Septoplasty

What is septoplasty?

Surgery that alters the septum, the ‘wall’ between the two nasal cavities, is referred to as septoplasty. There are several reasons why you might want septoplasty, but septoplasty most commonly involves straightening the septum, which may be crooked due to a birth defect or trauma. It may also be used to treat recurrent nosebleeds, or for nasal polyps, chronic sinusitis and various other conditions.

The septum consists of bone and cartilage, forming the structure that separates your nostrils. It supports the nose and guides air flow, as well as forming the base for membranes that produce mucus to protect the nasal cavities.

Septoplasty is used to correct any defect in the septum, but usually corrects a deviated septum. This is when the septum is moved towards one side of your nose, making it harder to breathe, sometimes causing frequent nosebleeds and pain.

A skilled surgeon will plan a septoplasty carefully. Each surgery is only conducted after a custom plan is created to guide the process, which requires a surgeon carefully examine your nose to give you the best possible outcome.

You can discuss the possibility of septoplasty with your surgeon to determine if it would be a good option for you.

Why choose septoplasty?

The nose is an important part of the body that is obviously involved in smell, but also plays a critical role in normal breathing. Depending on the way the septum develops, there could be deformities, birth defects or other issues that cause the nose to not work or look as well as it could. Septoplasty can help correct these issues by surgically straightening the septum.

This can greatly improve your ability to breathe through your nose as well as restore your sense of smell. Many patients report better quality of life as a result of improved sense of smell and ability to breathe as a result of septoplasty. Recent studies even found treatment of nasal obstruction through septoplasty can significantly improve sexual performance.

Septoplasty is not limited to a deviated or crooked septum, however. Some people who suffer from chronic rhinosinusitis, a recurrence of sinus infections, can benefit greatly with septoplasty treatment. This is because a straight septum allows better surgical access to treatment of the sinuses, and also allows better sinus drainage in some cases after surgery has been performed. Septoplasty may be combined with other forms of surgery to treat problems that cause obstruction, such as Turbinate hypertrophy (turbinoplasty), bleeding or recurrent infections to give you the best possible quality of life.

If you are considering a rhinoplasty (external nose surgery), septoplasty may be performed in combination with this procedure, to ensure that the changes made to your nose do not reduce your breathing space, and to ensure a complete treatment of your external and internal nasal structures.

What kinds of problems can septoplasty treat?

• Deviated septum
• Recurrent nose-bleeds
• Indirectly - Nasal polyps
• Indirectly - Recurrent / Chronic sinusitis

Septoplasty is a popular surgery because it offers a variety of benefits for those that need it, including:

• Quality of life. Many people suffer the inability to breathe normally due to a problem with their septum. They may be born with a defect, received trauma to the septum or suffer a range of complications that limit their breathing, make them more vulnerable to nosebleeds or cause them to get infections over and over again. For these people, septoplasty brings a quality of life they have sometimes never experienced before or thought they would never get back.
• Breathe better. Whether from a birth defect or due to an injury, problems with the septum can obstruct the ability of air to pass normally through the nose. Correcting this can help patients to breathe better through both sides of the nose.
• Smell better. As with breathing, repairing the septum allows for increased passage of odours and fragrances into the nasal cavity and up towards the smell sensory receptors for improved sense of smell.
• Improved cosmetic appearance: A deviated septum, whether from an accident, a fight, or from some other cause, can lead to distortions and asymmetries of the external nose. In some cases, a septoplasty is able to correct such gross deviations of the external nose, though generally, such surgery is performed in combination with rhinoplasty to ensure a complete treatment of any functional and cosmetic external nasal problems.
• Correct a wide range of birth deformities. Septoplasty generally needs to be performed from at least 16 years of age unless the symptoms are very severe. The impact this surgery has on someone who has lived 16 years or more with difficulty breathing and smelling can be a life-changing experience.

What are the risks of septoplasty?

Every significant surgery carries risks, including infection, bleeding and adverse reactions to anaesthesia. As with many surgeries, some people may require a second surgery if they are not satisfied with the results. There are other rare risks associated with septoplasty, including:

• Bleeding
• Scarring
• Incomplete resolution of symptoms
• Perforation of the septum, where a hole is formed in the septum
• Temporary numbness in your gums, teeth or nose.
• Change in the shape of the nose
• Change in colour of the nose
• Changes in your sense of smell

Is it easy to perform septoplasty?

If you consider the septum, it is easy to assume that performing septal surgery would be relatively simple. It’s not a heart or some other internal organ, after all. But the truth is that septoplasty is a relatively complex, difficult surgery. There are several reasons for this:

• Small changes can have big impacts. The changes the surgeon will make to your septum will often be very small. But even small changes can have a dramatic impact on the way your nose looks and how straight the septum is. Since the margin for making mistakes is small, your surgeon needs to be extremely careful with every aspect of the operation.
• Changes may not be visible during surgery. One of the big challenges with nose surgery in general is that the surgeon may not be able to see the results of the changes made. The surgery requires the application of local anaesthetic, which can cause the nose to swell – and any alterations made to the nose will also make it swell. All that swelling hides what the end result will look like.
• General anaesthesia is needed for most septoplasty surgeries. Most septoplasties are performed under general anaesthesia, where you will be unconscious for the surgery. Some septoplasties are performed under local anaesthesia with a pain-numbing injection, for some people where this is a better option.
• Every surgery must be customized. Some surgeries have a standard plan of action that is applied to most surgeries, but not septoplasty. Every step in your surgery must be made based on your unique circumstances to achieve the best outcome, as no two noses are the same.

Can you go home soon after surgery?

Yes! The vast majority of septoplasties are overnight or same-day procedures which means you are likely to go home the same day as the surgery, or the following morning. There are exceptions, though, so you will want to talk with your doctor to be sure what you should expect for your operation.

What is recovery like?

One benefit of septoplasty is that breathing is likely to improve shortly after the procedure. The wounds within the nose also generally heal quickly and there is no visible scarring, however the deeper structures such as cartilage heal over a longer period of time.

This process can be slow, taking up to a year, but as most of the septum is internal there is generally no concern with this causing an unusual appearance. Some people may require a plastic splint to hold the septum straight following surgery, which are usually removed in a clinic one week following surgery. Other sutures are generally dissolvable and do not require removal.

Does septoplasty lead to a lot of pain?

The nose is not usually very painful after septoplasty, but often may be tender and stiff due to swelling. Sometimes patients notice some minor ache or altered sensation in the upper central teeth and gums, due to swelling around common nerve endings at the base of the nose and upper jaw.

More commonly people are concerned about blood and/or mucous which often can drain from the nose for a few days after surgery.

This is normal and part of the healing process, and you will be provided with absorbent dressings to control this. Swelling is likely to last 2-3 days at most. Your surgeon will advise you on how to best look after your nose after surgery, including the use of rinses, simple first aid, and minor dressings, to keep your nose safe in the early days of healing.