Rhinoplasty of the tip of the nose: before and after photos, advantages of the method, prices

Rhinoplasty is the most spectacular operation that can change and beautify your face! Why put off solving the problem “for later” if you can become beautiful here and now.

Nose surgery is one of the most common aesthetic surgeries in the world. From year to year, rhinoplasty in Moscow ranks first or second in popularity among all plastic surgeries. Correction may be required after injury or illness to restore the nose to its original shape and breathing function. However, rhinoplasty is most often performed simply to become more attractive.

People of different ages, genders and nationalities resort to surgical correction of the nose. Many of them specially come to Ekaterina Sergeevna Kudinova from other cities and countries to get their perfect nose done by the best plastic surgeon, in a good clinic, and at a very reasonable price.

What is nasal tip rhinoplasty?

This is a surgical intervention during which the surgeon changes the location of the soft tissues and cartilage on the wings and tip of the nose. Cosmetic imperfections are eliminated using resection, transplantation, suturing, reposition and other surgical procedures. The procedure is performed in a hospital setting and in most cases under general anesthesia.

Rhinoplasty is one of the most difficult operations in aesthetic medicine, since the shape and structure of cartilage is individual for each patient. Surgical intervention requires pinpoint precision from the surgeon, otherwise the reconstruction will not produce results or will worsen the appearance.

Nasal implants

Implants for nose reconstruction are made of medical silicone or other synthetic materials. They have a shaped contour and are applied by the surgeon to the bridge of the nose. There are camouflage implants, when a thin film is placed on the bridge of the nose in order to cover all irregularities after rhinoplasty. Synthetic nasal implants are used quite rarely - usually only when it is necessary to increase the bridge of the nose when there is not enough tissue. Most often, rhinoplasty surgeons use cartilage and bone implants (autografts). You can use ear and rib cartilage, as such tissues take root better.

Correction methods

Rhinoplasty is performed in open and closed ways. In the first case, the doctor makes an incision on the bridge between the nostrils (columella) and releases the pterygoid cartilages. After this, excess tissue is removed, and the tip of the nose is given the desired shape using sutures. If necessary, the bridge is raised and strengthened using supporting cartilages. The open method provides a complete overview of the surgical field, therefore providing more options and reducing the risk of errors and inaccuracies. The only disadvantage of this method is a small scar on the columella. If the operation is performed by an experienced surgeon, the scar will be barely noticeable and will practically disappear over time.

Closed rhinoplasty is performed from the inside of the nasal cavity through an incision in the mucous membrane. The doctor releases the pterygoid cartilage and applies sutures, which will subsequently correct the shape of the tip of the nose. The operation takes less time compared to open rhinoplasty, and the results can be seen faster. Another advantage of the technique is that the postoperative scar is hidden in the nasal cavity and is completely invisible. The disadvantages of the procedure include limited access to the operated area. Because of this, the surgeon cannot use all possible techniques that give the best result. Limited visibility makes it difficult to control the condition of blood vessels, so the likelihood of bleeding and hematomas increases.

The technique is chosen depending on the nature of the aesthetic defect and the characteristics of the patient’s anatomy. In difficult cases, the open method is often used.

Rhinoplasty: on the path to perfection

According to reports from the International Society of Aesthetic Plastic Surgeons (ISAPS), approximately 1,000,000 rhinoplasty surgeries are performed annually worldwide[1]. And this is not surprising, because it is the nose that primarily influences how the face as a whole is perceived. Despite the complexity and relatively high cost of the operation, it can be a real salvation for people who are unhappy with their appearance.

The essence of the rhinoplasty procedure

Rhinoplasty is a plastic surgery of the nose, that is, correction of its shape. In addition, rhinoplasty includes septoplasty - correction of the shape of the nasal septum.

Rhinoplasty is performed for both medical and aesthetic reasons. Medical indications include correction of the shape of the nose after injury, correction of congenital deformities that interfere with normal breathing, as well as surgery on the nasal septum, when its curvature disrupts the flow of air in one of the halves of the nose.

As for aesthetic indications, it all depends on the preferences of the patient himself - someone does not like the hump, someone wants to make the nose thinner, reduce it or correct its tip, and so on.

What are the indications and limitations for the procedure?

