Septalplasty  > Procedures

The surgical procedure for correction of a nasal problem, or Septalplasty, that may involve breathing problems, (internal) reconstructive or cosmetic problems, (external), or a combination of internal and external complaints. The corrective procedures are called septalplasty and nasalplasty.

If You're Considering Septalplasty

At the time of your first office visit, the Doctor will discuss the surgical procedure with you. If you have problems such as airway obstruction you may have a deviated septum. the Doctor will look into your nose with a very thin scope to determine if this is the case. If you are interested in a cosmetic change, the Doctor will discuss possible goals of surgery with you.

Making the Decision

For patients having septal surgery, general anesthesia is usually used, as most septal deviations are deep in the nose. Most people have intravenous sedation and local anesthesia. This means you will be given medications to relax you through an IV and then the Doctor will numb the nasal area.

You should be aware that conditions may occur which may require less than total correction of symptoms (a limited resection). The Doctor will use his best judgment at the time of surgery. Rather than resect a greater amount of tissue and cause possible harm, the Doctor will do a lesser correction. He will discuss this with you before your surgery.

Preparing for surgery

Prior to surgery, you may be asked to:

Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Stop smoking well in advance of surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

What to do on the day of surgery
The use of anesthesia during your liposuction
Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Liposuction may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

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Important facts about the safety and risks of nose surgery

The decision to have nose surgery is extremely personal and you’ll have to decide if the benefits will fulfill your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks include:

Rupture of small surface vessels of the nose
Infection
Poor wound healing
Anesthesia risks
Bleeding (hematoma)
Nose asymmetry
Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
Change in skin sensation (numbness)
Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
Pain, which may persist
Unfavorable scarring
Skin contour irregularities
Skin discoloration and swelling
Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
Possibility of revisional surgery

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another minor surgery may be necessary to reach the intended aesthetic goal.

Be careful

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Procedural Steps:

What happens during nose surgery?

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.

Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.

Step 3 – Reshaping the nose structure

Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body.

Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose.

Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used.

Step 4 – Correcting a deviated septum

If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.

Step 5 – Closing the incision

Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.

Step 6 – See the results

Splints and internal tubes will likely support the nose as it begins to heal for approximately one week.

While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.

During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery.

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My recovery

After your procedure is completed, a splint, internal tubes or packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery?
When will they be removed?

Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?

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The results will be long-lasting

It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine.

Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.

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How much will nose surgery cost?

Cost is always a consideration in elective surgery. Prices for nose surgeries can vary widely. A surgeon’s cost may vary based on his or her experience as well as geographic office location.

Many plastic surgeons offer patient financing plans, so be sure to ask.

Cost may include:

Surgeon’s fee
Hospital or surgical facility costs
Anesthesia fees
Prescriptions for medication
Medical tests

Your satisfaction involves more than a fee

When choosing a plastic surgeon for nose surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

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Words to know

Cartilage: Connective tissue that forms the structure of the nose.
Columella: The narrow strip of tissue that separates the nostrils.
Deviated septum: Cartilage that separates the nostrils is misaligned which may cause partial nasal airway obstruction.
General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
Hematoma: Blood pooling beneath the skin.
Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
Rhinoplasty: Surgery to reshape the nose.

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Questions to ask my plastic surgeon

Use this checklist as a guide during your consultation

Are you certified by the American Board of Plastic Surgery?
Are you a member of the American Society of Plastic Surgeons?
Were you specifically trained in the field of plastic surgery?
How many years of plastic surgery training have you had?
Do you have hospital privileges to perform this procedure?

If so, at which hospitals?


Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?

Am I a good candidate for this procedure?
What will be expected of me to get the best results?
Where and how will you perform my procedure?
What surgical technique is recommended for me?
How long of a recovery period can I expect, and what kind of help will I need during my recovery?
What are the risks and complications associated with my procedure?
How are complications handled?
How can I expect my nose to look over time?
What are my options if I am dissatisfied with the cosmetic outcome of my nose surgery?
Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?

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