When patients are considering rhinoplasty (nose job), they often ask us why a cast is needed after surgery. What does it do? How does it work? Can I touch my cast after rhinoplasty?
Understanding the purpose of the cast—also called a nasal splint—often helps patients prepare for that aspect of recovery. In this blog post, we’ll answer some of those common cast questions so you can prepare for the procedure and its recovery with confidence.
Why Is There a Cast After Rhinoplasty?
The cast, or nasal splint, is needed for 3 main reasons: protection, compression, and positioning.
Protecting the nose: The cast protects the nose after surgery since the nose is fragile and must be protected from trauma or being accidentally bumped or shifted. The nose also needs time to set properly, which typically takes about a week.
Compression: The cast compresses the nose to keep the swelling reduced and minimize drainage and bleeding.
Positioning the nose: The cast keeps the nose positioned properly and keeps it straight while it’s healing.
During rhinoplasty, the nose is injected with local anesthetics (lidocaine and Marcaine with epinephrine) that reduce bleeding but cause the soft tissues to swell. Surgical manipulation and osteotomies (breaking the nasal bones) also cause swelling. (You can learn more about whether the nose has to be broken during rhinoplasty in our related blog post.) These factors make the cast applied at the end of the procedure a necessity.
For these same reasons, a cast is also used after revision rhinoplasty.
How Is the Nasal Splint Applied?
Following a rhinoplasty, I typically stand above the patient’s head to assess the nose for its position and any deviations, curvatures, or leaning tendencies.
DuraPrep™ is applied to the external nasal skin to allow better adherence of the cast. Steri-Strips™ are then trimmed to size and placed sequentially across the nasal tip in a horizontal fashion in several layers. A small, thin piece of adhesive foam is then applied in the midline over the Steri-Strips.
Next, the cast is applied and shaped. As an experienced facial plastic surgeon, I choose to use the Denver Splint™ for its durability and availability in several different sizes, according to the patient’s individual anatomy. The cast is a preformed composite of aluminum and a layer of adhesive foam. It is gently curved to the desired shape and placed over the nose.
Gentle pressure is applied to the sides of the cast to form a protective and compressive support. At this point, the nose is positioned midline. If the nose leans, sways, or has a tendency to turn to one side, asymmetric force or pressure can be applied to the cast to counter this.
How Long Does the Cast Stay On After Rhinoplasty?
The cast is removed about one week after surgery, once the nose has time to set properly. You can see what happens during a rhinoplasty cast removal in the video below:
Casting the nose is often underrated or glossed over, but it has an enormous impact on the overall results. It allows the surgeon to put the ‘finishing touch’ or artistic talents to work in the patient’s favor. You can see the results we create for our rhinoplasty patients in their before-and-after pictures.
If you are considering rhinoplasty and want to talk about your best options with an experienced rhinoplasty surgeon in the Orlando area, use our online form to request a consultation. Or call us at (407) 333-3040 to schedule a consultation.