The septum is the partition dividing the two sides of the nose. When it is bent, one or both airways narrow and breathing through the nose becomes hard work. Septoplasty straightens it. It is an operation about airflow, not appearance.
Septoplasty straightens a deviated nasal septum through incisions inside the nose, leaving no external scar and normally no change to the shape of the nose. It is done for persistent blocked nasal breathing that has not responded to medical treatment. Where the outside of the nose is also bent, septoplasty alone will not straighten it and a septorhinoplasty is needed instead.
The septum is made of cartilage at the front and bone behind, covered on both sides by lining. A deviation may be present from birth, caused by an injury, or develop with growth. When it narrows an airway enough, the result is a persistently blocked nose, mouth breathing, disturbed sleep, and often a feeling that one side never clears.
Septoplasty corrects that from the inside. The lining is lifted off one side, the bent cartilage and bone are straightened, reshaped or removed where necessary, and the lining is laid back down. Enough of the framework is always left to support the nose: taking too much causes the bridge to drop, which is a serious and difficult complication to correct.
What septoplasty does not do is change the shape of the nose. If the outside is bent, or there is a hump, that needs work on the external framework as well, which is a septorhinoplasty. Being clear about this before surgery avoids the common disappointment of a patient who breathes better but expected their nose to look straight.
Blockage is also frequently not only the septum. The turbinates, the shelves along the side wall, are often enlarged too, and are usually reduced at the same operation.
The question is whether the deviation actually explains the symptoms, because not every crooked septum causes blockage.
The inside of the nose is examined, before and after a decongestant spray, to see how much of the blockage is septum and how much is turbinate swelling.
An incision is made inside the nostril. There is no external cut and no visible scar.
The lining is carefully elevated off the septal cartilage and bone on one side, keeping it intact.
Bent cartilage and bone are straightened, scored or removed, always leaving an adequate strut to support the bridge and tip.
Where the turbinates are contributing, they are reduced at the same time.
The lining is laid back down and held with a dissolvable stitch, and soft splints are sometimes placed for a few days.
The nose feels blocked from swelling, which is expected and not a sign of failure. Saline sprays keep it moist. Do not blow the nose. Splints, if used, are removed around a week.
Breathing starts to improve noticeably as swelling settles. Most people are back at work. Avoid heavy lifting and contact sports.
Crusting resolves. Breathing continues to improve. Numbness of the upper teeth, if present, settles over this period.
Final result apparent. Persistent blockage at this point is reassessed rather than accepted.
Most patients get a clear improvement in nasal breathing, and for many it is dramatic. It is not always complete: allergy, turbinate swelling and nasal valve collapse can all contribute and are not fixed by straightening cartilage. The shape of the nose is generally unchanged, which is intentional. A small proportion of patients have some residual deviation, and a few need revision. Numbness of the upper front teeth is common for some weeks and settles.
Most are minor and temporary. Two are worth understanding properly.
Keeping the nose moist and not blowing it are the two things that matter most early on.
It straightens the partition inside. If the outside of the nose is bent, that needs work on the external framework, which is a septorhinoplasty.
The nose is usually more blocked for the first week or two from swelling and crusting. Real improvement is judged at six weeks, not at six days.
The incisions are inside the nostril. There is no external scar from a septoplasty.
Removing too much leaves the bridge unsupported and it can collapse, which is far harder to fix than the original problem. An adequate strut is always preserved.
The commonest source of dissatisfaction is a mismatch of expectation: a patient wanting a straighter looking nose who gets a straighter septum. Establishing which problem is being treated, and whether the external framework needs work too, is the important part of the consultation.
Septoplasty performed for nasal obstruction is commonly covered by health insurance and by government schemes, because it is a functional operation. Where it is combined with reshaping the outside of the nose for appearance, the cosmetic component is generally not covered, and that division is made clear in writing beforehand.
Most are about whether the nose will look different.
Ask your question →No. Septoplasty works on the partition inside the nose and is not intended to change the external shape. If you want the outside straightened as well, that is a septorhinoplasty and should be discussed as a separate decision.
Swelling and crusting inside the nose make it feel worse for the first week or two. That is expected. Breathing usually improves noticeably from around two to four weeks and continues to improve after that.
Often not. Many septoplasties are done with a dissolvable stitch and soft splints rather than packing, which is far more comfortable. Packing is used if there is more bleeding than expected.
Septoplasty for nasal obstruction is a functional operation and is commonly covered. If it is combined with cosmetic reshaping of the outside, that part is generally not, and the estimate separates the two clearly.
Yes, it is common. Small nerves to the upper front teeth run close to the surgical area and are often bruised. Sensation usually returns over several weeks to a few months.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
