How should one care for the operated nose?
Reviewed by Shivanchan Rajmohan

Although the past decade has brought advances in rhinoplasty techniques, postoperative care continues to be an area marked by notable variation among surgeons. The authors of this study sought to document contemporary postoperative practices for primary and revision rhinoplasty through a structured survey of experienced rhinoplasty surgeons in the USA. The authors designed a 29-item survey and distributed it to 23 board-certified plastic surgeons (members of Rhinoplasty Society and Dallas Cosmetic and Rhinoplasty Course instructors). The survey explored patterns regarding taping, triamcinolone (Kenalog) injections, steroid dose packs and isotretinoin use. In total, 73.9% of surgeons performed open rhinoplasties exclusively, with the majority performing fewer than 50 primary and revision rhinoplasties annually. Over half recommended postoperative taping in both primary and revision rhinoplasties, typically maintained for two to four weeks and longer in revision cases. Taping served to minimise tip depression, oedema and dead space, especially in patients with thick skin. Kenalog injections were widely adopted, used by 83% of surgeons in primary rhinoplasties and 87% in revision cases, typically administered one to six weeks postoperatively; supratip fullness, fibrosis prevention and scar healing being main indications. Isotretinoin practice was more heterogenous, with around half holding isotretinoin pre-surgery and resuming within one to six weeks postoperatively to address thick or sebaceous skin. Thirty-three percent use oral steroid dose packs for all patients for oedema control, with 33% not using steroids at all. While intraoperative advances have been rigorously studied, postoperative strategies remain guided largely by tradition and anecdotal experience rather than standardised evidence. The study found general agreement on taping and triamcinolone use but wide variation in isotretinoin and oral steroid practices. It calls for evidence-based guidelines to standardise postoperative care, recognising its equal importance to surgical technique in achieving optimal rhinoplasty outcomes. Could standardising postoperative care in rhinoplasty be the key to turning good surgical results into consistently exceptional outcomes?

Postoperative care in primary and revision rhinoplasty – A survey-based study.
Kumar NG, Sherif R, Rohrich RJ.
J PLAST RECONSTR AESTHET SURG
2025;111:34–42