The septum is the structure in the nose that separates the two nostrils. It is made up of bone and cartilage. In some patients, the septum can become crooked or otherwise misaligned. This makes one nostril larger than the other and it can inhibit proper airway function. Dr. Cilento has extensive experience in surgery to straighten the septum, evening out both nostrils. The surgery is called septoplasty.
What is septoplasty?
Septoplasty is a surgical procedure to correct a deviated septum, a displacement of the bone and cartilage that divides your two nostrils. The surgery straightens and repositions the septum. To do so, Dr. Cilento may cut and remove parts of the septum before replacing them in the proper position. The goal in septoplasty is to improve airflow through the nostrils; this is not a cosmetic procedure.
Am I a good candidate for septoplasty?
Damage to the septum is either congenital or from trauma. When the septum is damaged or malformed during pregnancy, it can happen when the baby is passing through the birth canal. Traumatic damage may be from a car wreck, singular sports injury, or even from repeated contact from sports such as wrestling. Over time the septum becomes displaced.
The question of needing a septoplasty is function. Dr. Cilento uses a scope to check the deeper tissues of the nose to evaluate airflow. Minor deviation of the septum may not merit correction, but problematic deviation will reduce airflow. This can impact normal breathing (creating more mouth breathing) and sleep. Plus, the additional exposure of a deviated septum to the drying effect of airflow through the nose can make that side of the nose crust and prone to bleeding. Septoplasty can repair the septum and return normal airflow.
For this surgery, Dr. Cilento is able to make all the necessary incisions within the nose. The first step is to lift the mucus membrane that covers the septum. He then straightens the nasal septum by trimming, repositioning, and sometimes replacing cartilage or bone. He may need to make a small incision between the nostrils. If the bones are crooked, he may make cuts in the bones before repositioning them. If there is a problem with a depressed bridge, spreader grafts (small reinforcing strips of cartilage) can be used to build it up. When the necessary changes have been made, the mucus membrane is returned and repositioned, and the incision is closed. Silicone splints are placed in each nostril and the nose will be packed to reduce bleeding. The packing will be removed in a day or two but the splints remain for support during healing.
Many people have some deviation in their septum, but it doesn’t cause breathing problems. However, if your deviation is severe, it can block one side of your nose. This obviously decreases your breathing capacity. This can create mouth breathing and cause snoring and sleep apnea while sleeping.
A septoplasty straightens and corrects the position of the septum to return normal, effective airflow through the nostrils.
What is recovery like after septoplasty?
The important thing during your recovery will be to keep your nose from any contact. You won’t be able to blow your nose, and you should wear clothes that button in the front, rather than pull over your head. Keeping blood pressure down through your face is important, so strenuous activities such as running or hard aerobic activity need to wait for a few weeks. Increasing blood pressure could cause your incision to bleed.
You’ll have some minor pain and swelling for a day or two, but swelling with this surgery doesn’t linger (unlike cosmetic nose surgery). Silicone splints will provide support inside your nostrils. You’ll need to sleep with your head elevated for a few days. Full recovery and stability of your tissues can take up to one year, but they should be relatively stable somewhere between 3-6 months.
Because there is minimal tissue trauma with this procedure, complications are rare. Continued bleeding is possible. The septum can be perforated. Your sense of smell can be decreased, although this is unusual. The main risk is that the procedure doesn’t improve your breathing to the degree you had hoped. If this is the case, some patients may opt for a revision septoplasty for further refinement.
After your surgery, cartilage and tissue can gradually reshape over time, but most of the time the changes remain stable and endure. This can take up to a year to fully settle, however. The majority of patients are very satisfied with the improvements in their breathing and decreased nasal congestion that was due to their formerly deviated septum.