FUNCTIONAL NOSE SURGERY

Septoplasty

Anterior septal correction

PROCEDURE

What is Septoplasty?

Septoplasty is a functional nose surgery that aims to reshape the nasal septum, the cartilage and bone wall separating the two nasal passages or nostrils. This operation is usually performed for patients with a deviated septum and nasal blockage. A deviated septum is when the septum is bent or displaced, causing one nasal passage to be smaller than the other.

It’s estimated that up to 80% of the population has a deviated septum, but for most, it causes no symptoms. However, for others, it can cause breathing difficulties, nasal congestion, frequent sinus infections, and affect sleep quality.

A deviated septum can be a congenital deformity, which means it is present from birth. However, it is often the result of trauma or injury. During a septoplasty, Annakan will typically make incisions inside the nose, known as a closed procedure. He will then address the bone and cartilage that compose the septum and restructure and realign the nasal septum in the midline.

Annakan wrote an editorial article in the British Medical Journal on the benefits of septoplasty for treating nasal obstruction which was widely read in the medical community.

An open technique may be required in some cases, and an incision is made on the columella between the nostrils. This may be required for patients who need more extensive septal trimming or other alterations in a procedure known as septorhinoplasty.

In an open septoplasty, Mr Navaratnam can lift the nose skin to trim or manipulate the nasal septum. Pieces of septal cartilage and bone may need to be removed. Dissolvable stitches are typically used, and it may be necessary to put internal splints inside the nose to stop the septum from moving while it heals.

Successful surgery will improve nasal breathing but may not eliminate other symptoms associated with nasal conditions such as allergic rhinitis or sinusitis. These conditions often need ongoing medical treatment in the form of topical nasal medication. A nasal septoplasty may help facilitate delivery of medication for these conditions.

Benefits of a septoplasty

Septoplasty surgery has several benefits and is typically considered a safe and effective procedure.

Improved breathing: usually the most noticeable benefit for patients is improved breathing through the nose.
Reduced snoring: a deviated septum is often the cause of snoring, and a septoplasty can lessen or even eliminate snoring and loud breathing while sleeping. This, in turn, leads to better sleep quality.
Cosmetic improvement: a septoplasty is a functional surgical procedure, but it may also improve the external appearance of the nose.
Improved delivery of medication for other nasal conditions such allergic rhinitis.

Septoplasty surgeon

At a glance

Surgery time

1 – 2 hours

Anaesthetic

General

Time off work

2 weeks

Hospital stay

Day Case

Shower

After 1 day

Reasonable mobility

After 2 days

Exercise

After 2 weeks

Sleeping on back

4 weeks

Full recovery

6 weeks

Driving

5 days

ENT SPECIALIST

Mr Annakan Navaratnam

Annakan Navaratnam is Consultant Ear, Nose & Throat (ENT) Surgeon whose private practice is based at Harrow and One Welbeck Hospital in Central London and The Clementine Churchill Hospital in Harrow. In his NHS practice, he works at Royal National ENT Hospital, University College London Hospital (UCLH) and is an honorary consultant at Great Ormond Street Hospital.

He has a subspeciality interest in rhinology and facial plastic surgery with particular expertise in septorhinoplasty and nose reshaping surgery.

Annakan is excellently placed to manage general adult and paediatric ENT presentations and in particular is able to assess and treat complex problems related to the form and function of the nose. This includes endonasal (scarless) rhinoplasty, revision septorhinoplasty as well as advanced endoscopic sinus surgery.

What to expect

Here you will find some essential information to help you prepare for surgery and the arrangements you should make to ensure you have the support you need and that everything runs smoothly on the day. However, we are on hand to answer any questions you may have.

The first stage is always a comprehensive consultation and pre-operative assessment with your septoplasty surgeon Mr Annakan Navaratnam.

During the consultation, he will listen carefully to your concerns and desired outcomes, and recommend whether surgery is appropriate at this time. The potential risks, post-surgery expectations, and recovery details of the specific procedure will also be discussed. A detailed medical history will be obtained to ensure your fitness for surgery.

Examination of the nose will be performed during the consultation to assess the nasal structures and to evaluate for any presence of nasal disease. This will often involve a procedure called nasoendoscopy to examine the underlying nasal anatomy.

Something investigations in the form of imaging such as a CT scan may be required as part of the assessment to help guide treatment.  Pre-operative photographs are always necessary prior to rhinoplasty surgery and aid in the consultation process. These are taken during the consultation.

A two-week reflection period follows the initial consultation, during which you can return for additional consultations free of charge.

If you decide to proceed, you’ll receive guidance on preparing for surgery. Pre-surgery tests may be required.

Mr Navaratnam will advise you on stopping smoking as far in advance of surgery as possible due to its impact on healing, infection risks, and complications during anaesthesia. Guidance on discontinuing blood-thinning medication and fasting before surgery will be provided.

Upon arrival at hospital, you’ll be escorted to a private room, and vital signs will be assessed. Your surgeon will finalise markings, and the anaesthetist will visit you. Clinical photography will document the pre-op and post-op phases.

The procedure is performed under general anaesthesia, followed by recovery in a specialist recovery room. Septoplasty surgery can be performed as a day case so once you have recovered sufficiently you will be discharged into the care of a friend or family member.

Post-surgery pain varies for each individual, but most patients find it minimal and can be managed with over-the-counter painkillers. It typically subsides within the first week or so along with any bruising.

A comprehensive recovery guide, including follow-up appointment dates. Our team will be on hand if you have any concerns.

Frequently asked questions

If you are experiencing breathing problems or other symptoms because of a deviated septum, you are a good candidate for a septoplasty as they are unlikely to improve without surgical intervention.

If you’re experiencing the following, then an assessment of your nasal structure is essential:

  • Difficulty breathing through your nose, and you’ll often suffer more from colds or allergies due to swelling and congestion
  • You may be more susceptible to nosebleeds
  • You often must compensate for a deviated septum by breathing through the mouth, which can lead to a dry mouth
  • Disrupted sleep, loud breathing and snoring, and sleep apnoea
  • Nasal congestion which can lead to sinus infections

Pain after a septoplasty is usually well-tolerated and managed with regular pain relief medication. The swelling initially after the procedure make it hard to breathe through your nose but this will resolve in a matter of weeks and you will experience improved breathing thereafter

Typically, a septoplasty is performed as a closed procedure, meaning no visible external scarring will occur. However, in more complex cases, Mr Navaratnam will have to perform an open rhinoplasty, which entails an incision made across the columella between the nostrils, so there will be a small scar that is usually not noticeable when healed.

The risks associated with septoplasty surgery include complications related to a general anaesthetic, infection, poor healing, numbness or pain, septal perforation and the possibility of revisional surgery. Mr Navaratnam will provide you with comprehensive aftercare instructions to help minimise risks.

Downtime after septoplasty typically involves taking a week off from work, and you may need to wear a splint for up to ten days. Avoid exercising for a minimum of four weeks after nose septum surgery, and you should avoid all contact sports for a minimum of eight weeks to minimise the risk of injury to the nose. Gentle activities like walking or stretching are encouraged, though, as they can aid healing by boosting circulation. You’ll also be advised to avoid blowing your nose for at least two weeks after.

A septoplasty focuses on the internal structure of the nasal, but it can have a subtle effect on the nose’s external appearance as the septum, the central structural support for the nose, will be straightened.

A septoplasty can be combined with a cosmetic rhinoplasty if the patient also has concerns with the external appearance of their nose.