Septoplasty

UT Southwestern Medical Center surgeons and their teams provide exceptional care to correct nasal airway problems through septoplasty.

Our skilled plastic surgeons and otolaryngologists have extensive experience and training in reconstructive and cosmetic surgical procedures to correct congenital (present since birth) conditions, injuries, and other issues. Using the latest septoplasty techniques, our surgeons help improve breathing and sleep for people who have problems with the nasal septum.

What Is Septoplasty?

Septoplasty is a surgical procedure that corrects a deviated nasal septum, the cartilage and bone that divide the two nasal passages. A deviated septum can cause difficulties breathing. With this procedure, surgeons can remove deviated portions of the septum or straighten and reposition it to restore airflow through the nose.

The surgery is performed as an outpatient procedure. Most patients return home the same day. Recovery includes mild swelling and discomfort, with initial healing taking about one week. Complete recovery may take several months.

What Deviated Septum Symptoms Can Be Resolved with Septoplasty?

Septoplasty primarily addresses symptoms caused by nasal obstruction, including:

• Difficulty breathing through one or both nostrils
• Chronic nasal congestion
• Frequent snoring or disturbed sleep due to airway blockage
• Recurrent sinus infections or poor sinus drainage
• Nosebleeds or headaches caused by septal spurs

What Are the Types of Septoplasty?

The type of septoplasty used depends on the severity of the septal deviation and the patient’s goals:

• Endonasal septoplasty involves accessing the septum through incisions made inside the nasal cavity, avoiding external scars. This technique is suitable for most cases and allows surgeons to lift and reshape the septum's mucosa without compromising its integrity.
• Endoscopic septoplasty uses a camera for enhanced visualization, offering precision in accessing and correcting septal deformities. This is particularly useful for revision surgeries or when combined with sinus procedures.
• Extracorporeal septoplasty is used for severe deviations, where the septum is removed entirely, reshaped outside the body, and reinserted. This approach can involve grafting techniques to provide structural support and prevent deformities, such as saddle nose.

Our surgeons can perform a septoplasty alone or at the same time as other facial procedures, such as:

• Rhinoplasty: Reshapes or reconstructs the external nose for cosmetic or functional purposes
• Turbinate reduction (turbinoplasty): Reduces the size of the turbinates, the structures inside the nose that warm and humidify air, to improve airflow and relieve nasal obstruction
• Functional endoscopic sinus surgery (FESS): Uses a small camera (endoscope) to remove blockages in the sinuses
• Skull base or orbital surgery: Addresses conditions affecting the base of the skull or the eye sockets, such as tumors, fractures, or infections

Various septoplasty techniques focus on correcting septal deviations while maintaining the structure and function of the nose.

Surgeons make precise incisions, such as a hemi-transfixion or Killian’s incision, to access the septum. Mucosal flaps are carefully lifted to expose the underlying cartilage and bone, which are then reshaped, repositioned, or removed as needed. Preserving the L-strut, a crucial support structure, ensures the stability of the nose.

What Are the Benefits of Septoplasty?

This procedure provides both immediate and long-term benefits for patients experiencing breathing difficulties or related symptoms, including:

• Enhanced airflow: Restores normal airflow in the nasal passages, improving overall nasal function
• Improved breathing: Reduces nasal obstruction, allowing for easier and more comfortable breathing
• Reduced snoring: Helps minimize or eliminate snoring for some patients
• Improved sleep: Enables better airflow, improving the quality and duration of sleep
• Fewer sinus infections: May decrease the frequency of sinus infections by improving drainage and reducing blockages
• Relief from congestion: Alleviates nasal congestion and pressure caused by a deviated septum
• Improved surgical outcomes: Provides better access for sinus or skull base surgeries when required
• Cosmetic correction of nasal asymmetry (additional nasal surgery may be required)

By addressing the structural causes of nasal obstruction, septoplasty offers patients relief from chronic symptoms and a noticeable improvement in their daily comfort and health.

What Can Patients Expect with a Septoplasty?

Before a Septoplasty

Patients meet with their surgeon for a thorough evaluation, which may include:

• Nasal endoscopy, a diagnostic procedure where a thin, flexible tube with a light and camera is inserted into the nasal passages
• Imaging, such as computed tomography (CT) scans or X-rays

The surgeon’s preoperative instructions will include guidelines on fasting and medication adjustments.

During a Septoplasty

Septoplasty is an outpatient procedure, and patients can go home the same day. In the first step, our surgeons discuss anesthesia options with patients to provide comfort during the procedure.

Anesthesia options include:

• General anesthesia: This option involves putting patients into a deep sleep so they remain unconscious and pain-free during the procedure.
• Sedation: A milder alternative to general anesthesia, sedation helps patients relax and minimizes discomfort while keeping them partially conscious or in a lightly unconscious state.

In the second step, the surgeon makes small incisions within the nasal cavity and sometimes across the tissue that separates the nostrils to access the septum. The surgeon then:

• Carefully lifts the mucous membrane (lining of the nose), which protects the surface of the septum, away from the septum
• Removes or straightens and repositions the septum
• Removes any excess bone or cartilage that might be blocking the nasal airway
• Replaces the mucous membrane around the septum and sutures it in place

In the final step, the surgeon closes the incisions using sutures. We might also insert soft silicone splints inside each nostril to support the septum or place packing to prevent bleeding. These structures are removed within a day or two after the procedure.

After a Septoplasty

Patients are monitored as anesthesia wears off and can typically go home the same day.

Recovery involves managing mild swelling, bleeding, and discomfort, similar to sinus infection symptoms. Patients can expect to receive medication to relieve pain or reduce the risk of infection for a few days after the procedure.

How Long Does Septoplasty Recovery Take?

Patients can expect to have some swelling and mild bruising for the first few days. Most swelling goes away in about two weeks, but some minor swelling can last several weeks.

Most people can return to work and most activities within a week and resume more strenuous activities after a few weeks.