Only if Dr. Naderi asks you to. Most patients don't need it, but for some he recommends firm massage to keep the nasal bones narrow or to guide the nose straight as it heals, and he shows you how in the office first.
Dr. Shervin Naderi, Double Board Certified Facial Plastic Surgeon
Good morning, everybody. I want to make a quick video showing nasal massage. I do have some patients massage their nose after rhinoplasty, and there are a few reasons for that. If you ever broke, God forbid, your leg or your arm, a major, strong bone, it may be plated. You may have screws and plates there. But even if you just have a cast, it may be there for six weeks or more holding it together, and there's still no guarantee it's going to heal perfectly straight. Now imagine the nose: thin, flimsy pieces of bone and cartilage. It's a hollow structure, a three-dimensional structure. You're only wearing a cast for a week. There are no pins or rods or screws, and sometimes you may need to guide it as it heals.
Now, there are two types of massage. One is medializing, basically keeping the nasal bones more narrow. When I break the nasal bones, when I do the osteotomies, sometimes they want to spread out a little bit. It never goes back to where it was before, but it's nice to keep it where it is. There are three ways you can do that. Keep your fingers together, or use your thumb, and place it up high on the nasal bone, and then squeeze. Really, really squeeze there. It's not in the middle section, definitely not in the middle, and not the tip. It's up high at the bone, where the nasal bone meets the facial bone. That's where it is. Or you can use your index fingers, or you can use your thumb this way. So either locked together, separate, or fingers like this. Don't poke holes in it. Use the longest part of your finger, and hold. You've really got to feel that pressure. It's almost got to hurt when you do it. If you're just barely holding it, it isn't doing anything. So that's one.
The second is to guide straightness and symmetry. Again, it's a flimsy structure, and scar tissue can sometimes push and pull things to the side. If you feel the nose is going a little bit in this direction, I want you to take your finger and really push it way across to the other side and keep it there for 30 seconds. Don't move it. Just stay there for 30 seconds. If you feel it's going the other way, massage it in this direction. Sometimes I may ask you to do both: push one side, then the other side, and again, keep it, keep it, keep it for 30 seconds. And I may have you do this twice a day for several weeks to several months, to allow it to heal. There's plenty of evidence that shows this is helpful. Many plastic surgeons use this technique, and again, it can help with symmetry. Nothing is ever perfectly symmetric, but this can help in some patients.
I want you to have this for reference. If I want you to do this, I'll tell you and I'll show you in the office, but I want you to be able to refer to this video later on. Have a good one.
3:58Rhinoplasty
3:12Rhinoplasty
8:52Rhinoplasty