Importance of Nasal Packing

Nasal packing is a technique used by plastic surgeons after rhinoplasty and revision rhinoplasty procedures. The pack itself is simple – a piece of gauze with a string attached. After your procedure, the surgeon will place the gauze high up into the nose where it will provide support and absorb any excess fluids during recovery.  

Packing the nose is not always necessary. But in certain types of surgery, such as septoplasty, it can be an important part of healing. Keep reading to learn more about the importance of nasal packing, including its many benefits and why some surgeons choose not to use it.

Nasal Packing Controversy

Nasal packing is an older plastic surgery method to assist in the first stage of healing after a nose job. The technique is less crucial since the introduction of advanced plastic surgery techniques which allow surgeons to operate with more accuracy and smaller incisions. Recovery times are getting shorter and complications fewer as techniques improve.

These days, cosmetic surgeons who don’t use nasal packing avoid it because of the negative impression it makes in rhinoplasty patients. Many rhinoplasty patients vividly recall the removal of nasal packing as the most painful part of their procedure. 

Patients are left with a vivid memory of the removal throughout their recovery and may develop an aversion to future cosmetic surgery procedures. In some cases, they may avoid returning to the same plastic surgeon, thinking it was simply the surgeon’s technique that they didn’t like.

Potential Risks

Aside from causing the patient pain, nasal packing has a few other related risks including rebleeding after removal or failure to stop the bleeding post-operatively. Packing might migrate or move further into the nose. The patient may aspirate it, drawing it further into the nasal cavity, which could be both painful and dangerous. 

Most potential risks are avoided by removing the packing within the first 48 hours. The surgeon will remove it for you or give you detailed instructions on how to remove the packing yourself. If you don’t feel comfortable doing so, feel free to let them know!

Other surgeons still consider nasal packing an important part of rhinoplasty recovery, having seen its benefits for themselves. Surgeons who use nasal packing believe its benefits outweigh the potential risks.

Benefits of Nasal Packing

Nasal packing’s primary purpose is to absorb blood and mucus. In the same way, you use gauze to slow down a nosebleed, the surgeon inserts nasal packing to soak up any postoperative bleeding. It’s often paired with a nasal drip pad, both of which are removed two days after surgery.

Bleeding and swelling are natural results of rhinoplasty, even with the increasingly advanced technology that makes incisions smaller and more precise. Nasal packing helps reduce both bleeding and swelling which can be the most severe in the first 48 hours.

Packing reduces swelling by adding pressure inside the nose. When you add pressure, you restrict the blood and fluid flow. The gauze itself should be smooth to prevent adhesions and begin blood clotting. Clotting also adds to the pressure which will help instigate healing.

Nasal packing provides support to separate tissues and structures in the nose. Blowing or picking the nose can be dangerous in the first few days after surgery. Any accidental bumps or movements to the healing nasal tissues worsen swelling, increase bleeding, and may ruin the results of your rhinoplasty.

Taking care of your nose in the first 48 hours is essential for a faster rhinoplasty recovery. While packing is uncomfortable, it prevents accidental damage. Pain during removal is a relatively small price to pay in return for better healing and results after your nose job.

Nasal Packing After Septoplasty

Septoplasty – or the rhinoplasty procedure during which the surgeon addresses a deviated septum – is a procedure that often uses nasal packing during recovery.

Some experts feel that packing supports the healing of the septum and keeps it from deviating again after septoplasty. Others argue that nasal packing should only be used in patients with an increased risk of bleeding. 

A 2013 comparison study of 50 septoplasty patients, half of whom had nasal packing inserted post-operatively, revealed that nasal packing was not absolutely necessary. Patients who received nasal packing found the removal of the packing to be the most painful part of the whole procedure. However, the packing did not interfere with the end results since all of the patients were satisfied with the appearance of their noses after three months.

Packing for Higher Risk Patients

In patients with an increased risk of postoperative hemorrhage and septal hematoma, packing is definitely recommended. 

Most surgeons suggest that you stop taking any medications prior to your procedure since prescriptions, herbal supplements, and several other over-the-counter medications interfere with your body’s ability to form blood clots. Ignoring your surgeon’s instructions in regards to your medications could dramatically increase your risk of a hemorrhage or hematoma. 

Men are more likely to develop hematomas post-operatively than women. Smokers and people who are overweight or obese also have a higher risk for postoperative bleeding.

Hemorrhages are more common amongst older rhinoplasty candidates and in those who are undergoing several cosmetic surgeries at the same time. Many patients add a brow lift, facelift, or other cosmetic facial procedures to save on office and anesthesia fees.

Your surgeon will discuss their recommendations for your recovery with you during your initial consultation. Feel free to ask any questions you may have about nasal packing and your specific risk factors to ensure that you go into your rhinoplasty feeling confident!

Schedule Your Consultation Today!

Dr. Becker is a board-certified plastic surgeon who specializes in rhinoplasty and revision rhinoplasty. His offices in Central and Southern New Jersey focus on a conservative approach to nose jobs to create natural-looking results. Call to schedule a consultation to learn more about nasal packing and the role it might play in your treatment with Dr. Becker.

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