Will Removing Nose Splint Early Affect Rhinoplasty Results?

I recently had a Rhinoplasty for narrowing my broad side walls and also for fixing sinus problem. But 3 days after, I took off the splint on my nose because it was irritating me a lot. Is it going to affect the shape of my nose? I can hardly see any difference in my previous and post-surgery nose. Shall I put on the splint back?

Doctor Answers 7

Early nasal splint removal by patient can ruin result--Do NOT Do THIS!

Unfortunately, I can state honestly that in the 23 years (as of 2010) I have done rhinoplasty surgery, I have had early splint removal by patients ruin the results--requiring reoperation--in 3 of the 4 patients who admitted they did this. I also believe that I may have caused less-than-perfect results by my own removal of nasal splints earlier than would have otherwise been better. I now leave nasal splints on for ten days in most cases.

Splints are used to hold the nasal skin in place over the surgically-altered support structures--the bones and cartilages--that have been carved, rasped, broken, and repositioned. In one week the tissues have just begun to stick together and heal, and if the splint is taped and/or glued in place to keep it secure, damage may be done even with "careful" removal. Patients who remove their own splint invariably do it incorrectly--they pull the splint away from the skin, which often pulls the skin away from the underlying bones and cartilages. A small amount of bleeding occurs, stops as the blood clots (like a cut or other minor injury), but in the nose this can turn into scar tissue that can leave an unsightly appearance or require re-operation!

If you can't see a difference in your post-operative appearance, then you could have caused loss of support for the new bony position, allowing them to "spring" back out to the old unwanted appearance. Or, you could have removed your swelling-reduction splint, causing swelling, bleeding, or scar tissue to obscure your improvements.

This is not a good thing, and if I were your surgeon I would be very unhappy that you did this to yourself, particularly if you were to later blame a poor result on your surgeon! How much "irritation" do you think you will experience if you need re-operation because of this! Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Nasal Cast/Splint Is Usually An Important

The effect of removing your spint will depend on the techniques that your surgeon used for your nasal surgery. You should schedule and appointment with your surgeon so that he or she can assess your nose and make sure that no negative consequences will arise from removing your splint early.

The external splint is a very important part of preserving your surgical result. Most surgeons place surgical tape/steri-strips on the exterior of the nose. This helps do two very important things: (1) protect the skin from the splint, and (2) most importantly, decrease the amount of swelling. The tape puts mild pressure on the skin envelope and can help prevent a blood pocket (hematoma) from forming between the skin and the nasal framework. When a hematoma develops, the blood is eventually replaced by fibrous tissue (scar tissue) and can distort the nose or add volume to the tip.

On top of the surgical tape, surgeons will put an external splint made of aluminum, plaster, plastic, etc. The purpose of this splint is to protect the nose and hold the nasal bones in position if they were broken.

Internally, most surgeons place some sort of internal splints. The internal splints do several things: (1) put mild pressure on the septum to prevent a septal hematoma, (2) help hold the inside straight during the early healing process, and (3) prevent scar bands from forming from the lateral side of the nasal passage to the septum. These can be soft plastic, silicone, telfa pads. They are left in place for one day to one week depending on the surgeon's preference.

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
4.7 out of 5 stars 146 reviews

This is highly likely to affect the final result.

I hate to say it, but taking off the cast early--especially if their are splints or packing in the nose or significant swelling in the nose--may well have permanently affected the final result. Most of the time, the cast and taping are actually critical parts of the final stabilization of the nose. If it were me, I would contact my surgeon immediately about this.

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

You will be more swollen after taking splint off too soon

Most surgeons prefer you to keep the splint on for anywhere from 5 to 7 days or longer after rhinoplasty. The splint helps to protect your nose somewhat from being bumped after surgery. But, the main function of the splint is to reduce swelling of your nose in the immediate period after surgery. Taking the splint off too soon will not usually change your end result but will cause you to have increased swelling for a longer period of time.

Jason Litner, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 51 reviews

Removing Splint

In my practice the nasal splint is routinely removed in 4-5 days. Every so often a patient will find the splint irritating and we will remove the splint early. Of course, you must be careful once the splint has been removed! But in my experience there has been no adverse effect from early splint removal.

Do not put the splint back on. If you were narrowing the nose you would not expect an obvious result at this early stage due to swelling. And if you have any questions you should consult your surgeon, who of course is best equipped to answer your question. Good luck !

Daniel G. Becker, MD
Voorhees Facial Plastic Surgeon
4.1 out of 5 stars 23 reviews

Post-Operative Instructions Should Be Followed

Increased nasal bridge width is a frequently seen component of nasal deformities. Correction of this problem requires an infracture of the nasal bones.This procedure involves cutting the nasal bones at their base and moving them in an inward direction. Once this has been accomplished the bones are held in place with a nasal splint.
The management of nasal splints varies from patient to patient and depends upon the patient’s specific anatomic deformity. In some cases, nasal splints may not be necessary. In other cases where the nasal bridge is narrowed, nasal splints may be an absolute necessity. Under these circumstances, premature removal of the splint may result in spread of the nasal bones. This can adversely impact the surgical result.
It takes time for nasal bones to heal following an infracture. For this reason, nasal splints are usually left in place for at least one week following rhinoplasty surgery. This allows time for resolution of swelling and bone healing. Removal of splints three days after surgery can result in spread of the nasal bones and a poor surgical result.
For this reason, it’s important that you contact your surgeon immediately. Your surgeon should be able to determine whether or not your splint should be replaced. It’s important to realize that post-operative instructions are made for specific reasons and are rarely optional.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Splint Removal PostRhinoplasty

There is no way to tell if you have altered the position of the nasal bones which were likely in-fractured due to your wide nose. You should go to your surgeon IMMEDIATELY to assess if there has been any change and to determine if it should be replaced. DO NOT do this yourself. Again by appling the splint while these in-fractured bones are healing may distort their position.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 7 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.