NASAL SURGERY

Septorhinoplasty

PROCEDURE

What is a Septorhinoplasty?

Septorhinoplasty is a surgical procedure that addresses both the form and function of the nose and essentially merges two operations into one procedure.

A rhinoplasty procedure reshapes and resizes the nose to improve nasal contours and enhance facial balance and proportion. A septoplasty corrects a deviated nasal septum to restore clear airflow.

When both septoplasty and rhinoplasty are performed together, the procedure is termed septorhinoplasty. Mr Annakan Navaratnam typically employs an open surgical approach to operate on the internal nasal framework.

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Addressing a deviated septum

The nasal septum is the partition inside the nose, composed of bone and cartilage, that separates the left and right nasal passages. When this structure becomes crooked, displaced, or uneven – whether due to trauma, injury, or congenital factors – one nostril may be narrower than the other.

This can cause several problems and significantly impact quality of life. Issues include blocked nasal passages, increased sinus infections, problems sleeping, the onset or worsening of snoring and reduced airflow during exercise or even normal daily activities.

A septoplasty straightens or reshapes the septum by removing or repositioning parts of cartilage and/or bone.

Am I suitable for a septorhinoplasty?

Aesthetic and functional concerns affecting the nose can impact both your confidence and quality of life. A septorhinoplasty can effectively address these concerns in one procedure.

Benefits of a septorhinoplasty include:

Enhanced facial harmony
Improvement in breathing problems caused by structural blockages
Nasal asymmetry or deformity as a result of trauma or genetics is addressed
Sleep quality improved
Snoring reduced or eliminated
Reduced risk of sleep apnoea symptoms
Recurrent nose or sinus blockages prevented so fewer sinus infections

At a glance

Surgery time

2 – 3 hours

Anaesthetic

General

Time off work

2 weeks

Hospital stay

Day Case

Shower

After 1 day

Reasonable mobility

After 2 days

Exercise

After 6 weeks

Sleeping on back

4 weeks

Full recovery

6 – 8 weeks

Driving

2 weeks

Rhinoplasty results

MORE BEFORE & AFTERS

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RHINOPLASTY SPECIALIST

Mr Annakan Navaratnam

Annakan Navaratnam is a Consultant Ear, Nose & Throat (ENT) Surgeon whose private practice is based at Harrow and 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 subspecialty interest in rhinology and facial plastic surgery, with particular expertise in septorhinoplasty and nose reshaping.

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, and advanced endoscopic sinus surgery.

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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.

01. The consultation

The first stage is always a comprehensive consultation and pre-operative assessment with your rhinoplasty surgeon 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 deeper 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.

02. Preparing for surgery

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.

03. Day of the procedure

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. Rhinoplasty 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.

You will usually have an external nasal dressing over the nose and occasionally dressings inside the nostrils are required. These dressings are removed at your first post-operative follow-up appointment, which is usually 7-10 days after surgery.

04. Your recovery

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.

You will expect swelling and bruising around the eyes and cheeks following surgery which will subside in the days and weeks following surgery.

We advise that you do not undertake strenuous activity or exercise for 2 weeks after surgery. Also avoid hot drinks and hot showers for 2 weeks after surgery as this may increase the risk of bleeding.

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

Frequently asked questions

What are the signs I might have a deviated septum?

Common signs include breathing more easily through one nostril than the other, as well as other symptoms such as frequent nosebleeds, recurrent sinus infections, snoring, and noisy or restricted breathing during exercise. Some people notice these symptoms worsen after a nasal injury, even one that happened years earlier.

Am I a suitable candidate for a septorhinoplasty?

Septorhinoplasty may suit you if you have both a functional concern, such as nasal obstruction from a deviated septum, and an aesthetic concern about the shape of your nose. A consultation with Mr Navaratnam, including a nasal examination, will help determine whether combining both elements in a single procedure is right for you.

Will septorhinoplasty help with snoring or sleep apnoea?

Straightening a deviated septum can improve airflow, reduce snoring caused by nasal obstruction, and help improve breathing at night if nasal obstruction is the cause. Septorhinoplasty is not the sole treatment for obstructive sleep apnoea in most cases, but it can improve nasal breathing, which may ease associated symptoms for some patients. Mr Navaratnam will assess whether nasal surgery is likely to help in the context of your wider sleep concerns.

How is septorhinoplasty different from a septoplasty alone?

A septoplasty addresses only the internal deviated septum to improve breathing, without changing the external appearance of the nose. Septorhinoplasty combines this with reshaping of the nose itself, so both function and form are addressed in a single operation and recovery period.

What is turbinate reduction?

In some cases, Mr Navaratnam may also carry out a turbinate reduction, also known as turbinoplasty, to further improve airflow. Turbinates are small, curved structures inside the nasal passage that warm, filter, and humidify the air you breathe. If they become permanently enlarged due to allergies or infection, they can obstruct breathing. Turbinate reduction involves removing or reshaping excess tissue, thereby providing extra space for airflow and easing symptoms such as snoring, nasal congestion, or sleep apnoea. If a turbinoplasty is performed by Mr Navaratnam, part of the turbinate lining is preserved to ensure that there is turbinate function and to avoid complications such as empty nose syndrome (sensation of nasal blockage) or atrophic rhinitis (excessive crusting in the nose).

How should I prepare for septorhinoplasty surgery?

To promote optimal healing and achieve the best possible results, Mr Navaratnam’s patients are advised to:

Stop smoking at least 4 weeks before surgery as smoking delays tissue healing and increases infection risk
Avoid aspirin or medication thats increases bleeding ahead of surgery, as these can increase bleeding risk
Refrain from taking certain herbal supplements pre-operatively

For more advice on how best to prepare for a septorhinoplasty, please download our guide.

What are the possible risks?

All surgery carries some potential risks, including bleeding, infection, or reactions to anaesthesia. For septorhinoplasty, additional specific risks may include:

Persistent nasal blockage symptoms
Unsatisfactory changes in nasal appearance
Septal perforation (hole in the septum)
Nosebleeds
Loss or reduction of the sense of smell
Formation of a septal haematoma
Temporary numbness in parts of the nose and upper teeth
Skin changes

What is the recovery process?

After surgery, Mr Navaratnam will usually place a plaster cast on top of the nose with tape. These are typically removed after 7-10 days after surgery.

Occasionally, Mr Navaratnam will insert soft internal splints in the nostrils to support the septum while it heals. These are typically removed 7-10 days.

Bruising and swelling, especially around the eyes, are common in the first week.

You are advised to:

Sleep on your back with your head slightly elevated
Avoid strenuous activity or bending forward for at least two weeks
Avoid blowing your nose for two weeks
Be gentle when dressing to avoid touching the nose
Use saline sprays to keep the nasal passages moist and clean

Most patients resume everyday activities after a couple of days, though strenuous exercise should be avoided for four to six weeks and contact sports should be postponed for at least eight weeks.

How soon will I notice improved breathing after septorhinoplasty?

Breathing often feels more restricted in the first one to two weeks due to swelling and any internal splints, so initial impressions can be misleading. Most patients notice a clear improvement in nasal airflow from around four to six weeks, once the internal swelling has substantially settled.

Is septorhinoplasty available on the NHS or through private medical insurance?

The septoplasty element, correcting the deviated septum for breathing purposes, may be considered for NHS funding if strict clinical criteria are met, though waiting times can be lengthy. Most private medical insurance policies will cover the functional septoplasty portion of the procedure if medically necessary, but not the cosmetic reshaping. Our team can help clarify what may be claimable.