Rhinoplasty can be performed for medical reasons at any age. Moreover, if we talk about small children, the sooner the correction is made, the better. Disruption of normal breathing in a child can lead to retardation in physical and mental development due to oxygen starvation of the brain.

Medical indications for rhinoplasty:

congenital deformities of the nose that interfere with normal breathing;
nasal injuries;
burns;
frostbite;
restoration of the nose after mutilating operations (for example, removal of a tumor, rhinophyma).

Rhinoplasty for aesthetic reasons is performed only on adults. Plastic surgeries of this kind are performed to change the size or shape of the tip of the nose, the distance between the nose and the upper lip, as well as to eliminate asymmetry, a hump with kyphosis, correct a “saddle” nose with lordosis, and narrow the back of the nose.

Contraindications for rhinoplasty are related to the patient’s health condition, they may include:

severe general diseases;
bleeding disorders;
diabetes mellitus - with this disease, normal tissue repair is inhibited and the likelihood of infectious complications is high;
tendency to form keloid scars;
systemic collagenoses are autoimmune pathologies that affect connective tissue, including that underlying the skin and cartilage;
dysmorphophobia is a mental pathology in which the patient is unable to adequately assess his own appearance, and therefore the result of the operation.

In addition, rhinoplasty is not performed on pregnant or breastfeeding women - drugs administered during anesthesia are harmful to the fetus: if they get into breast milk, they can adversely affect the baby’s health. In addition, during this period the woman’s hormonal levels change, which can lead to problems during rehabilitation that cannot be predicted.

Rhinoplasty is a complex operation that must be performed by a highly qualified surgeon. It is known that from 5 to 25% of all plastic surgeries in the nose area are repeated[2], that is, the need to perform them is caused by the fact that patients are dissatisfied with the aesthetic or functional (impaired nasal breathing) result. Therefore, having decided to undergo an intervention, you should carefully choose a doctor and a clinic, so as not to later correct the consequences of an unsuccessful operation.

Rhinoplasty methods and their features

When talking about changing the shape of the nose, one cannot fail to mention non-surgical rhinoplasty. This is a correction of the shape of the nose using gel fillers based on collagen, poly-L-lactic or hyaluronic acid, calcium hydroxyapatite, and acrylic powder. For example, a hump is smoothed by introducing gel above and below its area, a curvature of the back is smoothed by adding volume from the “concave” side. You can also raise the tip of the nose, even out the asymmetry of the wings, etc.

On the one hand, such an intervention is performed under local anesthesia and is reversible (the gel dissolves within 6–12 months, and there are fewer contraindications to its use). On the other hand, this can only correct minor deformations. In addition, the procedure will have to be repeated from time to time. And with an unprofessional approach to the process of administering the drug, when the filler gets into the lumen of the vessel, of which there are many in the nose, necrosis of the surrounding tissues may occur or even blindness may develop if the artery supplying the retina is damaged.

From these points of view, surgical methods for correcting the shape of the nose are preferable to non-surgical methods: the operation is performed once, and the result remains for life, while modern safe drugs are used for general anesthesia; doctors specializing in rhinoplasty, unlike most cosmetologists, know the topography very well vessels and nerves in the nasal area.

How is rhinoplasty performed? Surgical rhinoplasty can be performed open or closed. In open rhinoplasty, an incision is made in the columella, where the bridge between the nostrils meets the skin above the upper lip. After this, the soft tissues of the nose are peeled off from the cartilage and bones, on which, in fact, the correction is carried out. Open rhinoplasty is more traumatic, but the result of the intervention is more predictable.

In closed rhinoplasty, an incision is made on the inside of the nostrils. The further course of the intervention is largely determined by the author’s methods - some use endoscopic instruments, others use their own techniques. After such an operation, there are no external sutures left, but it lasts longer, and the result is less predictable and largely depends on the practice and even the intuition of the operating doctor.

Regardless of the specific technique, preparation for rhinoplasty is the same. The patient undergoes an examination , which includes:

clinical and biochemical blood tests;
coagulogram (determination of the state of the coagulation system);
blood test for syphilis and parenteral hepatitis;
fluorography;
ECG;
consultation with an anesthesiologist;
consultations with narrow specialists according to indications (in the presence of concomitant pathology).

