Improving Postsurgical Management of Rhinoplasty: A Comprehensive Review of Existing Literature

Overview

Effective postoperative care matters because swelling, bruising and pain affect both healing and satisfaction. The authors searched PubMed and Cochrane for articles published between 2014 and 2024 addressing care after rhinoplasty, and assessed quality by the Oxford Centre for Evidence-Based Medicine levels of evidence.

Sections of note

• Design: systematic literature review. Of 191 articles found, 22 met inclusion criteria and seven key studies were analyzed in detail.
• Corticosteroids were effective in controlling swelling and bruising.
• Antibiotics are generally not recommended.
• Silicone septal splints provide support, particularly when a damaged lining or septal cartilage needs stabilizing. Nasal packing is not recommended.
• Adhesive strips help reduce swelling in the bridge and the area just above the tip.
• Positioning the patient at 20 degrees reverse Trendelenburg during surgery, then keeping the head elevated at 90 degrees afterward, significantly reduced swelling and bruising.
• Drainage with a cannula and cooling techniques reduced postoperative morbidity.
• Patient education about expected outcomes and healing reduces anxiety and uncertainty.

What it means for a patient

• Several simple measures reduce swelling and bruising, most of them positioning, cooling, taping and a short course of steroid.
• Routine antibiotics and nasal packing are both advised against, which reverses long standing habits.
• Head elevation is the measure with the clearest reported effect, and it costs nothing.
• The authors state no consensus exists on optimal postoperative care and call for further systematic trials.

Why this paper matters

Postoperative care shapes the recovery experience and how quickly a patient can return to normal life, yet it varies widely between practices with little evidence behind it. Consolidating the last decade of studies gives a working list. Twenty two studies with seven analyzed in detail is a thin base for the recommendations drawn.

Terms

• Corticosteroid: an anti-inflammatory drug used to reduce swelling.
• Nasal packing: material placed inside the nose after surgery to control bleeding.
• Septal splint: a thin silicone sheet placed alongside the septum to support it while healing.
• Reverse Trendelenburg: a position with the head tilted higher than the feet.
• Ecchymosis: bruising, the discoloration from blood under the skin.
• Supratip: the area of the bridge just above the nasal tip.