Is there a "packing" inside the nose when you do a "nose tip" rhinoplasty? (photo)

Hi im a 22 years old man and i would like to refine my nosetip and make my nosetrils smaller (specially when i smile). I was wondering if there would be a "packing" inside my nose after the surgery if we don't touch the bridge? (I know it tilts to the left a little but i don't wanna change it.) And will it take off the "too much skin" i have on my cheeks (look at the blue circle)? And can we make local anesthesia? Thanks a looot and sorry for my english! :)

Doctor Answers 9


Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Every surgeon is different when it comes to packing the nose.  I don't place packing inside the nose in my practice.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Rhinoplasty and packing

Every surgeon is different. We essentially never pack the nose. A simple narrowing of the nostrils (alar base narrowing) can be done under local anesthesia but we would almost always use sedation or general anesthesia for a tip or complete rhinoplasty. One of the basic truths about rhinoplasty was taught to me by my mentor Jack Anderson MD from New Orleans.  When you make a single change in the nose it changes all the other relationships. For example if you narrow the base the tip will look wider or if you take down a "bump" the upper part of the nose will look wider. See an experienced surgeon to discuss all of these relationships before deciding on exactly what operation you would have.

Wayne F. Larrabee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews


I have not used packing in any form of rhinoplasty surgery for over twenty years. A tip rhinoplasty can be done under local anesthesia. The circled area on your cheeks is not going to be changed by what is done on the nose.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Rhinoplasty , some advices:

Thank you very much for the questions.

In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Kind regards 

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 270 reviews

Tip surgery

I do not routinely place nasal packing after a rhinoplasty. Some surgeons will use packing and you should run it by your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Is there packing inside the nose when you do a nose tip rhinoplasty?

In our practice we do not place packing on the inside of the nose. Most patients require a full rhinoplasty not a tip-plasty especially when there's a dorsal hump present and the nose is twisted. We perform the alar-plasty procedure at the base of the nostrils, not on the side of the ala on the cheek.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Packing after Rhinoplasty

I do not routinely use packing unless it is required.  However a word of caution, smiling will pull most noses sideways and this is not really something you can fix with surgery completely as the facial muscles will continue to pull the nose when you smile.  However, the alar base width can be narrowed with surgery.  Further the nasolabial fold that you have circled has nothing to do with your nose, this can be fixed with the use of dermal fillers which your surgeon can advice you on.  Hope this is helpful.

Packing after rhinoplasty?

Packing is not routinely placed after rhinoplasty surgery. It will not change the appearance (skin) of the cheeks. It typically is performed with sedation or general anesthesia (not straight local anesthesia) 

John B. Lazor, MD, MBA, FACS
Boston Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Nose packing is not usually needed

Unlike 20 years ago, packing is rarely used after nose surgery. Unless excessive bleeding is encountered during surgery, packing is not typically placed. It is even less likely in a tip only Rhinoplasty. 

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 52 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.