Is Nasal Packing Necessary After Rhinoplasty?

In the past, one of the major downsides of undergoing a nose job was the highly uncomfortable recovery process. Older techniques involved significant trauma to the nasal tissues and structures, resulting in a great deal of bruising, swelling, and postoperative bleeding. To control these side effects of the procedure, rhinoplasty surgeons used a technique known as nasal packing. This dreaded custom was the norm following rhinoplasty, whether for functional, cosmetic, or reconstructive purposes, and patients just had to put up with it to get the results they wanted.

But is nasal packing necessary following a modern rhinoplasty procedure, and how do the changing customs affect rhinoplasty patients?

What is Nasal Packing in Rhinoplasty?

Nasal packing involves stuffing the nasal passages with nasal packing materials like sterile cotton or gauze post-surgery. Many dread this because it’s highly uncomfortable and prevents breathing through the nose after surgery until the packing is removed, potentially lasting up to two weeks.

Why Nasal Packing Was Used

In the past, surgical techniques were not quite as refined as they are today, and more procedures resulted in postoperative bleeding and other issues caused by the trauma of surgery. The packing’s purpose was to absorb this blood and help prevent complications from the surgery. Today, if packing is used in the nasal passages, it is usually removed after only a day or two, and the materials that can be used are more advanced, sometimes encouraging processes like clotting.

A Mostly Obsolete Technique

Packing after nose surgery still happens, but it is becoming rare. Surgeons who keep up with current technique seldom need internal packing for most patients. Most rhinoplasties today involve very little bleeding, and the usual approach is a splint (cast) on the outside of the nose for 5 to 10 days to support the new shape and control swelling.

Modern Rhinoplasty Recovery

Recovery today is much simpler, though you still have to protect your nose while it heals. Even without packing, the nose feels very congested and uncomfortable for a while, much like a bad stuffy nose. The cast comes off after 5 to 10 days, most patients take about a week off work, and exercise waits for about a month. The nose is still very fragile for a few months after the surgery, and patients need to take care not to jostle it. Swelling subsides slowly, and results should be fully complete around the one-year mark or so.

Better Outcomes, Gentler Surgeries

Gentler techniques that cause less trauma mean surgeons can now get excellent results without the harsh recovery patients once expected. Better instruments and approaches such as open rhinoplasty also give the surgeon more control over the result.

Frequently Asked Questions

Is nasal packing still used after rhinoplasty?

Rarely. Most rhinoplasties today involve very little bleeding, so surgeons who use current techniques seldom need internal packing. When packing is used, it is usually removed after a day or two.

Will I be able to breathe through my nose after rhinoplasty?

Even without packing, expect your nose to feel very congested for a while, much like a bad stuffy nose. Breathing improves as the swelling inside the nose goes down.

How long does the splint stay on after rhinoplasty?

The cast usually stays on for 5 to 10 days. It supports the new shape of the nose and helps control swelling.

When can I go back to work after rhinoplasty?

Most patients need about a week off work. Avoid exercise for about a month, and be careful not to bump your nose for several months, since it stays fragile while it heals.

When will I see my final rhinoplasty result?

Swelling goes down slowly. The nose looks much better within weeks, but the final result takes about a year.

Choosing a Facial Plastic Surgery Specialist

Though many plastic surgeons offer rhinoplasty, it is one of the most difficult and complex procedures available. The bone, cartilage and skin of the nose all affect one another, the nose sits at the center of the face, and it still has to work for breathing. That combination is why rhinoplasty takes so much skill and experience, and why your choice of surgeon matters more than almost any other decision you make.

Dr. Shervin Naderi is a double board-certified facial plastic surgeon with more than 20 years of experience and a strong surgical focus on rhinoplasty. He performs a high volume of ethnic rhinoplasty, and many patients come to him for revision rhinoplasty. If you would like to discuss your goals for nose surgery with Dr. Naderi, call the Naderi Center in Reston, VA (703-481-0002) or Chevy Chase, MD (301-222-2020) to schedule a consultation today.