After Rhinoplasty Packing: Breathe Easy!

Koter Nasal Airway In and Out of the Nose

After nasal surgery – including cosmetic, reconstructive and sinus surgeries – some type of packing is placed in the nose.

But for years, patients have complained about packing because they must breathe only through their mouths.

Some complain that their noses feel as pinched as if a clothes pin had been placed there. Another said he felt like he was drowning on dry land – much akin to waterboarding – while yet another said he could not sleep well. Many have dry, sore throats after nasal packing.

But the medical benefits for packing is usually clear, at least to cosmetic plastic surgeons who have done the surgery.

The purpose of packing after nasal surgery includes:

• Holding reconstructed sections in the right position
• Limiting bleeding
• Delivering antibiotics and medications to speed healing

Nasal surgeries that lead to packing for one to five days include:

• Cosmetic rhinoplasty
• Nasal septoplasty, repairing a deviated septum
• Turbinate reduction surgery

Consequently, two interesting factors became clear. Some cosmetic plastic surgeons stopped using packing because it soured the surgical experience for too many patients. (Post continues below)

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The patient below had a botched rhinoplasty done elsewhere, left. Surgery could not be done again. An after picture, right, shows the result of using a permanent filler in a non-surgical injection rhinoplasty technique. (Photo, Robert Kotler, M.D.

Permanent Non-Surgical Injection Rhinoplasty

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(Continued from above) Secondly, it became more clear that surgeons who specialize in plastic surgery of the facial areas – head and neck surgeons; ear, nose and throat specialists and general plastic surgeons – were not giving very close attention to their patients’ after surgery experience.

Results? Even given a great outcome, patients ranked nasal surgery low on overall satisfaction.

But we wondered: what if there was a way to combine the benefits of packing with the ability to breathe normally?

Long story short: we invented a soft silicone plastic tube that can be laid on the floor of a freshly operated nose with packing placed around the tube.

Known as the Kotler Nasal Airway (KNA), we described it in a medical article about nasal surgery with the somewhat hefty title: “Solving the Problem of Post-operative Airway Obstruction in Nasal/Sinus Surgery.”

(Read how the KNA is now used in nasal surgery.)

Of course, we prefer regarding the airway from the perspective of patients, many of whom had previous nasal surgery with packing and immediately feel the difference.