adhesions and scars between the septum and the lateral nasal wall by acting as a physical barrier. It is unclear whether splints can help stabilize the septum in the midline post-operatively. Lastly, internal nasal splitnts with built-in conduits for air can help patients breathe through swollen nasal tissues.

In summary, i never pack, but use splints about half the time. Hope this helps,

Grigoriy Mashkevich MD

New York Facial Plastic Surgeon

Not all surgeons use packing after rhinoplasty surgery. For instance, I don't typically place anything in the nose when I finish performing rhinoplasty surgery. On rare occasion I will place a small packing inside that is removed within a few days. But, by avoiding nasal packing, my patients are much more comfortable following surgery. Instead of packing, I use more absorbable suture inside of the nose to close the lining together.

Dear Renap1,

 

Internal packing is one option to control and prevent a collection of blood from developing over your nasal septum.  This can have devastating consequences.  Another option is to use quilting sutures on the septum - I find this is less bothersome to patients.

As for external splints/casts - there's no good evidence that I know of to support this.  Many surgeons use it to protect the nose and decrease post-op swelling.  I don't think it's critical.  If anything, I think it's main function is to remind people that they have had surgery and that they should be careful.

Cheers,

Asif Pirani, MD, FRCS(C)

After rhinoplasty surgery (or septoplasty surgery), packing is generally used to help prevent any bleeding after the procedure.  Some surgeons may prefer to use packing, while others may not.  The decision is somewhat individualized as well, depending on the amount of bleeding during the procedure.  Splints are generally used to help prevent any adhesions from developing after the septum (middle of the nose) is straightened.  Again, this may be dependent on the individual preference of the surgeon as well as the circumstances involved with performing the surgery on the individual.  

Hi there.  At the end of surgery, a splint is placed inside the nose. These splints are soft and compressible, and have holes within to allow for nasal airflow. A cast is placed on top of the nose. The intranasal splints and casts are removed in approximately five to seven days after surgery.Hope this is helpful.  Good luck.

Splints are used almost always after any rhinoplasty to give the tissues support during the first few days of surgery. They are also a “reminder” to the patient to protect the nose early on, as usually there is not much pain after the procedure. Packing is not always done, though useful for internal “splinting” for the first 24 hours or so. This also helps in compression to prevent bleeding during the early couple of days post-op.

Nasal packing after rhinoplasty has been abandoned for over 30 years.  If your surgeon still uses packing after a rhinoplasty, look for a more experienced rhinoplasty surgeon.  Splints are only necessary if there has been trauma to the internal nasal lining of the nose to prevent adhesions.  We have performed thousands of nose surgeries without packing or splints and patients do much better without painful packing placed in their nose or large plastic splints placed inside the nose.