One of the greatest fears of many patients who are considering rhinoplasty surgery is that their nose will be packed during surgery, subsequently requiring removal sometime after surgery. That thought is one of significant uncomfortability at best and outright pain at the worst. I have found that many potential rhinoplasty patients often ask….are you going to pack my nose?
The good news is that the need for packing a rhinoplasty surgery patient is very infrequent. If you are having a cosmetic rhinoplasty, where only the external nose is being operated on (hence the concept of a cosmetic rhinoplasty), then there is absolutely no reason to have to pack the nose after surgery. If you having a ‘rhinoplasty’ for breathing purposes only, other wise known as functional nasal airway surgery or septoplasty and/or turbinate surgery, then that possibility exists but it is still in my practice a very low likelihood.
The purpose of nasal packing is only two-fold, to stop bleeding and to help adapt the lining of the nose back in its place against the cartilage or bone so no bleeding occurs underneath it. Whe performing septal straightening, a very important component of airway surgery, you must first lift the lining off of both sides before strsightening it. Once straightened, the lining must be put back in its original place. Historically, packing the nose with gauze squeezed this lining back in place. The use of packing has been replaced by many surgeons with sewing it back into place through a sewing technique known as quilting. This has virtually replaced the need for packing, much to the applause of patients and plastic surgeons alike. Only in cases where there is too much bleeding at the end of surgery will packing be sued to control it, much like the way it is used to stop difficult nose bleeds.
So to those patients considering most forms of rhinoplasty surgery, this is one issue that you need not concern yourself with!
Dr Barry Eppley
Indianapolis, Indiana