Is it totally necessary to wear nose cast 24/7 for 2 weeks after rhinoplasty?

My board certified cosmetic surgeon is ADAMANT about his patients wearing the external nose cast for 14 days post op, regardless how involved a patient's rhinoplasty was. I've read extensively online that many board-certified doctors only require their patients to wear the cast during the day for 5-7 days. Is my surgeon just being extra cautious? His assistant told me that even a week after surgery, the nasal bones were still "floating around" inside my nose.

Doctor Answers 9

Rhinoplasty splint

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Our protocol here at Athena Plastic Surgery in Stuart and Palm Beach Gardens is hard splint off after 5 - 7 days

steristrips to control swelling for 2 weeks thereafter.

Sutures out at 1 week (same time as hard splint removed)

Nasal cast after surgery by a Board Certified surgeon

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Splinting after rhinoplasty does two things: it helps control swelling and it stabilizes bones and cartilage. In my practice the splint is worn for no more than 10 days since the splint is hard on the nasal skin (clogged pores, oily buildup, etc.).  By 7 days the nasal bones are "sticky" and as long as there is no direct nasal trauma they should not shift (but you still need to be careful for about 4 weeks until total bone healing has occurred).

It is important to fully investigate your surgeon: the "Cosmetic Surgery" boards are not recognized by the ACGME (Accreditation Council for Graduate Medical Education).  Be sure your surgeon is Certified by the American Board of Plastic Surgery and can review with you a comprehensive portfolio of pre- and post-op pictures.  Properly credentialed surgeons will have no problem discussing their training and Board status with you.

Is it totally necessary to wear nose cast 24/7 for two weeks after rhinoplasty?

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In our practice for over 30 years, we have taken the cast off at day 6 after a rhinoplasty procedure. Rhinoplasty is it very difficult endeavor, so it's important to choose your surgeon based on extensive experience. Study your prospective surgeon's before and after rhinoplasty photo gallery which should be extensive and reflective of their work. In addition, we perform all rhinoplasty procedures with a closed rhinoplasty approach, and there's no painful packing placed on the inside of the nose.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

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Is it totally necessary to wear nose cast 24/7 for 2 weeks after rhinoplasty?

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Every qualified BC PS who performs Rhinoplasty has their own protocols for post-op care. Since you decided on that Surgeon I urge you to follow his/her instructions. 

Wearing cast post rhinoplasty

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While it is correct that each surgeon has different postoperative guidelines, you should heed the guidance of your surgeon as he/she knows the scope of the surgery performed and the specifics about you.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Nasal bones and cast

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You are correct, everyone has a different post op regimen.  That being said, its always best to follow your doc's recommendations as they know what gives the best results in their hands and for their technique.  Not only that, but keeping the cast on longer will help reduce the swelling, so thats an added bonus.  Best of luck with your healing, and congratulations on your procedure! 

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Nose cast 24/7 for 14 days after rhino

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This will vary from surgeon to surgeon.  The length of time depends on how extensive your rhinoplasty was and how well your nose is healing. Sometimes patients can have their casts removed earlier if they are progressing very well, while other patients may need to keep theirs on for a longer period of time.

Best to trust your board certified plastic surgeon's judgment.

Kenneth Hughes, MD, Board Certified Plastic Surgeon

Los Angeles, CA


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Usually a week is all that is necessary.  This has proven to be a safe time to wait and acceptable to patients who need to get back to their normal routines.  It may be that in your particular case due to a more involved procedure, additional time with a cast is requested by your surgeon. 

Is it totally necessary to wear nose cast 24/7 for 2 weeks after rhinoplasty?

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You chose your surgeon. So why would you question his postop requirements? Lets change the scenario, you on you own removed the nasal cast and after 3 weeks your nose has slide slightly. Whose at fault than? It is you, because you did not follow your surgeon's postop instructions!. 

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.