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

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

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 

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. 

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.

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.

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

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.

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 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)