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

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)

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. 

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. 

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! 

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 SurgeonLos Angeles, CA

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.

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.

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!. 

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.