Before the intervention, the operating surgeon is obliged to explain the entire course of the operation and recovery, and state what possible complications exist. The intervention does not require special preparation. If the patient is taking medications that affect blood clotting, such as aspirin or hormonal contraceptives, they should be discontinued two weeks before surgery. During the same time before the procedure, you should give up alcohol and smoking, since nicotine constricts blood vessels and impairs regeneration, alcohol changes the clotting ability of the blood, and its breakdown products cause intoxication of the body.

The operation process depends on the existing defect.

Nasal tip surgery allows you to correct a “hook nose,” upturned nose, and asymmetry in this area.
Plastic surgery of the base of the nose allows you to reduce the width of the nostrils.
When correcting the shape of the nose, the cartilaginous and bone structures of the nasal dorsum are corrected, making it smoother, narrower, and removing the hump.
With plastic surgery, the columellae give a more harmonious appearance to the area of the bridge between the nostrils.
During septorhinoplasty, the nasal septum is corrected, cartilage “spikes” and other defects that narrow the nasal passages are removed, causing breathing problems.
Augmentation plastic surgery allows you to “strengthen” the bone structures of the nose; it is often used to correct the consequences of unsuccessful previous interventions.
Reconstructive rhinoplasty allows you to restore the nose after injuries, burns, frostbite, operations, including with the help of implants.

After surgery, tampons (or silicone dilators that allow breathing) are inserted into the nostrils, and plaster is applied to the bridge of the nose. The patient spends the first few hours in the intensive care ward, after which he is transferred to a regular room. They are usually discharged from the hospital within a day or two.

In the first three days, it is not recommended to eat hot, spicy, or solid foods, so as not to provoke bleeding. You should also refrain from salty foods to avoid increased swelling.

Nasal swabs are removed on the first or second day after surgery, plaster cast on the seventh to tenth day, and sutures are also removed after about a week. Until this moment, you should not wash your face or wash your hair. After removing the sutures and plaster, the area of the postoperative scar is allowed to be wetted, washed carefully with delicate detergents and gently blotted with a soft cloth.

The first conclusions about the result of the operation can be made no earlier than three months after the operation, when the swelling begins to subside. All this time you should not overheat (visit a bathhouse, sauna, sunbathe) or actively engage in sports. The new nose can be fully assessed no earlier than a year after rhinoplasty, when the so-called callus has formed.

What to look for when choosing a surgeon?

When choosing a specialist, many begin by studying the portfolio - photographs of patients “before and after”. In fact, this is the last thing you need to pay attention to. Much more important are such “boring” things as the availability of licenses and certificates, the availability of which many are for some reason “embarrassed” to ask.

So, what aspects should you consider when choosing a place for rhinoplasty?

Availability of a valid license from the clinic in which the plastic surgeon operates. Moreover, the license must include not only aesthetic surgery, but also anesthesiology - this will mean that in the event of an unexpected reaction to anesthesia or complications in the early postoperative period, the clinic will have all the necessary equipment to save the patient.
Specialist certificate , or specialist accreditation. This is a document confirming that after graduating from medical school, the doctor underwent additional training in a field such as plastic surgery, confirmed his qualifications before a special commission and continues to study, regularly gaining new knowledge. A specialist certificate, or accreditation, is valid for five years, after which it must be confirmed.
Certificates of additional education , participation in scientific and practical conferences, certificates of awarding an academic degree and other similar documents - all this is also not just a tribute to the doctor’s vanity, but a confirmation of the level of his qualifications.
The condition of the clinic itself . Even the most ingenious surgeon will not be able to guarantee a positive result of an operation performed in unsanitary conditions or in the absence of the ability to provide proper care to the patient.
Willingness to take responsibility for the result . The human body is not a machine, and how the recovery process after rhinoplasty will proceed and what the patient’s final appearance will be depends largely on the individual characteristics of his body. But an experienced doctor is able to take into account all anatomical and physiological aspects, and in case of an error, he is ready to correct the result until it becomes as satisfactory as possible for the patient.
Issue price . The qualifications of a plastic surgeon and nursing staff, consumables, anesthesia, equipment operation - all this costs money. Therefore, in most clinics the prices for rhinoplasty are on average the same. A price that is too low may mean that the facility is skimping on patient health. And the excessively high cost of services in a medical center often means that it includes an additional payment for non-core services - interior design, location in the very center of the city, and much more. Whether this really requires additional costs is up to the patient to decide.

