Plastic Surgery

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Barry Eppley
The thought of ansal packing removal is unpleasant at best and downright painful at worst. I have found that many potential rhinoplasty patients often ask....are you going to pack my nose? After hearing this concern numeruos times over the years, I have come to appreciate a patient's apprehensions over the issue of packing in the nose after rhinoplasty surgery.
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 your nose surgery is to improve your breathing, known as functional nasal airway surgery, nasal packing may have to be used if there is persistent bleeding still at the end of the operation. My experience, however, is that this is not very frequent.
Nasal packing achieves two purposes; 1) to control or stop bleeding and 2) 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 straightening it. Once straightened, the lining must be put back in its original place. Packing of the nose has been traditionally used to push this lining back into its original place. The use of packing has been replaced by many surgeons with sewing it back into place through a sewing technique known as quilting. Much to the happiness of patients and plastic surgeons alike, this internal suturing method has replaced the need for nasal packing in most cases. Only in cases where there is too much bleeding at the end of surgery will packing be used 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 overly concern yourself with! Modern rhinoplasty techniques have virtually eliminated the need for this uncomfortable consideration. Not only is the concern about pain associated with packing removal eliminated, but the fear of not being able to breathe through your nose at all ( a claustrophobic sensation) right after surgery is also alleviated.
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