Septoplasty

Septoplasty is a type of rhinoplasty procedure which is designed to reconstruct the nasal septum by removing or reshaping deviated parts of the septal cartilage or nasal bones.

The septoplasty procedure results in better airflow in patients who suffer from nasal airway obstruction, often related to having a deviated septum. Septoplasty is designed to improve function by treating nasal blockage, which differs from an aesthetic rhinoplasty for the improvement of the appearance of the nose. Septoplasty is commonly combined with rhinoplasty to improve both appearance and function in one procedure. This surgery is known as septorhinoplasty.

Centre for Surgery is home to some of the best rhinoplasty surgeons in London, with expertise in both aesthetic and functional rhinoplasty for bent septum correction.

Septoplasty is a surgical procedure aimed at correcting and reshaping the nasal septum. Also known as septal deviation surgery, septum surgery, or nasal septum correction, it can be performed as a standalone procedure or in conjunction with a full rhinoplasty to reshape the entire nose. Trauma often causes septal deviation, which can occur during birth and become increasingly noticeable as a person grows.

The nasal septum is a wall composed of bone and cartilage that divides the inner nasal cavity into left and right chambers. The nasal septum comprises:

A hard bony part

The upper and posterior portion of the nasal septum consists of sturdy bone (ethmoid and vomer bones).

A soft cartilage part

The anterior and lower portion of the septum is made of cartilage – a flexible, firm type of tissue (similar in firmness to the tip of your nose). This part extends to the end at the columella, the tissue column between your nasal openings.

Septoplasty surgery is performed to correct a deviated septum, which can have several benefits for patients. Some of the potential benefits of septoplasty surgery include the following:

Improved breathing

The most obvious benefit of septoplasty is improved breathing through the nose. A deviated septum can cause nasal congestion or blockages, which can make it difficult to breathe through one or both nostrils. After septoplasty, patients may experience a significant improvement in their ability to breathe through their nose.

Reduced sinus infections

A deviated septum can also increase the risk of sinus infections, as the blockages caused by the deviation can trap mucus in the sinuses. Septoplasty can help to reduce the frequency and severity of sinus infections.

Reduced snoring

A deviated septum can also contribute to snoring, as the blockages can cause turbulent airflow in the nose, which can lead to vibration of the soft palate. Septoplasty can help to reduce or eliminate snoring.

Improved appearance

In some cases, a deviated septum can cause the nose to appear crooked or uneven. Septoplasty can help to improve the appearance of the nose by straightening the septum and creating a more symmetrical appearance.

Improved sleep quality

Septoplasty can improve the overall quality of sleep, as patients will be able to breathe more easily through their nose and have reduced snoring, which can lead to better quality sleep and reduction of sleep apnea symptoms.

Septoplasty or nose septum surgery is an excellent treatment option for addressing the negative effects caused by a deviated septum with a subsequent improvement in quality of life. Many patients report difficulty breathing with recurrent nosebleeds which affect their daily activities. Partners may be unable to sleep due to excessively loud snoring and periods of sleep apnoea. Having any of the symptoms may mean you are ideal for septoplasty surgery.

We would recommend stopping smoking at least four weeks before the procedure, as smoking has a negative effect on healing and recovery. The constituents of cigarette smoke delay healing with an increased risk of wound infections and may result in irritation of the delicate internal nasal lining. Smoking affects the blood supply to the healing area. Patients should be over the age of 18 to be considered for treatment, and there are certain medicines which should be stopped before surgery, including aspirin and medicines containing aspirin. These medications have an increased risk of causing bleeding during or after the procedure. You should also avoid taking over-the-counter herbal supplements.

When planning for septoplasty, a surgical intervention to correct a deviated septum, there are several important preparatory steps to ensure your safety and the surgery’s success. Your healthcare provider will guide you through specific instructions tailored to your individual needs, but here are some general guidelines to follow.

Medication Guidelines

A critical part of preparing for your surgery involves adjusting your medication intake. Your surgeon will advise you to stop taking certain medications that can increase bleeding risk, such as aspirin, ibuprofen, and any blood thinners, two weeks before your surgery. This precaution significantly reduces the chance of excessive bleeding and bruising during and after the procedure.

Communication is Key

If you have any allergies, especially to medications, or if you’ve experienced bleeding problems in the past, it’s vital to inform your surgeon or the anaesthetist well ahead of your surgery date. This information helps them ensure your safety throughout the surgical process.

Fasting Before Surgery

Since septoplasty is typically performed under general anaesthesia, you’ll need to fast for at least 8 hours before your operation. This means no eating or drinking anything during this time frame. Fasting is essential to prevent any complications during and after the surgery.

Arranging Transportation

Due to the lingering effects of anaesthesia, you won’t be in a condition to drive yourself home post-surgery. It’s necessary to arrange for a family member or a friend to pick you up and take you home safely after the procedure.