Only after studying all these points can you begin to familiarize yourself with the doctor’s portfolio. As a rule, by this point the number of “candidates” is significantly reduced: from the two or three remaining specialists, it is necessary to choose the one whose ideas about “beauty” seem the most correct, and whose work seems the most harmonious from an aesthetic point of view.

So, rhinoplasty is a widely demanded operation. However, it is quite complex, therefore, when choosing a surgeon, it is better to choose a specialist who specializes in performing this type of aesthetic surgery and has all the necessary licenses and certificates. This will help reduce the likelihood of possible complications and ensure that the “new” nose causes only positive emotions and not additional problems.

Indications

The operation is carried out according to direct and indirect indications. In the first case, the procedure is used to correct serious congenital defects or anomalies that are caused by burns, frostbite and mechanical damage. Indirect indications mean the patient’s desire to improve his appearance, to make his facial features more proportional and attractive.

Surgery is indicated if the tip of the nose:

too wide;
forked;
curved;
upturned or down;
deformed as a result of injury or surgery.

Computer modeling is used to predict results. Thanks to this technology, the patient can see how his face will change after surgery.

Types and features of the operation

Surgery is performed through an external or internal incision. Endonasal (closed) correction is performed with an internal incision in the nasal cavity. With this approach, vascular bundles and nerves are not cut. Manipulations can be performed on any tissue of the nose. In this case, numbness of the nose and disruption of trophism, that is, tissue nutrition, does not occur. Incisions are made on the mucous membrane in the area of the wings, through which the surgeon inserts instruments.

Exonasal (open) correction - the incision is made on the columella (fold of skin under the tip of the nose). The outer scar after such an incision and healing is practically invisible. The technique and features of surgical intervention depend on the location of the defect:

widened nostrils, bulbous tip - truncation of wing cartilages and soft tissues;
flattened nose - the formation of a raised back with your own cartilage or synthetic implants;
wide bridge of the nose and bridge of the nose - plastic surgery with osteotomy is performed.

Wide nose surgery involves not only changing the shape, but also adjusting the seat height. The result of the operation is assessed according to several criteria: the width of the nose is proportional to the face, there is no excess tissue on it that gives volume, the scar is invisible.

Contraindications

Any operation has contraindications if there are health problems. Plastic surgery is not performed if the patient has the following diseases and pathological conditions:

oncology;
diabetes mellitus;
herpetic infection;
severe pathologies of the heart, kidneys and liver;
low blood clotting;
hepatitis B and C.

There are also time restrictions for surgical intervention. These are inflammatory processes in the operated area, respiratory infections and exacerbations of chronic diseases. The operation is not performed on women during menstruation, pregnancy or breastfeeding.

Types of correction

There are many types of plastic surgery, depending on the physiological characteristics of the patient and the goals set. In particular, the wide tip is reduced by resection (excision of “extra” cartilage tissue) or in a more gentle way by suturing the pterygoid cartilages in the dome area. The problem of an upturned nose is solved by transplantation. To do this, the patient’s own cartilage tissue is used, which replenishes the volume in the problem area. In case of “bifurcation” of the columella, the right and left pterygoid cartilage in the area of the dome and medial crura are sutured.

The drooping tip is corrected using various techniques. For example, the lower fragment of the nasal septum and part of the pterygoid cartilage are excised, and then the remaining structures are brought together. An alternative method is tissue transplantation into the columella area. For transplantation, a miniature fragment of the auricle is usually taken.

The method of correction is determined by the surgeon after studying the patient’s problem. When choosing a technique, the doctor takes into account physiological characteristics: the general anatomy of the face, the density of cartilage tissue, the shape of the nostrils and nasal septum.

Anatomy of the nose

Anatomically, the human nose consists of three sections: the external nose, the nasal cavity and the nasal sinuses. The external nose is the part of the nose that we see. It is a bone-cartilaginous skeleton covered with skin. Between the oral cavity and the anterior cranial fossa is the nasal cavity. Here, in anticipation of the nasal cavity, thanks to numerous hairs on the skin, the air is cleared of debris, then enters the respiratory area, where the nasal passages are covered with mucous membrane with ciliated epithelium. When exposed to irritants, the mucous membrane swells and the nasal passages close. The anatomy of the nose also includes cavities in the bones of the skull that communicate with the nasal cavity, which are called paranasal sinuses.

How is the operation performed?

