Septoplasty

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What is a deviated septum?

A deviated septum is a condition in which the nasal septum is significantly off-centre or crooked. The septum is the bone and cartilage inside your nose that separates the two nostrils. A crooked septum can cause breathing difficulties and affect overall nasal function.

In many cases, a deviated nasal septum can be congenital, meaning you are born with it. However, it can also result from nasal injuries or trauma. Symptoms of a deviated septum include nasal obstruction, frequent sinus infections, nosebleeds, facial pain, headaches, sleeping disturbances and difficulty breathing through the nose.

Correcting the deviated septal cartilage and bone through septoplasty can significantly improve airflow and alleviate these issues, enhancing your quality of life. The septoplasty procedure involves repositioning the nasal septum to restore proper nasal function, providing relief from the problems associated with a deviated nasal septum.

Understanding whether you have deviated bone and cartilage is crucial for determining if septoplasty is right for you. Consulting with a specialist can help diagnose the condition and discuss potential treatment options, ensuring you receive the care you need to breathe comfortably.

How common is septoplasty?

Bent septums, which can cause significant breathing problems and chronic nasal obstruction, affect a large portion of the population. As a result, many ENT specialists and plastic surgeons recommend septoplasty for symptom improvement.

Statistics show that septoplasty is one of the most commonly performed nasal surgeries worldwide. Its prevalence underscores the importance of addressing nasal obstructions to improve quality of life. If you experience symptoms of a crooked septum, consulting with a specialist can help determine if septoplasty is the right option for you.

Septal deviation can be a hereditary feature and the chances of having it increase when a family member has it. Individuals are usually born with problematic septal cartilage and bone; symptoms can become more noticeable or worsen as people age. This is prevalent during late adolescence when bursts of hormonal changes can dramatically increase nose growth and irregularities of existing deviation in the septum.

Septoplasty is a common, low risk procedure that is routinely performed. This surgical procedure offers significant benefits for those struggling with nasal blockage and related symptoms. Deviated septum surgery has a very high success rate globally and a quick recovery process, as it is not a major surgery.

Reasons for Septoplasty

Septoplasty is performed for various reasons, primarily to correct functional issues and improve nasal breathing. It can also be undertaken for cosmetic purposes to enhance the appearance of the nose, which can be impacted by septal deviation. Here are the main reasons why septoplasty is recommended:

Medical Reasons

A deviated nasal septum that causes:

• Nasal airway obstruction
• Regularly blocked nose
• Difficulty breathing through the nose
• Post nasal drip
• Nasal polyps contributing to obstruction
• Recurrent sinus infections (sinusitis)
• Frequent nosebleeds (epistaxis)
• Sleep apnea, mouth breathing or snoring
• Facial pain and headaches caused by nasal blockage

Cosmetic Reasons

• Correct asymmetry caused by a bent septum
• Enhance facial aesthetics by aligning the nasal structure
• Improving the appearance of the nose post-injury or trauma

Why would I need a septoplasty?

Septoplasty is necessary when a nasal septum is crooked, causing significant trouble breathing or other health issues that affect your quality of life. If you suffer from a crooked septum that causes nasal blockage, recurrent sinus problems, frequent nosebleeds, or persistent post-nasal drip, septoplasty can offer relief. Additionally, this nose surgery can improve your overall health and well-being if the deviation impacts your sleep or causes significant facial pain. A specialist plastic surgeon will recommend septoplasty during a consultation after assessing your circumstances and symptoms, and this surgery is required to enhance your nasal function.

Septoplasty procedure details

What happens before septoplasty?

Before undergoing septoplasty, you will undergo a thorough consultation with your specialist. This initial consultation is crucial for diagnosing a deviated septum and understanding your specific symptoms and concerns.

Your doctor will review your medical history and discuss any breathing difficulties, such as permanent or regular blocked nose sensations or other symptoms you experience.

You will undergo a physical examination, during which the doctor will inspect inside your nose using a nasal speculum or endoscope. This helps assess the extent of the septal deviation and identify any additional issues, such as nasal polyps or sinusitis.

A deviated nasal septum diagnosis is typically confirmed through a combination of physical examination and imaging studies, such as a CT scan if needed. These images provide a detailed view of the nasal structure, highlighting deviations or obstructions.

Your doctor will provide specific pre-operative instructions on how to prepare for the surgery. These may include guidelines on fasting, medication adjustments, and avoiding certain activities or substances before the procedure. Fasting from midnight onwards is recommended for a septoplasty.

You might also be advised to arrange for someone to drive you home after the surgery and help you during the initial recovery period.

By following these steps, you ensure that you are well-prepared for your surgery, which increases the likelihood of a successful septoplasty and smooth recovery.

What does a septoplasty involve?

Septoplasty is an outpatient procedure that is typically performed under general anesthesia, ensuring you are asleep and pain-free during the surgery. In some cases, local anesthesia with sedation may be used.

