Facial Plastic Surgery Treatments
Improve a chronic stuffy nose by correcting a deviated nasal septum
Dr. Thomas Lamperti, double board-certified in both Facial Plastic and Reconstructive Surgery and Otolaryngology (Ear, Nose, Throat surgery), is an expert in treating all areas of nasal dysfunction and has performed thousands of nasal surgical procedures. This includes addressing functional symptoms such as chronic nasal congestion, sinusitis, allergies, and skin cancer reconstruction along with cosmetic nasal concerns. Septoplasty, surgical treatment of the deviated nasal septum, is one of the cornerstones in improving functional breathing issues.
Things to know about having a Septoplasty:
- What is the nasal septum?
- How the septum becomes deviated
- How the septum can affect breathing
- What septoplasty invovles
- How long septoplasty takes
- Septoplasty anesthesia
- No packing needed after septoplasty
- Insurance coverage for septoplasty
- Septoplasty recovery
- Septoplasty risks
- Having a concurrent rhinoplasty
- Turbinate surgery to fix nasal congestion
- Having concurrent sinus surgery
The septum can become deviated as result of the normal nasal growth process or, more commonly, from nasal trauma. The patient on the right suffered several nasal fractures which resulted in the deviation of her nose and septum, including her anterior septum. This caudal septal deviation is what causes the patient's asymmetric nostril size in the photo.
A deviated septum can be diagnosed by having a comprehensive nasal exam. Importantly, the more easily seen anterior septum may be straight, but the harder to examine posterior septum may be significantly deviated. This is one reason that Dr. Lamperti routinely assesses the entire nose using a small endoscope.
Learn more about the septoplasty incision here. This allows Dr. Lamperti to elevate the skin lining off of the deviated cartilage and bone of the septum. The misaligned cartilage and bone is then removed which allows Dr. Lamperti to sew the skin lining back to itself using a quilting type suture. All the sutures used are dissolvable and come out on their own. With the deviated cartilage and bone removed the skin lining is able to lay much straighter which then allows for smoother airflow when breathing. You can see a video of a septum before and right after septoplasty here.
Occasionally, in more complicated deviations, a small external incision is also used to allow for complete reconstruction of the septum. This was the approach used in the patient shown above.
Septoplasty surgery is done in the operating room. Either IV sedation or general anesthesia can be used. Once this anesthesia has been administered, Dr. Lamperti injects local numbing medicine that will last a couple hours. Surgery is done as an outpatient procedure; you are able to go home once you have recovered from anesthesia.
Septoplasty recovery is usually 2 to 3 days and can often occur over a weekend. The recovery for more extensive septoplasties or septoplasty done in conjunction with rhinoplasty usually takes about 7 days.
The risks of septoplasty include the risks of any surgery such as bleeding, infection, reaction to the anesthesia, injury to surrounding structures. Risks specific to Septoplasty include persistent congestion or asymmetric breathing. There is also a rare chance of a hole developing in the septum (septal perforation) during the healing process. Even more rare risks are that of injury to the smell organ or spinal fluid leak. Dr. Lamperti limits his manipulation of the upper boney portion of septum to avoid injury to the smell organ or bone of the skull base and has never had this complication occur in his practice.
The time of your septoplasty is an ideal time to have a rhinoplasty to reshape your nose. Dr. Lamperti often uses portions of septal cartilage during rhinoplasty surgery to create the planned changes in the nose's appearance. The cartilage removed during an isolated septoplasty is otherwise left out of the nose, making it more difficult (though not impossible) to perform rhinoplasty in the future.
Can septoplasty help with my snoring or sleep apnea?
Improving nasal breathing can, in certain situations, help with symptoms of snoring or sleep apnea. This occurs as you are able to do less mouth breathing while sleeping. Septoplasty is not a cure-all, however, and may not affect your sleep symptoms at all. Dr. Lamperti can assess your situation during your consultation to let you know whether nasal surgery has a chance of improving your sleeping issues.