Rhinoplasty of the tip of the nose is performed under general or local anesthesia. The method of pain relief is chosen depending on the type of operation. During general anesthesia, strong sedatives are administered intravenously or multicomponent endotracheal anesthesia is used. During the operation, the doctor makes incisions inside or outside the nose, separates the cartilage from the soft tissue, and removes excess muscle and bone structures using special instruments. At the final stage, the tip of the nose is formed and cosmetic sutures are applied using biodegradable material. The affected area is covered with a bandage and fixed with a plaster splint.

Rhinoplasty BEFORE and AFTER

All photos

Plastic and maxillofacial surgeon Ekaterina Sergeevna Kudinova - Candidate of Medical Sciences, senior researcher at the leading Moscow scientific and clinical center of otorhinolaryngology - has extensive experience in performing all types of operations on plastic and reconstructive surgery of the nose and midface.

Rhinoplasty of the nose in Moscow

Rehabilitation period

With proper preparation and adherence to the surgical technique, rehabilitation proceeds quickly and without complications. Patients may be bothered by minor swelling, hematomas and pain that go away on their own or after taking anti-inflammatory drugs. Sometimes mild swelling persists for 2–3 months, which is considered normal.

After the intervention, the patient must follow several rules:

sleep on your back, leaning on a high pillow;
protect the wound from contact with water for several days;
for at least 3–4 weeks, avoid physical activity, visiting the sauna, bathhouse and solarium;
stick to a diet, avoid spicy, salty and fatty foods.

Often, the doctor gives individual recommendations to consolidate the result and shorten the rehabilitation period. Changes in appearance can be assessed after 8–10 weeks, and the tip of the nose will take its final shape 6–12 months after surgery.

A few words about the important things. Preparing for surgery

Before undergoing rhinoplasty, you need to undergo preparation. You will need to consult a plastic surgeon to discuss the desired changes. The surgeon examines the nose and explains the reality of obtaining the desired result. During the consultation, questions about limitations, the operation, features of its preparation, rehabilitation after it, as well as possible complications are discussed.

Before the operation, the patient needs to be examined to ensure that there are no contraindications and undergo the following tests:

blood for HIV infection and hepatitis C and B;
clinical blood test;
blood biochemistry;
laboratory urine analysis;
prothrombin index analysis;
fluorography;
electrocardiography;
tumor marker test;
radiograph.

The patient also needs to listen to the doctor’s recommendations and adhere to them. Avoid drinking alcohol for a week before surgery, stop smoking, do not take blood thinners, and do not drink water or eat food for five hours before the procedure. It is important to refrain from active pastime and walking under the scorching sun a couple of days before rhinoplasty.

Possible complications

Complications usually arise due to the surgeon’s unprofessionalism and violation of the preparatory and rehabilitation regime. The most common negative consequences are a rough scar at the incision site, wound infection, dry mucous membrane, loss or distortion of sensitivity in the operated area. For any complications, medical consultation is required. If necessary, the patient is prescribed additional therapy, and in severe cases, repeated surgery.

Mobility of the nose after rhinoplasty is normal. Within 12–18 months after the intervention, patients may experience spontaneous changes in the shape of the tip, which lowers, rises, or moves to the side. Experienced surgeons warn in advance about this problem and help solve it.

Advantages of rhinoplasty with Dr. Kudinova:

Ekaterina Sergeeva Kudinova is among the TOP 5 best specialists in Moscow in the field of rhinoplasty and reconstructive nose surgery. Patients from other cities in Russia and abroad often come to her clinic. Some turn to her to have their nose corrected by the best plastic surgeon in Moscow, while others want to undergo complex reconstructive surgery or re-correction of the nose after a previous unsuccessful rhinoplasty.

Ekaterina Sergeevna Kudinova is not just a plastic surgeon who has extensive practical experience in performing all types of rhinoplasty, she is a recognized Russian expert in performing the most complex reconstructive surgeries of the nose and midface. Dr. Kudinova defended her dissertation on the topic of reconstruction of post-traumatic defects and deformities of the midface. For a long time she specialized simultaneously in plastic and reconstructive surgery of the face and nose, working under the guidance of the best Russian and foreign specialists in this field. If you are interested in the price of nose surgery in Moscow, open our price list or contact us by phone.

