Your nasal cavity is divided into two sides by the nasal septum, a thin wall of narrow bone and cartilage. Fairly commonly, this septum can become “deviated” or misaligned from its normal position. A deviated septum can result from injury, such as a broken nose, or it may be present from birth. Many people aren’t aware they have a deviated septum, even though it can be the cause of a number of health issues, such as sinus infections (sinusitis), snoring, sleep apnea, chronic nose bleeds, or headache, among others.
Fortunately, you can find relief from the discomfort and health conditions caused by a deviated septum. Deviated septum repair is possible with a simple in-office septoplasty procedure performed by nationally renowned nose and sinus surgeon, Dr. Alen Cohen, M.D., F.A.C.S., at the premiere provider of nasal and sinus care in Los Angeles, the Southern California Sinus Institute.
What to Expect with Septoplasty Surgery
Even though the benefits from septoplasty can feel like a major improvement, septoplasty surgery itself doesn’t have to be a major intimidation.
How do I prepare for the procedure?
Before septoplasty surgery, you’ll have a consultation with Dr. Cohen, which will include a review of your medical history and a physical exam, inspecting your nasal septum and cavities, as well as the outside of your nose. Photographs of your nose may also be taken that will be used for reference during the septoplasty procedure.
Dr. Cohen will discuss all the risks and benefits of septoplasty. As with any surgery, deviated septum repair carries some risk. Some risks of septoplasty may include:
- adverse reaction to anesthetic
- change to nose shape
- change in sense of smell
- need for additional surgery
But since it is a common and minimally-invasive procedure, most risks are minor and many people find the long-term health benefits outweigh the risks.
In preparation for surgery, you may be advised to avoid certain medications that can increase bleeding in surgery, such as aspirin and ibuprofen. Make sure to talk to us about any prescription medications that you take. If you smoke, it’s a good idea to stop smoking before surgery. Smoking can increase risks both during and after surgery and cause longer recovery.
How long does in-office septoplasty take?
Septoplasty is an outpatient procedure, which means it can be performed conveniently right in our office. Most procedures take between 45 minutes to one hour. Some people opt to have a septorhinoplasty, which combines septoplasty (deviated septum repair) with rhinoplasty (cosmetic nose reshaping), which makes the total procedure time about two hours.
What happens during the procedure?
Anesthesia: Most in-office septoplasty procedures are performed with local anesthesia. Local anesthesia means providing pain-numbing medicine only to the part of the body affected by the procedure. This is different from general anesthesia, which makes you completely unconscious during surgery. For local anesthesia during septoplasty, an anesthetic is injected directly into the nasal tissue, so that you’ll be awake but won’t experience pain during surgery.
You may also be sedated using IV medications that will make you groggy, but not fully unconscious during surgery. In more complex surgeries, some patients may be under general anesthesia, receiving either IV or inhaled medications to be temporarily unconscious for the procedure. Dr. Cohen will discuss the best anesthesia option for you.
Surgery: The in-office septoplasty procedure itself repositions the nasal septum to its correct alignment in the middle of the nose. To achieve this, Dr. Cohen makes a very small incision, about a half an inch long, inside the nose. Nasal cartilage and bone may be trimmed, repositioned, and replaced during the procedure. Typically, nasal bones don’t need to be broken during a septoplasty.
When the repositioning is complete, the small incision may be closed with a suture (stitches) that can be absorbed into the nasal tissue and some patients may have temporary supportive splints placed in the nostrils. Nostrils may be packed with a small amount of soft bandages or cotton to prevent bleeding.
Septorhinoplasty: Some people choose to have a septorhinoplasty, combining deviated septum repair with cosmetic nose surgery. In this procedure, there may be additional small incisions, including across the base of the nose in complex cases, in order to achieve cosmetic reshaping of nasal cartilage and bones inside the nose.
What is recovery from septoplasty like?
Many people are pleasantly surprised at the ease of recovery from septoplasty. Because in-office septoplasty is minimally-invasive, you’ll be able to go home shortly after surgery.
Before you leave, we’ll discuss all your post-surgical instructions and precautions. Some patients may be advised to avoid blowing their nose for several days or weeks after surgery, sleeping with the head elevated, and avoiding blood-thinning medications or activities that may increase blood pressure and the risk of nose-bleeds.
Immediately after surgery, when the anesthetic wears off, your nose may be swollen and slightly painful, but you won’t have external bruising on the nose and you won’t have to wear a cast. Dr. Cohen may prescribe pain medication to make you more comfortable. After a day or two, you can remove the nasal packing. Patients who have had septorhinoplasty will likely wear a nasal splint for about a week or more, and may have bruising on the nose and around the eyes.
Within three days, most symptoms from the previous deviated septum and from the septoplasty itself are gone. You should be able to completely resume all normal activities by five days after surgery.
What are long-term expectations after deviated septum repair?
Like any surgery, results can vary by person, but after septoplasty most people find relief from the symptoms that were caused by the deviated septum. After the surgical recovery is done, nasal passages should be more open, allowing proper draining and easier breathing, leading to improvement in conditions like snoring and chronic sinusitis, among other issues.
Although you may feel better almost right away and shouldn’t experience any symptoms, it can actually take many months or even up to a year for the nasal cartilage and tissues to settle after surgery.
In rare cases, the nasal tissue and cartilage can shift over time—or if you experience additional injury—leading to the need for a second surgery.
How can you get started?
If you experience sinusitis, sleep apnea, or other issues from a deviated septum, septoplasty may be the best long-term solution. Learn more about the signs of a deviated septum, and give us a call for a consultation today!