The Effect of Cannula Drain in Reducing Edema and Ecchymosis after Rhinoplasty

Sulaiman SY, Alnori H, Al-Talibi I, Goksel A.

What this paper says

In 40 patients who had a drain placed on the left side of the nose only, the drained side had significantly less swelling and pain on every postoperative day, while bruising was lower but not significantly so.

Overview

Swelling, bruising and pain after rhinoplasty contribute to dissatisfaction. The authors tested whether a small drainage cannula reduces them, with each patient serving as their own control: a drain was placed on the left side only and each side scored separately. All had open structural septorhinoplasty with internal lateral osteotomy at a tertiary referral centre from April to November 2022.

Sections of note

Design: randomized comparative study, each patient acting as their own control with the drain on the left side only.
40 patients, 80 sides in total. 22 women, 18 men, ages 18 to 44, mean age 29.
All had internal lateral osteotomy using a lateral saw aided by an osteotome. The drain sat in the subperiosteal tunnel.
Patients were assessed on days 1, 3, 7, 14 and 21 for swelling around the eyes, bruising, pain and blockage.
Swelling and pain were significantly lower on the drained side on all postoperative days, p reported as 0.000.
Bruising was lower on the drained side but not significant, p greater than 0.29. Nasal blockage was significantly reduced only on day 7.

What it means for a patient

Placing a drain reduced swelling around the eye and pain on that side of the nose across the first three weeks.
Bruising did not improve significantly, so a drain does not appear to prevent the visible discoloration.
Using each patient as their own control removes differences in healing between people, a strength at this size.
Limits: 40 patients, one centre, one bone cutting technique, and the drain always on the same side.

Why this paper matters

Recovery appearance drives much of the early patient experience, and cheap measures that shorten it have practical value. A split nose design is a stronger test of a local intervention than comparing separate groups. Whether the drain affects the final result, and whether it carries infection risk, is not addressed.

Terms

Cannula drain: a thin tube left in place to let blood or fluid escape rather than pool.
Subperiosteal tunnel: the space created beneath the membrane covering the bone.
Periorbital edema: swelling around the eye.
Ecchymosis: bruising, the discoloration from blood under the skin.
Lateral osteotomy: a cut along the side wall of the bony nose.

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

From the abstract

“Rhinoplasty is one of the most common plastic surgeries and is commonly associated with postoperative edema, ecchymosis, and pain which play a role in patients' dissatisfaction. In this randomized comparative study, we discuss the effect of cannula drainage in the reduction of postoperative periorbital edema,…”

Excerpt; the full abstract is on PubMed.