8
Management
Table 6. Summary of Key Action Statements (KAS)
Statement Action Grade
1. Communicating
expectations
Clinicians should ask all patients seeking rhinoplasty
about their motivations for surgery and their
expectations for outcomes, should provide feedback
as to whether those expectations are a realistic goal
of surgery, and should document this discussion in
the medical record.
R-C
2. Comorbid
Conditions
Clinicians should assess rhinoplasty candidates
for comorbid conditions that could modify, or
contraindicate surgery that include obstructive
sleep apnea, body dysmorphic disorder, bleeding
disorders, or chronic use of topical vasoconstrictive
intranasal drugs.
R-C
3. Nasal airway
obstruction
e surgeon, or the surgeon's designee, should
evaluate the rhinoplasty candidate for nasal airway
obstruction during the preoperative assessment.
R-C
4. Preoperative
education
e surgeon, or the surgeon's designee, should
educate rhinoplasty candidates regarding what
to expect aer surgery, how surgery might affect
the ability to breathe through the nose, potential
complications of surgery, and the possible need for
future nasal surgery.
R-C
5. Counseling for
obstructive sleep
apnea patients
e clinician, or the clinician's designee, should
counsel rhinoplasty candidates with documented
obstructive sleep apnea (OSA) about the impact of
surgery on nasal airway obstruction and how OSA
might affect perioperative management.
R-B
6. Managing pain and
discomfort
e surgeon, or the surgeon's designee, should
educate rhinoplasty patients before surgery about
strategies to manage discomfort aer surgery.
R-C
7. Postoperative
antibiotics
When a surgeon, or surgeon's designee, chooses to
administer perioperative antibiotics for rhinoplasty,
they should not be routinely prescribed for a
duration of >24 hours aer surgery.
R-B
(against)
8. Perioperative
steroids
e surgeon, or the surgeon's designee, may
administer perioperative systemic steroids to the
rhinoplasty patient.
O-B
9. Nasal packing Surgeons should NOT routinely place packing in
the nasal cavity of rhinoplasty (with or without
septoplasty) patients at the conclusion of surgery.
R-C
10. Outcome
assessment
Clinicians should document patient satisfaction
with their nasal appearance and with their nasal
function at a minimum of 12 months aer
rhinoplasty.
R-C
