PRS-GO Plastic and Reconstructive Surgery Global Open · 2019

Rhinoplasty and External Nasal Splinting: Is It Really a Must?

Challita R, Shouman M, Ghanime G.

PubMed 31592389 Publisher (DOI)Free full text (PMC)

What this paper says

Across 211 rhinoplasties done with tape dressing only and no external splint, revision was needed in 3.48 percent and 79.60 percent of patients had a narrower nasal bone width afterward.

Overview

Surgeons routinely apply an external splint after rhinoplasty to hold the tissues and bones in their new position, though the authors state no evidence supports the practice and splints carry drawbacks. This retrospective review reports cosmetic results when no splint was used.

Sections of note

Retrospective cross-sectional study reviewing records of 211 patients operated by the same surgeon from 2015 to 2017.
All patients were operated using the open technique.
After surgery a Steri-Strips dressing with an overlying layer of surgical tape was applied, with no external nasal splint.
Most patients were followed for 18 months.
Complication rates: skin infection 0.99 percent, skin necrosis 0.99 percent.
Secondary revision rate 3.48 percent.
79.60 percent of patients had a decrease in nasal bone width after surgery.
The authors conclude external splinting should not be routinely used.

What it means for a patient

The rigid cast on the nose after surgery was omitted here, and the bones still narrowed in about four fifths of patients.
The revision rate of 3.48 percent is at the low end of published rhinoplasty figures.
Splints add cost, bulk and their own complications, which is the case for leaving them off.
Limits: single surgeon, retrospective, no control group receiving splints, and lateral osteotomies are described as routine but their use in each case is not specified.

Why this paper matters

External splinting is near-universal after rhinoplasty and rests on convention rather than trial evidence. This provides a substantial series without it and reports acceptable outcomes. Without a splinted comparison group the study cannot show splinting is unnecessary, only that omitting it was compatible with good results in this practice.

Terms

External nasal splint: A rigid cast placed over the nose after surgery.
Lateral osteotomy: A bone cut along the side of the nose allowing the bones to be moved inward.
Steri-Strips: Adhesive skin closure strips.
Nasal bone width: The measured width across the bony part of the nose.
Secondary revision: A further operation to correct or improve the result.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

Abstract

Unlabelled: Rhinoplasty is a common and challenging procedure. Lateral osteotomy is routinely performed in most cases. Most of the surgeons have the habit of applying external nasal splints to stabilize the nasal tissues and bone in their new position postrhinoplasty. These splints are widely used despite the absence of any evidence supporting this practice. Moreover, these splints have a lot of disadvantages, so we conducted this study to evaluate the cosmetic result in their absence.

Patients And Methods: A retrospective cross-sectional study was performed. Medical records of 211 patients operated on for rhinoplasty by the same surgeon from 2015 to 2017 were reviewed. All patients were operated using open technique. After surgery, a Steri-Strips dressing with an overlying layer of surgical tape was applied to the nose without the use of an external nasal splint. Most of the patients were followed up for 18 months. Complication rates, revision rates, and nasal bone widths were recorded.

Results: Complication rates and revision rates were as follows: skin infection 0.99%, skin necrosis 0.99%, and secondary revision 3.48%. Finally 79.60% of patients had a decrease in their nasal bone width postsurgery.

Conclusion: Based on the present study, external nasal splinting postrhinoplasty should not be routinely used. Satisfactory cosmetic results can be obtained while avoiding the complications, cost, and bulky dressings associated with external splints.

Abstract as indexed by PubMed; the article is open access (PubMed Central).