The specialist plastic surgeon will make an incision inside the nasal cavity to access the septum. This internal approach ensures no visible scars on the nasal tip or external nose, as it is designed to access inside your nose. This technique is commonly referred to as closed rhinoplasty.

The surgeon will then carefully lift the mucous membrane, a soft layer of tissue covering the septum, to reach the underlying cartilage and bone.

The surgeon will remove or reshape the bent cartilage and bone using precise surgical techniques to straighten the septum. This may involve trimming, repositioning, or replacing sections of cartilage and bone to ensure a more aligned structure.

Once the septum is corrected, the mucous membrane is repositioned over it. The surgeon may place nasal packing inside the nose to support the new structure and minimise bleeding. A soft splint, which is small and flexible, can be used for more severe bends. This is different from the rigid and uncomfortable rhinoplasty nasal splints.

The small incision is commonly closed with dissolving stitches to secure the membrane and support the healing process.

The septoplasty procedure usually takes 45 to 90 minutes, depending on the complexity of the deviation or if a combination of surgeries like a turbinate reduction or rhinoplasty is involved.

By addressing the structural issues within the nasal cavity, septoplasty effectively improves breathing and alleviates symptoms associated with septal deviation, ensuring better nasal function and enhanced quality of life.

What happens after septoplasty?

Immediately after the septoplasty surgery is completed, you will be moved to a recovery room where medical staff will monitor you as you wake up from the anaesthesia.

You may feel groggy or disoriented as the anaesthesia wears off. This is normal and typically resolves within a short period.

You may experience nasal congestion, pressure, and mild pain. The surgeon may have placed soft splints or nasal packing inside your nose to support the septum and control bleeding.

Pain medication will be provided to manage any discomfort you may feel.

The medical team will give you specific instructions on how to care for yourself at home, including how to manage the nasal packing or splints, gauze replacement, medications to take, and activities to avoid.

Usually, septoplasty is a day procedure, meaning you go home on the same day as your surgery. Once the medical team is satisfied that you are stable and your vital signs are normal, you will be discharged from the recovery room.

You will need to arrange for someone to drive you home, as you will not be able to drive yourself due to the effects of the anaesthesia.

It is essential to have a responsible adult accompany you home and stay with you for the first 24 hours post-surgery to assist with any immediate needs and ensure your safety.

How can I prepare myself for the operation?

• Consult with your surgeon to discuss medical history and medication and answer all questions.
• Adhere to the surgeon’s specific pre-op guidelines.
• Follow instructions on stopping certain meds and lifestyle behaviours such as smoking
• No food or drink after midnight before surgery.
• Arrange for a family member or friend to drive you home and stay with you.
• Set up a recovery area with pillows and supplies for your return home.
• Wear loose, front-buttoning clothes and shower with antibacterial soap before surgery.

What are the advantages of septoplasty?

• Improved breathing function.
• Reduce the prevalence of a blocked nose.
• Improves overall sleep quality.
• Better quality of life by alleviating nasal congestion and improving nasal function.
• Relatively quick recovery process.
• Reduced swelling, less invasive and more comfortable recovery than rhinoplasty.
• No external scars, as incisions are made inside the nose.
• Does not alter nose shape due to internal correction.
• Go home the same day as the surgery.
• Helps prevent recurrent sinus problems.
• Decreases frequency and severity of nasal-related headaches.
• Unlike rhinoplasty, septoplasty does not require uncomfortable nasal casts and nasal splints.

Septoplasty recovery

The key information for the recovery of septoplasty includes the following:

• 1-2 week period of downtime.
• Minimal swelling and bleeding
• Replacing gauze and dressing.
• 4-5 weeks before strenuous exercising.
• Douching and medication daily.
• Post-operation consultation cleanouts.

Septoplasty recovery timeline

Week 1

• Days 1-2: Expect some swelling, bruising, and nasal congestion. Rest with your head elevated to reduce swelling.
• Days 3-5: Nasal packing may begin to fall out. Trim where necessary. Continue to avoid strenuous activities. External swelling is minimal or settled.

End of Week 1

• Most patients can return to work and light activities but should still avoid heavy lifting and exercise.
• The pain has subsided, and medication can be stopped.
• Reduced bleeding, upper teeth and lip numbness.

Week 2

• You may still experience mild discomfort and congestion.
• Post-op consultation a few weeks after surgery for cleanout.
• Sense of smell to return as dressings fall out and nose clears out mucus with douche.

Week 3-4

• Significant improvement in breathing and reduction in congestion. Resume most normal activities, but avoid contact sports and strenuous exercise.
• Internal swelling is still maturing.

