Doctor doesn’t use nasal packing in revision rhinoplasty/septoplasty. Do I need stents with an extensive surgery like this?

Question

I went to two top ENT/cosmetic surgeons in my state. I’m having a revision rhinoplasty and septoplasty along with cartilage grafting. One says he usually doesn’t use packing. The other says he uses stents. Do I need stents with an extensive surgery like this to “hold things in place” and make sure my nose forms correctly or will my nose be ok without any type of packing? Thanks!

Thomas Trevisani, MD · Answer

Without posted photos, and of course the benefit of physical exam- impossible to give the best answer. However, I favor the closed technique  for all Rhinoplasty -primary and revision - an believe that packing-- is essential to achieving the best level of immobilization and therefore -the best result. Be sure you analyze the styles of your intended Surgeons to determine if their previous results meet your standards.

William Portuese, MD · Answer

In practice for over 25 years, we have not used any painful  packing.  Stents are only used rarely when the are significant scar adhesions present in the nose from previous surgery.  Keep doing your homework

Tarek V. Copty, MD, FACS · Answer

Hi, Thank you for your question. Your questions involves a matter of preference and experience. Personally I have been doing revision Rhinoplasty for 9 years and have stopped using stents and packing 5 years ago. I use quilting sutures to prevent septal hematomas and I believe the structural support should be done without the need for packing and stents. Of course, your plastic surgeon will have his own expertise and I believe that whatever he or she chooses you will be in safe hands. Best wishes, Tarek V. Copty, MD FACS 
American Board of Surgery American Board of Cosmetic Surgery Jordanian Board of Plastic & Reconstructive Surgery Fellow, American College of SurgeonsFellow, American Academy of Cosmetic Surgery Fellow, International Society of Aesthetic Plastic Surgeons

John Frederick, MD · Answer

Hi and thank you for your question,
One of the main reasons to use stents after surgery is to prevent blood from collecting inside the septum.  If blood collects there it will form a septal hematoma which can have devastating consequences.  Some surgeons prefer to use a specific type of suture technique to prevent blood from accumulating instead of splints. It is likely that the surgeon who does not use splints is using the suture technique to prevent blood from accumulating.  Speak with both surgeons about this issue and hear their reasoning behind the choices they make.
I hope this helps,
John Frederick

Doctor doesn’t use nasal packing in revision rhinoplasty/septoplasty. Do I need stents with an extensive surgery like this?

Answers (4)

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