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FAQ – Nasal Surgery

Read more about Nasal Surgery

Millions of people perennially suffer the discomfort of nasal stuffiness. This may be indicative of chronic breathing problems that don’t respond well to ordinary treatment. The blockage may be related to structural abnormalities inside the nose or to swelling caused by allergies or viruses.

There are numerous causes of nasal obstruction. A deviated septum (the partition between the nostrils) can be crooked or bent as the result of abnormal growth or injury. This can partially or completely close one or both nasal passages. The deviated septum can be corrected with a surgical procedure called septoplasty. Cosmetic changes to the nose are often performed at the same time, in a combination procedure called septorhinoplasty.

Overgrowth of the turbinates is yet another cause of stuffiness. (The turbinates are the tissues that line the inside of the nasal passages.) Sometimes the turbinates need treatment to make them smaller and expand the nasal passages. Treatments include injection, freezing, and partial removal. Allergies, too, can cause internal nasal swelling, and allergy evaluation and therapy may be necessary.

Aging is a common cause of nasal obstruction. This occurs when the cartilage in the nose and its tip are weakened by age and droop because of gravity. This causes the sides of the nose to collapse inward, obstructing airflow. Mouth breathing or noisy and restricted breathing are common.

Try lifting the tip of your nose to see if you breathe better. If so, the external adhesive nasal strips that athletes have popularized may help. Or talk to a facial plastic surgeon/otolaryngolgist about septoplasty, which will involve trimming, reshaping or repositioning portions of septal cartilage and bone. (This is an ideal time to make other cosmetic improvements as well.) Internal splints or soft packing may be placed in the nostrils to hold the septum in its new position. Usually, patients experience some swelling for a week or two. However, after the packing is removed, most people enjoy a dramatic improvement in breathing.

Bruises around the eyes and/or a slightly crooked nose following injury usually indicate a fractured nose. If the bones are pushed over or out to one side, immediate medical attention is ideal. But once soft tissue swelling distorts the nose, waiting 48-72 hours for a doctor’s appointment may actually help the ENT doctor in evaluating your injury as the swelling recedes. (Apply ice while waiting to see the doctor.) What’s most important is whether the nasal bones have been displaced, rather than just fractured or broken.

For markedly displaced bones, surgeons often attempt to return the nasal bones to a straighter position under local or general anesthesia. This is usually done within seven to ten days after injury, so that the bones don’t heal in a displaced position. Because so many fractures are irregular and won’t “pop” back into place, the procedure is successful only half the time. Displacement due to injury often results in compromised breathing so corrective nasal surgery, typically septorhinoplasty, may then be elected. This procedure is typically done on an outpatient basis, and patients usually plan to avoid appearing in public for about a week due to swelling and bruising.

The procedure

The specific type of surgery will be determined by the surgeon based on:

  • your age, overall health, and medical history
  • severity of the deformity
  • your tolerance of specific medications, procedures, or therapies
  • your opinion or preference

Although each procedure varies, generally, nasal surgeries follow this process:

  • Location options may include:
    • Surgeon’s clinic-based surgical facility
    • Hospital surgery center
    • Hospital Day case center
    • Hospital inpatient
  • Anesthetic options may include:
    • local anesthesia
    • general anesthesia
  • Average length of procedure: about two hours
  • Recuperation period:
    • External nasal dressings and splints are usually removed
    • five to seven days after surgery.
    • usually up and around in a few days
    • usually return to school or sedentary work a week or so after surgery
    • surgeon will provide guidelines for resuming normal activities

Bruises around the eyes and/or a slightly crooked nose following injury usually indicate a fractured nose. If the bones are pushed over or out to one side, immediate medical attention is ideal. But once soft tissue swelling distorts the nose, waiting 48-72 hours for a doctor’s appointment may actually help the ENT doctor in evaluating your injury as the swelling recedes. (Apply ice while waiting to see the doctor.) What’s most important is whether the nasal bones have been displaced, rather than just fractured or broken.

For markedly displaced bones, surgeons often attempt to return the nasal bones to a straighter position under local or general anesthesia. This is usually done within seven to ten days after injury, so that the bones don’t heal in a displaced position. Because so many fractures are irregular and won’t “pop” back into place, the procedure is successful only half the time. Displacement due to injury often results in compromised breathing so corrective nasal surgery, typically septorhinoplasty, may then be elected. This procedure is typically done on an outpatient basis, and patients usually plan to avoid appearing in public for about a week due to swelling and bruising.

  • Healing is a slow and gradual process.
  • Some swelling may be present for months, especially in the tip of the nose.
  • Final results of nasal surgery may not be apparent for a year or more.
  • When a traditional open surgical technique is used, or surgery is performed to narrow flared nostrils, small scars will be located on the base of the nose. The scars usually are not noticeable.
  • Scarring is not visible when rhinoplasty is performed from inside the nose

Recovery

  • A splint may be applied to nose.
  • Nasal packs or soft plastic splints may be placed inside the nostrils.
  • The face will feel puffy.
  • The nose may ache.
  • You may experience a dull headache, swelling around the eyes, and/or bruising around the eyes.
  • A small amount of bleeding is normal in the first few days.
  • Small burst blood vessels may appear as tiny red spots on the skin’s surface.

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