Septoplasty – Correcting a Deviated Septum

A septoplasty is a procedure (discussed on our deviated septum page) to straighten the septum (the dividing wall separating the nasal airway). This structure is made of cartilage and bone that may be deformed due to several potential causes. Misalignment of the nose affects about 80% of us. For many, this deformity causes few, if any, issues. However, a severely deviated septum can make it harder to breathe and, over the long term, cause sinus infections. Depending on how the septum has settled, it can block the opening to one or both sides of the nose. The deviated septum is a common concern, and septoplasty is a very common procedure as the cartilage is easily bent.

Are You a Candidate for Septoplasty?

Every patient will have different concerns associated with a deviated septum. As such, there is no way to judge a patient’s candidacy for septoplasty without proper consultation with Dr. Boger or your local ENT. The Nasal Obstruction Symptom Evaluation (NOSE) scale is an excellent way to understand if surgery may be a good option. This scale gives us a better idea of your symptoms and how those problems limit your lifestyle. Generally, we look to see how the deviation may be affecting your sleep, your ability to exercise, and day-to-day breathing.

How a Septoplasty Is Performed

There is no way to straighten the nasal cartilage and bone without surgery, during which Dr. Boger will remove parts of the existing crooked septum and reposition them to straighten the septum and rebuild the structure in the nose. The length of the procedure largely depends on the complexity of the surgery and the structures involved. Every nose is different but requires about 30 to 60 minutes of operative time under general anesthesia.

The incisions are concealed inside the nose and are closed using absorbable sutures, which will disappear on their own. You may need splints in each nostril to support the rebuilt structure of the septum. Your nose may also be packed with sponge-like material to absorb blood.

Further, these procedures are performed on an outpatient basis, meaning that patients can leave the surgery center by the end of the day of surgery. You will need someone to drive you home as the anesthesia will impair your ability to operate a vehicle. Recovery will continue at home, and we suggest having a friend or a loved one available to help you in the few days after surgery.

In most cases, a septoplasty is very successful in restoring proper airflow through the nose. You will likely need to take a week off work, and full recovery will take about 1-3 months after surgery.

Of course, as with any surgery, there are some risks that we will discuss below.

The Risks and Considerations of a Septoplasty

As with any surgical procedure, there are risks inherent to the operation, including infection, reaction to anesthesia, pain, and bleeding. Other rare risks specific to septoplasty can consist of the following:

Continued remodeling of the septum as it heals, leading to less-than-ideal cosmetic or airflow results.
Septal hematoma or collection of blood in the nose
Perforation of the septum
Long-term smell changes (usually decrease in sensation)
Failure to completely resolve breathing problems, or a need for revision surgery in the future

And some things to remember:

You will likely experience nasal congestion for about 1-4 weeks after surgery
You may feel temporary numbness in your upper lip and the tip of your nose
You may experience mild pain in your upper teeth for a time
You cannot blow your nose for at least two weeks after surgery
Activity will be restricted for a week after surgery
Time off of work for about a week is typically recommended; this varies by profession

Is a Septoplasty Painful?

We all have different pain thresholds, so the answer to this question is nuanced. However, most patients report nothing more than mild to moderate discomfort, which is often managed with over-the-counter pain medication. We do not expect you to experience significant pain due to surgery. Pre-existing pain conditions, such as migraine and fibromyalgia, increase the risk of significant post-operative pain.

Will My Voice Change after Surgery?

We’ve all experienced a stuffy nose, and we know that it makes us sound hyponasal – a deviated septum can cause the same problem. Most of our patients will experience an improvement in how they sound simply because they can breathe more fully through the nose. So, don’t worry if people on the other side of the phone call don’t recognize your voice immediately!

Discussing Empty Nose Syndrome

No discussion about nasal surgery can exclude the possibility of empty nose syndrome, and there is a relatively poor understanding of the onset of this potential complication. Still, we know that a small number of nasal surgery patients experience symptoms, including the sensation that they are not receiving enough air, excessive dryness, reduced mucus production, headaches, and the sensation of congestion despite clear nasal passages. This typically occurs as a longer-term complication of turbinate reduction. We take great care to avoid this potential outcome by minimizing the amount of tissue removed at the time of surgery. Of course, we do encourage you to talk about this concern with Dr. Boger, as well as the other risks of surgery.

Is a Septoplasty the Same as a Rhinoplasty?

The short answer is no. A rhinoplasty is performed purely for cosmetic reasons, while a septoplasty is performed to correct a problem causing a medical concern.

Rhinoplasties are never covered by insurance, while a septoplasty may have varying coverage, depending on the case. For patients who intend to pay out-of-pocket for their septoplasty, we have negotiated excellent cash pay rates with our surgery center to make it as affordable as possible.

Next Steps

We encourage you to contact our office to schedule an evaluation of your nose by Dr. Boger. During this consultation, we will discuss surgical options and dig into potential nonsurgical changes to minimize symptoms and possibly avoid or delay surgery.