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McLean, VA 22101
Septoplasty
Septoplasty
Background:
The nasal septum is made up of bone and cartilage, lined with mucous membranes. This structure separates the two nasal passages, providing structural support to the outside of the nose, and improving airflow dynamics inside the nose. A deviated septum can cause and combination of the following issues:
direct physical obstruction of the nasal passages causing difficulty breathing
obstruction of the sinus openings resulting in decreased drainage and ventilation of the sinuses and propensity to sinus infections irritation of the nasal lining resulting in intermittent nose bleeding and/or chronically runny nose
Background: A septoplasty is a surgery to enhance the function of the nose, specifically the septum.
Evaluation: Trauma and/or variations in natural nasal anatomy can lead to anatomic issues causing obstruction.
Pre-op Considerations: Septoplasty surgery has risks and benefits like any surgery. Please see below for specifics.
Surgery: Septoplasty surgery can be done through incisions inside the nose, at times requires an external incision between the nostrils depending on the severity of the problem.
Post-op care: Recovery after septoplasty is typically one week off work, followed by another week of decreased activity.
What is a Septoplasty?
A septoplasty is a surgical procedure that is performed, often by a head and neck surgeon, to correct a crooked or “deviated” septum. The septum of your nose is the bone and cartilage in between your nostrils. If the septum is deviated, it may cause a nasal blockage or nasal obstruction, difficulty breathing, or narrow nasal passages. A crooked septum can be caused by trauma, such as a broken nose, or can occur naturally. A deviated septum can obstruct your nasal passages and can cause you to have chronic sinus infections, runny nose, or nosebleeds.
Septoplasty is often performed at the same time as a functional and/or cosmetic rhinoplasty surgery, turbinate reduction, and/or sinus surgery.
How is a nasal septoplasty performed? Will I have scars from this type of nasal surgery?
How is a nasal septoplasty performed? Will I have scars from this type of nasal surgery?
During a septoplasty, your ENT surgeon will remove, contour, reposition, and/or strengthen portions of your nasal septal cartilage to stabilize the structure and improve symmetry of the left and right nasal cavities. Septoplasty surgery is most often performed under general anesthesia and can often be executed with incisions inside your nose. Depending on the severity of the type of deviated septum and severity of the problem, an external incision is made on the skin between your nostrils, usually about 5 mm in length. Nasal packing is not usually required, but you may need thin plastic splints inside your nose for the first week, post-operatively, to help reinforce the septum correction and to prevent scarring.
Septoplasty Pre-operative Considerations
You are considering an operation to improve your nasal breathing and/or nasal health by straightening the nasal septum (the thin sheet of cartilage and bone that divides the nose into two halves). The operation is called septoplasty, which involves surgical incisions inside the nose. The vast majority (~90%) of patients who undergo this operation for the appropriate indications have an improvement in their subjective breathing ability. Rarely, complications such as nosebleeding, recurrent septal deviation, and septal perforation (small hole connecting the two sides of the nose) do occur, but in the vast majority of patients, the desired surgical result is readily achieved.
Details of Surgery:
During septoplasty, portions of the cartilage and bone are removed, thinned, repositioned, and/or strengthened to stabilize the overall nasal structure and improve symmetry of the nasal cavities. This is done to address any combination of the issues mentioned above. Packing is usually not required with this surgery, but most patients will have thin plastic splints placed inside the nose to aid keeping the tissues in the desired position and to decrease the risk of scarring in the immediate post-operative period.
Septoplasty Post-operative Recovery
- Arrange for someone to stay with you for the first 24 hours if you have undergone general anesthesia.
- Go to bed and rest, lying on your back, with your head elevated with 2-3 pillows. You should be lying at a 45 degree angle.
- You may be up and around and able to go to the bathroom. You will be able to eat a light meal with assistance.
- Take medication only as directed.
- Mild to moderate pain after surgery is a normal occurrence, which should be relieved by the pain medication prescription you have been given. Most patients require pain medication for less than 7 days after surgery.
- Bloody drainage is expected from your nose after surgery and will gradually progress to blood-tinged mucous. You will have a drip pad placed under your nose that may be changed every 1-3 hours when saturated completely. This is often necessary for 2-3 days after surgery. If you have an active nosebleed with copious flow of blood, please call immediately and/or come to the ED for evaluation.
- Gently place ice packs or a bag of frozen vegetables on and around the nose for the first 24 hours after surgery (on for 20 minutes, then off for 20 minutes).
- You may be up and around as tolerated but expect to tire more quickly than usual.
- Keep activity and meals light.
- On the post-op day after surgery, start using nasal saline spray at least 3 sprays in each nostril at least 3 times per day (available over the counter from the drug store). This will help keep the nasal lining moist so as to avoid excessive crusting in your nose.
- For the first 48 hours, be sure to keep the incisions clean and dry; apply petroleum ointment as needed. After 48 hours, you may shower; avoid scrubbing the surgical are and do not submerge your face in water. Any external bandages may be changed daily or as needed, if they become saturated.
- You will come into the office for a post-operative check-up and to have your nose cleaned and any nasal packing and/or splints removed.
- No alcohol for the first 7 days after surgery, which can increase bruising and swelling.
- Your swelling and congestion will gradually fade over this time period, but may persist for up to 3 weeks.
- No strenuous activity or heavy lifting for 2 full weeks after surgery.
- Rest and good nutrition are important healing factors, especially during the first 6 weeks.
- Numbness and tingling of the upper lip, roof of mouth, and /or upper teeth may occur, which resolves with time.
2024 Dr. Michael Reilly Washington DC Rhinoplasty, McLean VA. Rhinoplasty and Plastic Surgeon. All rights reserved.