Before and After Photos

Your surgeon will take photographs of your nose before the surgery and during your recovery. These images serve a dual purpose: they provide a visual record of your nose’s structure for medical reference and allow you to see the changes in your nasal appearance clearly post-surgery.

Septoplasty is a surgical procedure to correct a deviated septum, which can be done under both general and local anaesthesia depending on the patient’s preference, the surgeon’s preference and the complexity of the surgery.

General anaesthesia is when the patient is put to sleep and does not feel any pain during the procedure. This is typically used for more complex cases and for patients who have a higher level of anxiety about the procedure.

Local anaesthesia is when the patient is awake, but the area around the nose is numbed to block pain. This is typically used for less complex cases and for patients who would prefer to be awake during the procedure.

Additionally, some patients may receive a combination of local and IV sedation. This is called conscious sedation. In this form of anaesthesia, the patient is awake but relaxed and less aware of the procedure.

The type of anaesthesia used will be determined by the surgeon and anaesthetist based on the individual case and patient preferences.

Before the procedure, you will have a detailed preoperative assessment by one of our skilled nurses to review your medical history and organise blood tests as required by your surgeon. Septoplasty surgery is most commonly carried out under a general anaesthetic, although in some cases, particularly when it is performed on its own, the procedure can be performed using a local anaesthetic and sedation. The complexity of the procedure as well as your surgeon’s preference, will determine the most appropriate type of anaesthetic.

After administering anaesthesia, the surgeon begins by making an incision in the nose. In most cases, surgeons typically employ the “closed technique” for septoplasty, where the incision is made inside the nostril without any external incisions.

However, sometimes the surgeon may opt for an “open technique” for septal correction, which involves an additional incision on the columella between the nostrils. This approach is more common in patients who require more extensive septal trimming and possibly other interventions, such as tip plasty, alarplasty, nasal bridge reduction, or a nose lift. This type of procedure is called septorhinoplasty.

Next, the surgeon lifts the nose skin and tissue to better visualize the nasal septum from the inside. The surgeon then cuts, trims, sculpts, reshapes, bends, and manipulates the nasal septum to attain the desired orientation and size. Removed pieces of septal cartilage, and sometimes even bone, may be utilised to correct septal deviation. In some instances, sutures might be employed to secure the cartilage in position.

Once the surgeon is satisfied with the shape, size, and orientation of the nasal septum, they will close the small wounds. Dissolvable stitches are typically used to ensure seamless healing.

In some cases, your nose might be packed with gauze or a silicone splint to keep the septum in place until it heals properly.

Septoplasty on its own takes approximately one hour to carry out, depending on the amount of septal reconstruction required. Septoplasty is a day-case procedure at Centre for Surgery in London which means patients can recover in the comfort of their own homes later the same day.

Once the septoplasty surgery is complete, your surgeon will place internal splints into the nostrils to support the healing septum and this should be worn for at least 2 to 3 days after the procedure before they are removed in the clinic. It is common to notice bruising and swelling under the eyes. There are several ways to reduce localised bruising and swelling, and we would recommend the following measures for two weeks after the procedure:

• Sleep on your back with your head raised on a couple of pillows
• Avoid strenuous exercise, including going to the gym
• Avoid blowing your nose
• Be careful when putting on shirts which go over the head to avoid contact with the nose

The vast majority of patients can return to their normal activities after 48 to 72 hours, although physical exercise should be restricted for at least four weeks after deviated septum surgery. You should avoid blowing your nose for at least two weeks after septoplasty surgery, as this can increase the risk of bleeding. Gently cleaning the nose can be carried out using sachets of sterile saline. Patients should avoid exercising for a minimum of four weeks after nose septum surgery and should avoid all contact sports for a minimum of eight weeks to minimise the risk of injury to the nose.

We recommend stopping smoking for at least six weeks after the surgery, as smoking lengthens the recovery time and can increase the risk of wound breakdown and infection.

Septoplasty, as with any type of surgical procedure, carries a number of risks and potential complications, which include bleeding, infection or an allergy to the anaesthetic. Other potential complications of septoplasty include:

• Persistence of nasal blockage symptoms
• Recurrent bleeding
• A change in the appearance of the nose
• Nasal septum perforation
• Reduced sense or no sense of smell
• Septal haematoma formation
• Numbness of the middle third of the face

The cost of the septoplasty procedure will depend on the complexity of the septal correction required and whether the procedure will be combined with cosmetic rhinoplasty, also known as septorhinoplasty. For patients who would like to improve the appearance of their nose, we would always recommend having a combined septorhinoplasty procedure, which can significantly save on costs.

Once you have had your face-to-face consultation, your dedicated patient coordinator will give you an all-inclusive quotation, which includes the facility costs, anaesthetic and surgical fees and the cost of care.

Does private medical insurance cover septoplasty?

Septoplasty is a type of functional nose surgery and may, therefore, be covered by private medical insurance. If you are unsure, please ask your surgeon at the consultation.