Over the past years, Dr. Kudinova has been a leading researcher in the department of plastic and reconstructive surgery at one of the leading medical centers in Moscow - the Federal State Budgetary Institution Scientific Center for Otorhinolaryngology. Here she performs the most complex plastic and reconstructive nasal surgeries for patients injured in accidents and accidents. Contacting her is the best solution if you need the best rhinoplasty in Moscow. Our prices for nose correction are quite reasonable.

If you want to find out how plastic surgery can help improve the appearance of your face, sign up for a consultation with a Ph.D. plastic surgeon Ekaterina Sergeevna Kudinova through the online registration form or by phone 1 or +7 (903) 790-69-58.

Cost of the procedure

The price depends on the complexity of the operation, technique, type of anesthesia, equipment and medications used. There are other factors that influence pricing. The cost of the procedure in the capital’s clinics is higher than in most Russian regions. The services of a qualified surgeon who knows the original technique will cost more than the average specialist. And the primary operation will cost less than correction of unsuccessful surgery.

What are the risks of rhinoplasty?

We are talking about surgery, which is associated with risks, and sometimes side effects are observed. These are good reasons not to undergo rhinoplasty, especially if the surgeon does not see any abnormalities or medical indications.

An anaphylactic reaction to anesthesia is possible - a rapid allergy phenomenon that threatens life. In 0.017% of cases, toxic shock syndrome is observed - a shock condition that is caused by the activity of exotoxins from bacteria or viruses.

Overall, adverse events develop in only 4–18.8% of patients, with one in ten of this group experiencing skin and soft tissue complications.

During the operation, excessive bleeding, ruptures of the skin, mucocartilaginous structures, burns, violations of the bony pyramid, and others are recorded.

In the first hours and days after surgery, anaphylaxis and visual and respiratory dysfunction may develop. Hidden complications include bleeding and septal hematoma.

Very rarely , an infection gets into the wound, which requires a course of treatment with antibiotics; in the case of sepsis (blood poisoning), hormones and blood transfusions are used.

Other complications include:

Decreased sensitivity.
Scars, cicatrices requiring repeated intervention.
Difficulty breathing.
Deterioration of sense of smell.
Perforation (holes) of the nasal septum.
Cartilage atrophy.
The appearance of a vascular network, pigmentation.
Rarely - necrosis (death) of tissue.

In addition, the patient is not always satisfied with the result - 3 out of 10 such patients . The probability that the view will be as planned is about 70% . The nose may seem too regular, look unnatural, and may not fit in with the rest of your facial features. Therefore, before deciding to make changes, you should weigh the pros and cons.

After this, repeated correction may be required, which is carried out after 6 months, but not earlier. Indications include improperly stitched or excessively removed cartilage, in which the nose appears short, small columella (the lower part between the nasal passages), etc.

When is it better to refuse surgery?

People with dysmorphophobia or body dysmorphomania often turn to plastic surgeons for help. In the first case, we are talking about a painful attitude towards a minor defect or feature of the body, in the second - about an imaginary external defect.

If the surgeon does not find deviations from the average parameters in the size of the nose or its location in relation to other parts of the face, a consultation with a psychologist is recommended.

You should also study reviews about the clinic and the specific specialist. The lower the qualifications of the doctor, the higher the likelihood of complications.
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conclusions

Rhinoplasty of the tip of the nose allows you to eliminate serious cosmetic imperfections and radically change your appearance. Thanks to the operation, patients solve aesthetic and psychological problems and gain confidence in their own attractiveness. However, in some cases the procedure is contraindicated for objective reasons or is useless because it will not give the desired results. Therefore, it is better to make the decision about surgery after consultation with an experienced surgeon. He will assess the feasibility of the intervention and, if necessary, recommend an alternative, for example, non-surgical rhinoplasty using threads or fillers.

Suture material and anesthesia

In closed rhinoplasty, the stitches are located inside the nose. The suture material dissolves on its own. In open rhinoplasty, a very thin thread is used for sutures, placed on the skin part of the septum. A clear overlap of the edges is important here in order to obtain the thinnest possible scar after surgery. Naturally, such stitches must be removed.

Rhinoplasty is most often performed using intravenous anesthesia. On average, the operation lasts about an hour, but the time is influenced by the complexity of the case and the desired result. Once completed, the nasal passages are packed and a solid dressing is applied, most often a plaster cast or Denver splint.