What is septoplasty?
Septoplasty is a reconstructive plastic surgery performed to correct an improperly formed nasal septum. The procedure is performed entirely through the nostrils, so that no incisions are visible on the outside skin. During the procedure, badly deviated portions of the septum cartilage and/or bone may be removed partially, entirely, or they may be readjusted and re-placed into the nose. Most importantly, when performed properly, septoplasty does not lead to any change in the external appearance of the nose. The septoplasty procedure is performed exclusively to improve functional air passage into the nose, and is not a ‘nose job’ that is meant to improve the aesthetic appearance of the nose. Also, following septoplasty surgery, patients may be mildly swollen for 1-2 days, but we guarantee that patients are never ‘black and blue’ after this surgery, or have nasal splints or tape strips placed on the outside parts of the nose.
How is septoplasty performed?
At the Stanford Sinus Center, septoplasty surgery is performed using the modern endoscopic surgical technique from inside the nostril passages. Incisions are not visible when this type of internal nasal surgery is performed. Depending on the severity of the deviation, septoplasty may be performed in:
- an outpatient surgery center
- a hospital - outpatient
- a hospital - inpatient
The surgeon will provide guidelines for resuming normal activities. Septoplasty is an outpatient surgery, in which patients are up and around and independent within a few hours, and are driven home by a friend/family member.
Usually there is some mild post-operative fluid/bloody oozing from the nose that significantly decreases in 24-48 hours, and there is naturally some nasal pain that is experienced for 2-5 days after surgery typically. The latter is readily controlled with a combination of narcotic and OTC pain medication that is recommended by your doctors. Patients uniformly use saline sprays and rinses immediately post-operatively to keep the nose clean and open.
Patients are usually able to return to desk work/computer use the day following surgery, and perhaps go to school or or the office within 3 days after surgery (half day to full-day is very individual). Work typically needs to be light duty, whereas those who perform heavy lifting/construction work probably instead need 6-10 days off from work. A mask may need to be worn for several weeks if known exposure to a patient is returning to work in a known dirty/dusty environment (like a construction site).
Short-term expectations of surgery may include:
- plastics splints applied to inside the nostrils to help keep nasal tissues stabilized during healing
- the nasal area may be slightly puffy for 0-3 days
- the nasal tip and central nose may ache
- minor bleeding/oozing from the nostrils in first few days
Healing is a slow and gradual process. Some sensitivity may be present for 2-3 months (where the internal incision was made, and instruments were placed during surgery), especially in the tip of the nose, but this will resolve. Final results of nasal surgery varies because everyone heals at different rates, but most will have their final result in 2-4 months.
What are the complications associated with septoplasty in general?
Individuals vary greatly in their starting anatomy, cartilage strength, nasal skin/tissue thickness and healing ability, and the outcome is never completely predictable. Complications may occur, including:
- Septal hematoma – a blood collection under the skin of the nose. This can usually be recognized and drained in the office.
- Minor nosebleeding/oozing
- Septal perforation – a hole that develops in the central nasal septum when thin areas of tissue come together. This can often be avoided by meticulous technique during surgery, but sometimes cannot. If this occurs, rarely do symptoms or issues develop, but your surgeon can tell you more about this as well.