Septorhinoplasty

Length: 2 - 3 hours.

Anaesthesia: Usually general.

In/Outpatient: Usually outpatient.

Side Effects: Swelling and bruising of the nose for several days after surgery is a normal occurrence.

Risks: Infections, excessive bleeding; relapse of the nasal obstruction may require revision surgery.

Recovery: Back to work: 2 weeks. Avoid exercising and playing contact sports: 6 weeks. Avoid flying: 2 weeks. Final results: 1 year or more.

Duration of Results: Permanent.

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If You're Considering Septorhinoplasty...
Septorhinoplasty is a surgical procedure done on the nose and the nasal septum. The septum is the thin wall of cartilage and bone between the nostrils that divides the two nasal cavities. In some people, the septum is bent to one side of the nose, blocking it. Sometimes the septum is crooked at birth or because of an injury.
The first part of the septorhinoplasty surgery is septoplasty - an operation to straighten the septum. The second part of the operation is rhinoplasty, a procedure to change the shape of the nose.
Septorhinoplasty can significantly enhance the appearance of the nose; however, what can be achieved is not automatically what should be performed. The nose is part of the facial framework and needs to fit within it.
So the proportions of the nose after the surgery must be in harmony with the proportions of other parts of the face. For instance, shortening the nose too much in a tall person with long and narrow facial proportions leads to an adverse overall result.
If you’re thinking of undergoing septorhinoplasty, this information will give you general understanding of the procedure – when it can improve your appearance, how it’s done, and what outcomes may be expected. However, it can’t cover all questions you may have because many answers depend on individual circumstances.

The Best Candidates For Septorhinoplasty
Septorhinoplasty can improve your looks and enhance your self-esteem, but it won’t necessarily change your appearance to equal your ideal, or make other people treat you in a different way. Before you decide to undergo the surgery, think about your expectations and discuss them with your surgeon.
The best candidates for septorhinoplasty are those who are seeking for enhancement, not perfection, in their look. If you are in a good physical and emotional state, and have realistic expectations, you may be a good candidate for the surgery.
Septorhinoplasty is performed for reconstructive or aesthetic purposes. After trauma, the nose may be broken which may lead to breathing difficulty or a severely deformed external nasal appearance. In such cases, septorhinoplasty is performed for reconstructive purposes, and to improve breathing. However, most septorhinoplasties are carried out to enhance the aesthetic appearance of the nose. Septorhinoplasty is performed for both men and women. Children who need the operation should wait until they’ve stopped growing, around age 16.

All Surgery Carries Some Uncertainty and Risk
When septorhinoplasty is performed by a qualified plastic surgery specialist, complications are rare and usually minor. Yet, the possibility of complications remains.
As with any operation, there are risks associated with having a general anaesthetic. However, septorhinoplasty is in general a very safe operation. There is a one percent risk of bleeding after the surgery, so you may need nasal packs to stop the bleeding. There is also some risk of infection. Scar tissue can form inside the nose, but this normally doesn’t cause problems. In very rare cases, patients experience numbness in their teeth, which resolves with time.
You can lessen the risks by carefully following your surgeon’s instructions both before and after the surgery.

Planning Your Surgery
Good communication between you and your physician is important. During your first consultation, the surgeon will ask what improvements you want, evaluate the structure of your nose and face, and discuss surgery possibilities with you. He or she will also describe the factors that may influence the procedure and the results. The surgery depends on the structure of your nasal bones and cartilage, the thickness of your skin, the shape of your face, your age, and your expectations.
Your surgeon will also tell what techniques and anaesthesia he or she will use, the type of facility where the operation will be carried out, the costs and risks involved, and any options there may be.
Inform your surgeon if you’ve had any nose surgery before, or any injury, even if it was long ago. You should also tell your surgeon if you suffer from any allergies or have breathing problems, if you smoke and if you’re taking any medications, vitamins or recreational drugs.
If you have any questions regarding your expectations about the results, ask without hesitation.

Preparing For Your Surgery
You will be given detailed instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Closely following these instructions, you may expect a more smoothly-going surgery.
While preparing for the surgery, make sure that someone will be able to drive you home after your surgery and be near for a few days if any help will be needed.

Types of Anaesthesia
The type of anaesthesia – general or local – does not have much influence on the degree of discomfort or the eventual result of the nasal appearance, but may affect the overall experience of the patient. Often, patients who undergo operation under local anaesthesia say it was a very positive experience. On the other hand, the choice of anaesthesia depends on such factors as the patient’s preference, the planned procedure, the surgeon’s preference, and the institution where the operation is to take place.

The Surgery
Since most of septorhinoplasty is performed from inside the nose, you may only have a couple of small scars around your nose. First of all, the surgeon will make an incision inside your nose and straighten the septum by removing some of the cartilage and bone. Afterwards, the surgeon will break the bones of your nose in order to reshape it. To keep it all in place, dissolvable stitches are used. The surgeon will also reshape the external appearance of your nose. When septorhinoplasty is completed, patients normally have a plastic splint applied on the outside of their nose to help keep the shape of the bones.

After the Procedure
You may have a dressing (known as a nasal pack) in the nostrils to stabilize the septum and to prevent bleeding. You will have to breathe through your mouth while the dressings are in place. The dressings are typically taken away the morning after surgery. You may also have small pieces of plastic (known as splints) applied externally to maintain the newly shaped bony structure. They will be taken out 1 to 2 weeks following operation.
Your nose may feel uncomfortable and blocked for the first several weeks. Your surgeon may prescribe some drops or spray to ease this. It may take up to 3 months for your nose to settle down and for your breathing to be clear again.
You may get some blood coloured watery fluid from your nose for the first two weeks or so. This is normal and is nothing to worry about.
There may be bruising and swelling for a few weeks after your operation. Do not blow your nose for about a week after your surgery, otherwise bleeding may start. If you feel you are going to sneeze, try to do it with your mouth open to protect your nose. The stitches inside your nose will dissolve and fall out by themselves.

Getting back to normal
Patients are usually up and about very soon after surgery. By 2 or 3 days following operation, healthy patients are normally recovered to 90%. If the procedure was performed under general anaesthesia, it may take 4 or 5 days to regain one’s energy level. Usually, it is safe to take 7 or 8 days after surgery to completely recuperate. Another thing which may preclude work is the bandage or splint applied on the bridge of the nose in most patients.
You should take at least 2 weeks off work. To lessen the risk of infection during this period, rest at home and avoid crowds, smoky places and people with coughs and colds. Moreover, you should avoid exercising and playing contact sports for 6 weeks after the surgery. Avoid flying for 2 weeks.

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