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One of the most common questions asked before rhinoplasty concerns the packing placed inside the nose after surgery. Stories about the gauze packing used in past decades can create anxiety in people considering the operation. Today, internal support is usually provided with silicone splints that contain an airway channel, and the process is generally more comfortable than expected. This article explains, for informational purposes, why packing is used, what modern silicone splints do and what may be expected when they are removed.
Why is packing used after nasal surgery?
Rhinoplasty often involves more than the external shape of the nose; the septum and the breathing structures inside may also be addressed. These tissues may need support while they heal. In general terms, packing can help control bleeding, support the septum in its new position, reduce the risk of the mucosal layers sticking to each other and limit irregularities related to internal swelling. The approach is not the same for everyone: whether packing is used at all, and which type is chosen, depends on the extent of the procedure and on the surgeon’s assessment.
How do modern silicone splints differ from classic packing?
The gauze packing that was widely used in the past filled the nasal cavity completely, so patients had to breathe through the mouth during those days. Because such packing could adhere to the tissue, removal was often described as uncomfortable. The silicone splints frequently preferred today have a channel running through the middle. Thanks to this channel, many people can breathe through the nose to a limited degree while the splints are in place. The smooth surface of silicone reduces adhesion to the tissue, so removal is usually tolerated more easily. Even so, swelling, crusting or secretions may block the airway channel from time to time; this is an expected and temporary situation.
What to pay attention to while the splints are in place
During this period it is important not to touch the inside of the nose, not to blow the nose forcefully and not to try to move the splints. Breathing through the mouth can cause a dry mouth, so sipping small amounts of water frequently is usually relieving. Sleeping with the head slightly elevated may help reduce swelling. A slight blood-tinged discharge from the nostrils can be expected in the first days; however, bleeding that does not stop, fever, increasing pain or marked swelling are reasons to contact your doctor. Nasal sprays, pain medication and antibiotics are planned individually, and it is advisable not to change any medication on your own.
What does removal feel like?
Removing the splints is usually a short procedure carried out in the outpatient clinic. A feeling of pressure, watering of the eyes or a brief stinging sensation may be described during removal. The intensity of these sensations varies from person to person, and two people who have had the same procedure may report very different experiences. Immediately afterwards, a light blood-tinged discharge and a sense of blockage can continue for a while, because the swelling of the mucosa persists for some time after the splints are taken out. It is therefore more realistic to expect nasal breathing to improve gradually rather than all at once.
Frequently Asked Questions
How many days do the splints stay in the nose?
There is no standard duration. It is decided by the surgeon according to the extent of the procedure, whether the septum was addressed and how healing progresses. Rather than relying on a fixed number of days, it is best to follow the assessment made at your follow-up appointment.
Can I breathe through my nose while the splints are in place?
Silicone splints with an airway channel usually allow limited airflow. Swelling, crusting or secretions may temporarily close this channel, in which case breathing through the mouth may be necessary; this is an expected situation.
Is packing used in every nasal operation?
No. In some procedures only suture techniques or thin silicone sheets are preferred, and in some cases nothing is used at all. The decision depends on the content of the operation and on the individual anatomy of the nose.
For detailed information about nasal surgery and revision procedures you can visit the Piezo-assisted rhinoplasty and revision rhinoplasty page, and you may reach us through the contact page for your questions.
This article is for informational purposes only; a medical examination is required for diagnosis and treatment.
Written by: Op. Dr. Yahya Melih Işık — Specialist in Plastic, Reconstructive and Aesthetic Surgery (Kayseri, Türkiye). His education, residency thesis and scientific publication are listed on the academic profile page.
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