Years ago, when I trained, we put a lot more packing in the nose and left it in for many days. Now, much less packing is used and it is often removed after one day. This has little discomfort and actually a relief to get the packing out. Even taking off the cast, if done gently is painless.
The external splint comes off easily, and although that can be mildly unpleasant, it’s not really painful. Internal splints, which are sometimes used after septoplasty, are more uncomfortable to remove. But still, the pain is modest, and in general does not necessitate a pain pill. If the nose is packed, and the packing must be removed, many patients find that to actually be painful. I use absorbable packing that does not need to be removed when doing a septoplasty.
The removal of the splint on the outside of the nose is painless. If there are some inner splints then it is mildly painful. The worst pain happens with heavy gauze packing inside the nose but most surgeons do not use it any more.
Removal of the splints and/or packing of the nose does not need to be, and should not be a painful process. As we use less packing than in years past, this makes it easier. More importantly, with communication and coordination, the splints and packing removal should be an easy process and not a painful one.
Garrett Wirth, MD, MS, FACS
Wirth Plastic Surgery
Following rhinoplasty a nasal cast or tape may be placed. If the procedure was completed with in an open approach, external sutures were also placed. Intranasal splints may be used to help with septal healing after a septoplasty. These are often removed at your first post-operative visit.
Removal of the nasal cast, tape and sutures do not typically cause any discomfort. Some patients may experience some minor discomfort during the removal of the splints due to crusting, however most patients experience relief when the splints are removed as their presence can cause some mild nasal obstruction. It is helpful to utilize saline nasal spray in the immediate post-operative to help reduce crusting and reduce irritation when the splints are removed.
It really depends upon what the surgeon uses inside the nose. Some surgeons use no packing, but in my experience, this leads to more troublesome oozing the first night after surgery and excess swelling inside the nose for the first few weeks. I generally place a light dressing of soft gauze for the first night only: this not only eases how often you have to change the drip pad overnight, but also helps reduce the build-up of swelling by pushing the nasal tissue against the external splint. When we remove it, there is momentary pressure followed by immense relief and the ability to breathe. If we have to put internal splints in the nose, we use soft silicone sheeting that does not hurt upon removal. Larger packing, fortunately not used much anymore, may be more painful.
Usually when I perform rhinoplasty, I put splints on the inside and the outside of the nose. This is because most commonly I perform a septoplasty with my rhinoplasty. I would say for most patients there is a little bit of discomfort particularly removing the splints from the inside of the nose. However it takes literally 1 to 2 seconds to remove the splints. I feel that the splints are important to keep the surgical area well protected from bleeding and swelling. Please discuss your concerns with your surgeon.
In our practice, we do not use nasal packing, but if we are repairing a severely deviated nasal septum, temporary septal silicone splints may be placed and removed two weeks postoperative. The external splint and sutures are removed around 7 days postoperative, and this does not hurt. Septal splint removal at 14 days postoperative is also painless, and typically leads to gratifying nasal breathing.Hope this helps you.Dr Joseph
Generally, removing the splints following a rhinoplasty is more
uncomfortable than painful. Patients may want to take an over the counter
painkiller if worried about pain or if they have a low pain tolerance. I
use small silicone splints inside of the nose. I feel these are the best
tolerated by patients and are not painful to remove. Speak with
your surgeon about your concerns before your splint removal appointment. I hope
Removing splints after Rhinoplasty should not be painful; although you may experience a weird sensation. There are different techniques that can be used when preparing to have the splints removed that can make the experience more comfortable. Talk to your doctor about what recommendations he/she may have for your post-operative appointment.