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Septoplasty and breathing improvement surgery

About the procedure

A deviated nasal septum is a common cause of nasal obstruction and difficulty breathing. Sometimes, the deviated septum is a result of trauma or injury, while other times patients are born with the deviated septum. In order to improve the airflow, the part of the septum that deviates into the airway needs to be removed or realigned. There are many ways to perform a septoplasty, and they can be performed through a closed approach with no external skin incisions as well as through an open approach, which involves an incision across the columella (underside of the nose). Dr. Hirsch help you decide which approach is best for you during your consultation.

When the deviated septum is present during the early years of lift, the turbinate on the opposite side of the septal deviation may grow larger and block the airway, which creates breathing problems. In order to correct the airway obstruction, the turbinate should be removed or modified so that airflow can be improved.

Other causes of airway obstruction are collapse or deformity of nasal valves. The external valve, or alar opening, is kept open by the lower lateral cartilage of the nose. If this cartilage is weak or damaged, the external valve will collapse and the patient will not be able to breathe through that side of the nose. In order to correct this collapse, Dr. Hirsch will typically add support to the nose in the form of a cartilage graft, such as an alar batten graft or a lateral crural strut graft. These supportive grafts help stent the airway open to improve breathing. Another cause of airway obstruction is collapse of the internal nasal valve, which is formed by the junction of the nasal septum and the upper lateral cartilage of the nose. When the internal nasal valve is collapsed, air will not pass through the airway properly and the patient will experience breathing difficulties and occasionally there will be a cosmetic deformity as well, such as the inverted V deformity. Dr. Hirsch will correct both the cosmetic deformity and the breathing obstruction by using a cartilage graft, such as a spreader graft or a spring graft. The breathing improvement is noticed by patients immediately after surgery and their symptoms of obstruction such as snoring or difficulty breathing disappear quickly!

After surgery, depending on what was performed, a nasal splint (on the outside of the nose) or nasal stent (on the inside of the nose) may be used for 3-7 days to help minimize swelling after surgery. Functional rhinoplasty patients may experience swelling of the nose and occasionally bruising around the eyes and cheeks for 1-3 weeks following surgery. Swelling of the nose, expecially in revision rhinoplasty when extensive reshaping is performed, can take several months to resolve. However, pain after rhinoplasty is usually mild, and patients are able to resume normal activities 1-2 weeks after surgery.

Frequently asked questions about septoplasty and breathing improvement surgery:

I am interested in improving the appearance of my nose at the same time as improving breathing. Is it possible to perform a cosmetic rhinoplasty at the same time as septoplasty?


Yes, it is definitely possible to perform cosmetic adjustments at the same time as septoplasty or breathing improvement surgery. However, insurance generally does not cover cosmetic procedures although they will often cover the functional components of the procedures. Dr. Hirsch and his staff will work with you to help figure out which parts of your surgery are and are not covered by insurance.

How long until I notice the breathing improvement after septoplasty or functional rhinoplasty?


If Dr. Hirsch does not use nasal packing in your surgery, you will notice an improvement in breathing immediately after surgery. This improvement may decrease in the next few days as the nose becomes swollen and breathing becomes more difficult, but it will continue to improve as swelling decreases.

I like the way my nose looks and I am not interested in changing it’s appearance. Will I still look the same after septoplasty?


If you are only interested in improving your breathing and have a deviated septum, the septoplasty procedure will not change the appearance of your nose. If there are other components to your breathing difficulty such as internal or external valve collapse, then the procedures that may be required to improve your breathing can subtly change the appearance of your nose.

Will I have a scar on the outside of my nose after septoplasty?


If you are only interested in a septoplasty and do not want any cosmetic adjustments to your nose, a standard septoplasty can be performed from inside your nose without creating an external scar.

Additional resources about functional rhinoplasty and breathing improvement surgery


Feel free to browse the following links to learn more about functional rhinoplasty, septoplasty, and other forms of breathing improvement surgery:

http://www.plasticsurgery.org/cosmetic-procedures/rhinoplasty.html

Dr. Elliot Hirsch

Meet Dr. Elliot Hirsch

Los Angeles plastic surgeon Dr. Elliot M. Hirsch has been educated at some of the most prestigious institutions in the country, including Johns Hopkins University, the University of Southern California, and Northwestern University. He is an active researcher and has published over 40 original papers and book chapters, and holds patents for his inventions in plastic surgery. Dr. Hirsch’s specialties include not only aesthetic surgery, but reconstructive surgery with special attention to aesthetic detail to ensure that patients achieve the best possible results.

To read more about Dr. Hirsch, please visit his extended biography page.


Read Dr. Hirsch's Biography