Tape, Splint or Re-cast After Septo/rhinoplasty?

Question

I had a deviated septum & had rhino-septoplasty 2 wks ago. After the cast was taken off on day 6, the nose looked great. Some 4 days later it was very crooked like b4. My surgeon admitted it had moved back into the "old" position. He pushed it back using his hand and I was told to tape it at night. Now the question, with my 10k, 2 wks of pain and time, my results will now rely on a roll of tape? Will this work? Is Splint or re-casting more reliable than tape b4 its too late? Need help. Thanks

Francis R. Palmer, III, MD (retired) · Answer

I have performed Rhinoplasty and revision Rhinoplasty for over 20 years and if the bones shifted, after the cast was removed, manually pushing or taping them will not make them go back to the midline of your nose.  The bones would need to be re-fractured using surgical osteotomy during another Rhinoplasty. 

	 Hopefully, this is hard swelling that can be associated with the lateral aspects of the nasal bones.  IMHO, if you ask your surgeon to apply gentle but sustained pressure, over the lower aspect of the deviated nasal bone using the tip of a finger and after several minutes a doughnut space is achieved...this is swelling.  If this does not occur, the hardness is truly a deflected nasal bone and will require surgery as described above.  Hope this helps and good luck.

Daniel Greenwald, MD (in memoriam) · Answer

Taping alone is unlikely to help this problem. A rigid splint, after proper alignment, may offer some help, but if shifting of the nasal support structure is due to significant instablility then reoperation with grafts may be needed. Do what your surgeon recommends and wait for at least three months. If breathing is a problem then early revision is indicated. For a purely cosmetic problem I would wait 6-12 months before going back in.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

	Honestly I don't think tapping the nose is going to fix your problem. Either the cartilage or the bone and cartilage shifted for some reason. To correct this you may need to have your nose reset or re-operated on.

	Best,

	Dr.S.

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