Weeks 5-6

• Full recovery of nasal function, with minimal internal swelling.
• Continue to follow up with your surgeon as needed.
• Resume strenuous activities and weight training

Septoplasty post-operative care

• Rest and sleep during the first week, and keep your head elevated to minimise swelling. Do so for as long as possible or otherwise advised by your surgeon.
• Take prescribed pain relievers and antibiotics as directed to manage discomfort, allow for consistent sleep and prevent infection. Pain is the most prominent in the first few days and will subside.
• Keep the surgical site clean, and replace the medical gauze and tape after adequate blood absorption. This is a good way to see if your bleeding has reduced over time. If you are experiencing excessive bleeding or bleeding well into recovery, contact your surgeon as soon as possible for advice.
• Avoid blowing your nose for at least a week. Use saline nasal sprays to keep the nasal passages moist and clean. Light blowing is to occur after a couple of weeks. Refer to your surgeon’s instructions.
• Refrain from heavy lifting, strenuous activities, and bending over to reduce pressure on the nose and prevent heavy bleeding.
• Stay well-hydrated and eat a balanced diet to support healing. Avoid spicy foods that may cause nasal irritation.
• Attend all scheduled follow-up appointments with your surgeon to ensure proper healing and cleanouts and address any concerns.
• For at least six weeks, avoid swimming, contact sports, and any activities that might result in nasal trauma.

Adhering to these post-operative care instructions and attending follow-up consultations can ensure a smooth and successful recovery from surgery.

Alternatives to septoplasty

While septoplasty is the most effective surgical option for correcting a bent septum, there are some non surgical treatments that can provide temporary relief:

• Nasal corticosteroid sprays can reduce inflammation and improve nasal airway function.
• Decongestants help alleviate nasal congestion.
• Antihistamines can manage symptoms if allergies contribute to nasal obstruction.
• Nasal strips can open nasal passages externally to improve breathing during sleep.

However, these non surgical treatments do not correct the structural issue and may only provide temporary relief. For long-term improvement and resolution of symptoms, septoplasty remains the best option.

Not all nose breathing-related issues are caused by an irregular septum as seen in the following examples:

• When turbinates enlarge inside the nose, they can block your airflow. This requires a turbinate reduction.
• Where there is trauma, issues with collapsing nasal valves, or other structural nose issues that cause breathing difficulties, nose surgeries that are more aligned to rhinoplasty are a better solution.

Combining septoplasty with other nose surgeries

Septoplasty can commonly be combined with other surgeries to address both functional and cosmetic concerns:

• Combining septoplasty with rhinoplasty can correct trouble breathing while also improving the external appearance of the nose, addressing both medical and aesthetic needs in a single procedure. This is commonly referred to as septorhinoplasty. Also, a rhinoplasty alongside a septoplasty may be necessary if you have a blocked nose because your nasal bones are crooked or damaged.
• Septoplasty can be performed alongside sinus surgery to treat chronic sinusitis, improving overall nasal function and sinus health.
• Not all breathing issues relate to the septum. Turbinates, which are structures inside the nose, can become enlarged and block airflow. Combining a turbinoplasty with septoplasty can further enhance breathing and nasal function. There is a correlation between turbinates enlarging and deviated septums. Individuals experience enlarged turbinates on the side of the nose that have more space due to the bent septum, as the turbinate seems to grow to fill the space.

These combined procedures can provide comprehensive treatment for various nasal and sinus issues, enhancing function and appearance. The combination of septoplasty with other surgeries is very common, and increasingly septorhinoplasty is being performed as patients who have breathing issues also desire cosmetic changes to their nose.

What will happen if I postpone my septoplasty surgery?

In most cases, your septum will remain unchanged and will not worsen over time. The discomfort associated with your blocked nose and deviated septal bone and cartilage will also remain.

In some cases, your turbinates can enlarge to fill in the gap inside your nose that a straight septum would otherwise preoccupy. To adequately improve nasal function, this would require a turbinoplasty and rhinoplasty.

Although less likely, more severe septum circumstances, if left untreated, can exacerbate symptoms such as headaches, nasal congestion and facial pain.

Although septoplasty can be postponed, it is best to address the breathing concerns quickly since individuals who suffer from deviated nasal septum:

• Reportedly have a lower quality of life.
• Worse sleep quality and energy levels.
• May experience worsened symptoms over time.
• Have worse aerobic capacity and fatigue potential.

Our Plastic Surgeons that specialise in Septoplasty Surgery:

How much does septoplasty cost?

As every patient we see has different requirements, it is difficult to provide standardised pricing as each procedure is tailored for each individual patient’s requirements. During your consultation your Surgeon will discuss with you the best options for you. You are then provided with a quote so you know exactly what is involved in your cost of septoplasty.

Our philosophy is simple. We want you to be fully informed, understand all your options, and have one accurate price quoted once. The consultation fee is $350, and a referral from your doctor is required, which can qualify for a Medicare rebate.

How do I find out more about Septoplasty Surgery?

Please contact the me clinic or phone at (03) 9569 3511. We have over 35 years of Plastic Surgery & Cosmetic Surgery experience to share with you. We ensure you will be fully informed and understand your options before any procedure.