What should I do if my rhinoplasty cast keeps falling off?
I have seen this question posed on other sites and forums related to cosmetic rhinoplasty. My advice to patients that ask this question is to call your rhinoplasty specialist and ask them what to do first.
I can tell you from experience that it is extremely uncommon for the nasal cast to simply fall off after having undergone cosmetic rhinoplasty or revision rhinoplasty. My normal routine is to apply a medial adhesive to the skin of the nose prior to placing my nasal bandages and the cast. As you can see in the attached photo of one of my own primary rhinoplasty patients, the dressings and cast fit very tightly over the nose. In fact, so tightly that it is highly unlikely the cast would fall off during the first week of healing. I even have to use some degree of effort when I go to remove the nasal cast in my office. So when I hear that the cast fell off ‘on its own’ I immediately question what the patient might have done to precipitate this. Usually there is some explanation – such as accidentally getting the cast wet or incidentally hitting the nose.
Some surgeons might have you try and replace the cast at home (since it should already be molded properly to your nose) and reinforce it with tape across the midface region. Others might just tell you to leave it off. Keep in mind the cast is intended to keep the nasal bones in position following reshaping of the nose during the rhinoplasty. If the bones happen to drift or shift a little during the early post-operative period, your rhinoplasty surgeon can show you how to do nasal, or digital, exercises to put the bones back into the desired position. So not all is lost if the cast does ‘happen’ to fall off!