Making Sense of Nasal Surgery

Who needs nasal surgery?

“Nasal surgery” includes surgical procedures performed to improve the function and/or the appearance of the nose. Individuals who have nasal obstruction, recurrent sinus infections or are dissatisfied with the appearance of their nose may be a candidate for nasal surgery.

What are the different nasal surgeries?                   

Surgery for chronic or recurrent sinusitis and nasal polyps is called Endoscopic Sinus Surgery.         

When there is an anatomical obstruction due to a deviated nasal septum, a Septoplasty is performed.

Rhinoplasty is a procedure that combines reshaping and restructuring the bone and cartilage of the nose. The goal of the procedure is to improve the appearance and/or the function of the nose.

What is endoscopic sinus surgery?                    

Endoscopic sinus surgery is the procedure used to facilitate normal, healthy sinus drainage. The surgery is performed using specialized cameras, or endoscopes, in the nasal cavity to open the sinus drainage pathways. Sinus infections occur when the sinuses cannot drain mucus properly, such as from a blockage, leading to a buildup of mucus that cannot be cleared. Treatment can be medical or surgical, depending on the cause of the blockage. There are no external incisions with this procedure. This surgery is often performed using computer guided imaging from pre operative CT scans that function as a navigation system of the patient’s anatomy.

What is a septoplasty?

Septoplasty is a nasal surgery aimed at improving nasal breathing by addressing a crooked, or deviated, nasal septum. The septum is the cartilage in the middle of the nose that separates the right nostril from the left nostril. When this cartilage is twisted or deviated into the nasal airway, patients can experience nasal obstruction. The nasal obstruction may be mild or severe with resulting sinus obstruction leading to sinus infections. Septoplasty surgery removes the portion of the septal cartilage that is causing the obstruction.

This surgery is often times paired with an inferior turbinate reduction. The inferior turbinates are bony structures inside your nose that are covered by mucous membranes. The turbinates help to humidify the air we breathe. The turbinates can swell with exposure to allergens or infections. During a septoplasty surgery, the turbinates can be reduced in size to further open the nasal cavity and facilitate the passage of air.

What is a rhinoplasty?

The goal of rhinoplasty is to surgically create a functional, aesthetic, and natural appearing nose. The reasons for seeking out nasal surgery vary from a nose that is out of proportion to the face, a congenital or traumatic nasal obstruction, or headaches and sinus problems that require external nasal straightening to address the problem. The procedure is a combination of reshaping and restructuring the bone and cartilage of the nose to improve the function and the appearance.

How is rhinoplasty different from septoplasty?

The goal of rhinoplasty is to improve the appearance of the nose. The goal of septoplasty is to improve nasal breathing. Often times both procedures are performed in the same patient. Nasal obstruction is very common. Nasal obstruction can be related to a deviated septum, swollen tissues in the nose (turbiantes), polyps or other growths, or narrowing and collapse of the side of the walls of the nose. To effectively improve nasal breathing, each of these factors must be evaluated by your physician to determine the best intervention for you. Surgical correction of a crooked septum, collapsing nose, or removal of growths may be required when these factors are significant.

What results can be expected?

Rhinoplasty is one of the most complex procedures performed in facial plastic surgery. With proper analysis, realistic patient expectations and the skill of a facial plastic surgeon, rhinoplasty is a very rewarding procedure for both patient and surgeon alike.

What happens during rhinoplasty?

During the procedure, the bones and cartilage that support the nose are accessed through small incisions. In most cases, these incisions are made inside the nostrils to minimize the appearance of scars. Depending on the goals of the surgery, various maneuvers are performed to reshape the bone and cartilage to create an aesthetically pleasing and well functioning nose. At the end of the procedure, splints may be placed both inside and outside the nose to support it while it heals.

How long does the procedure take?

Every rhinoplasty is unique. Depending on the extent of surgery being performed, rhinoplasty may take 2-5 hours to complete.

Is hospitalization necessary?

Rhinoplasty is most commonly performed at a surgical center under general anesthesia for patient safety and comfort. Patients are able to return home on the day of the procedure after a short recovery period.

What is the recovery like after rhinoplasty?

Most patients do not have much pain after the surgery though medications to assist with pain control are prescribed in case it is needed. It will be important to avoid strenuous activity for the first three weeks after surgery. Depending on the extent of surgery, the recovery period length can vary. There are specific instructions to help with healing after surgery that will carefully be reviewed with you.

What are the risks of rhinoplasty?

During rhinoplasty, general anesthesia is administered, which may pose risks. Other risks associated with rhinoplasty include nasal blockage, infection, skin problems, injury to the septum, and bleeding. However, these complications are rare.

What is non surgical rhinoplasty?

Non surgical, or injection rhinoplasty, is performed in the office using dermal fillers. Injection rhinoplasty is an alternative to surgical rhinoplasty for minor defects. Filler can be used to reduce the appearance of nasal irregularities, or a prominent dorsal hump. The risks are minimal in the hands of an expertly trained facial plastic surgeon.

Lucia S. Olarte, MD

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