Packing vs. No Packing

Rhinoplasty Packing: Why I Don’t Use Nasal Packing

One of the first questions patients ask is whether I use nasal packing during rhinoplasty. Many people are understandably worried about discomfort, difficulty breathing, or the painful removal associated with traditional packing.

Here’s the answer:
I do NOT use nasal packing in my rhinoplasty or revision rhinoplasty cases. NEVER HAD AND DONT EVER USE IT.

And patients are always relieved to hear it.

Why Some Surgeons Still Use Packing

Traditional packing was designed to:

  • control bleeding

  • reduce the risk of hematoma

Some surgeons also use packing when:

Doing closed rhinoplasty: Surgeons cant see the blood vessels of the nasal bridge and so they rely on packing to help prevent a nose bleed. In open surgery we dont have this problem.

Why I Don’t Use Nasal Packing

My surgical philosophy is structural, stable, and low-trauma.
Packing is unnecessary in that context.

1. Structural Techniques Replace Packing

Because I use:

  • excellent bleeding control during surgery

  • closure of the nasal septum with quilting sutures.

2. Packing Makes Recovery Harder

Packing often leads to:

  • mouth breathing

  • dryness

  • difficulty sleeping

  • pressure and discomfort

  • anxiety

  • uncomfortable removal

  • increased swelling

Patients do significantly better without it.

3. Breathing Is Better Without Packing

I want my patients to breathe through their nose as early as possible.
This helps:

  • reduce swelling

  • improve comfort

  • reduce mouth dryness

  • calm nerves

  • enhance recovery

Packing blocks airflow for days.

4. No-Packing = Faster, Easier Recovery

Patients consistently report:

  • less pressure

  • less pain

  • easier first night

  • more normal sleep

  • better early breathing

Rhinoplasty already has swelling — packing just worsens it.

What I Use: Slim, Comfortable Internal Splints

Unlike packing which is designed to stop bleeding (which I dont use) I do use very small (0.25 mm thick silastic splints) , splints that stay for 1 week (or until cast is removed (5-7 days). These are not the large doyle splints that hurt to remove.

These splints:

  • support the septum

  • keep breathing passages open

  • maintain alignment

  • improve airflow compared to packing

They are thin, low-profile, and patients tolerate them extremely well.

Removing them is quick and painless, nothing like pack removal.

Bottom Line

Modern rhinoplasty doesn’t require nasal packing.
With structural techniques, careful handling of tissue, and slim internal splints, recovery is more comfortable, breathing is better, and patients feel significantly less postoperative discomfort.

Rhinoplasty, Revision Rhinoplasty, ethnic rhinoplasty, asian rhinoplasty, thick skin rhinoplastyARI HYMAN