Follow Dr. Nassif into the operating room as he places external dressing and internal splints after a rhinoplasty.
Post-op & Placement of Nasal Dressings
Dr. Nassif: We’re putting our dressing on now after we just took photos. She did not want too drastic of a change of her profile. She did want her hump removed she didn’t want the tip changed much. She didn’t want a big, what we call a super tip break. She wanted everything very conservative, just a very gentle rhinoplasty. So I think she’ll be happy with this, I’m very pleased.
So this tape is very important; it helps mold the nose and keeps some of the swelling down. However, when we take off the cast next week she’ll still be very swollen. You need a good two weeks to have a decent amount of the swelling to go down. Now we’re putting the cast on. Ok now I have to put in the Doyle splints next. These are Doyle splints which we’ll put them inside the nose along the septum and this will help support the septum and keep it straight.
So we’re smothering this Doyle splint with antibiotic ointment and we’re going to insert that in the nose and that’s going to help keep the septum straight. And so we use this instead of packing. Ok we’ve put the Doyle splints in and now we’re going to stitch them together and then we’re done.
The benefit of putting Doyle splints in is that they’re more rigid and will help stabilize the septum that was fixed, especially when it was really deviated. This is just a lot more pleasant to remove than packing plus you can breathe through the little hole in the tube here. When the patient wakes up they’re really happy because they can breathe without having a completely stuffed up nose. These will come out in a week, just like the cast and everything else will come out in a week. Then for the second week she’ll have tape on her nose. With that we closed up everything and we’re done. It went fantastic and I think she’ll be really happy.
Today I saw Luisa she’s about seven weeks following a closed rhinoplasty, septoplasty, and turbinoplasty. We performed multiple procedures on her to take down her hump, make the middle part of her nose more symmetric, and fix her deviated septum to help open up her airway. The surgery went very smooth it was exactly what I expected. At this point she is very early in her healing phase but she’s fine, everything looks great, and she’s healing beautiful.
Dr. Nassif: Ok we just finished the rhinoplasty and now this is a very important part of the procedure, putting on the proper dressing and the tape and the cast. So this is a little sticky solution. We’re going to place some tape on the nose and we’ll lay the tape very carefully. So this tape is very important, it helps mold the nose, keeps some of the swelling down. The nose will look swollen after next week and the patient will say ‘it’s swollen and it feels a little bit numb’ and that’s all normal.
So we just finished taping. We’re going to take a little bit of this tape off around the incisions just so that we are able to clean them. These are Doyle splints and we’re going to insert that into the nose. So we use this instead of packing. The benefit of putting Doyle splints in is they’re more rigid and will help stabilize the septum that was fixed. This is just a lot more pleasant to remove than packing plus she can breathe through the little hole in the tube here.
Ok, we put the Doyle splints in and now we’re going to stitch them together. Now we’re going to put on our cast. So this hardens with that cold water, and this splint will be taken off and removed in seven days with the tape and all the sutures and the Doyle splints inside the nose. Following that the nose will be taped for another week. Sometimes if there’s a good amount of swelling we’ll have the patient tape their nose nightly up to six to eight weeks after surgery. We’ll have them do episodic nasal exercises where we will have them put pressure on their nasal bones. Every case is different it just depends on the healing.
What’s very important though about a procedure to make everything go nice and smooth is a good surgical technician. So Christine my niece has been with me since day one. She has done a wonderful job and always makes everything go easy for me. Ok, we’re done!