Septoplasty and Nose Aesthetics

Septum refers to the separating wall made of bone and cartilage between two nostrils. Septum creates two compartments within the nose and these compartments are supposed to be symmetrical so that the breathing is made with both nostrils. However, people might have deviated septum as a result of an external impact. Deviated septum causes asymmetry within the nose structure and nostrils.

A deviated septum can be present at the birth. But it can also be a result of an injury received on the nose. The deviated septum causes different problems for people. First problem is the lopsided space within nose structure. A person can have breathing problems as a result of a narrowed nasal passage on the one side. A narrowed nasal passage causes other problems than breathing such as snoring during sleep, bleeding in the nose, facial pain and even difficulty in speech. Correction of the septum structure, which is called as septoplasty in medical literature, is the only solution to solve all these problems. Septoplasty surgery basically aims at correcting nasal curvatures if the latter causes congestion in nose, difficulty in breathing via nose, snoring, frequent bleeding in nose, recurrent sinusitis complaints, discharge in nose frequently and headache complaints. In addition to the septum, the internal structures within nose such as “concha”, which is responsible for easy breathing and making the internal environment humid in nose, can grow and swell. As a result, many complications might arise such as allergy, difficulty in breathing.

There are several other causes of nasal obstruction such as allergies, polyps and turbinates – lengthy bone ridges and structures within the nose that continues until the nostrils. If turbinates are larger than the normal, it can congest the chambers within nose. Temporary solution for nasal obstruction or swelling in turbinates are relieving nasal sprays or sticky nasal strips.

Diagnosis of Septum Deviation

Doctor can easily detect the presence of septum deviation within the nose. He or she will perform nasal endoscopy, which entails placing a tube with a camera, to take the internal photo of the nose. The endoscopic examination is conducted also to view structures such as turbinate bone, posterior part of septum other parts, in order to monitor areas through where sinus canals lead into the nose. The endoscopic camera used in this procedure is 2.7 or 4 mm thick and there is little camera located on the top of the device. There is also possibility to perform a computed tomography (CT) scan to detect a bent cartilage, but it is a less common way. Both examination methods are easy, painless and tolerable by the patient. The examination usually lasts 1-2 minutes.

Doctor will detect a crooked septum rather than straight structure. The chambers within the nose, which are supposed to be equal and symmetrical, will be asymmetrical. As a result of a blocked compartment within nose, airflow will be hampered which causes many complications that can be corrected only through a surgery. Septum deviation can be a result of trauma or can develop within the mother’s womb. Hereditary factors can also take role in the occurrence of a crooked septum.

Septoplasty Surgery

The patients who are detected to have bent cartilage as a result of the causes mentioned above are required to undergo septum deviation surgery, also called as septoplasty. In this surgery, the bone tissues that obstruct proper inhalation through the nose are removed and the curved or bent cartilage structure is corrected. The remodeling of septum deviation and crooked bone tissue takes 30 to 90 minutes depending on the extent of the case. The procedure is performed under local or general anesthesia, which is also decided according to the complexity of the case.

After the surgery, the patients are not hospitalized in most of the cases and can be discharged in the same day. The doctors generally perform the surgery under the general anesthesia. Local anesthesia is also on the table for doctors, but it depends on the complexity of individual cases.

The surgery takes place entirely within the nose. The plastic surgeon makes an incision in a wall on one side of the nasal structure and elevates or gets rid of the mucosa, which is a thin substance that is located over the septum and protects it. By removing the mucosa, the surgeon will be able to change the shape of the septum bone and cartilage structure. In some cases, doctor might remove some bone parts and cartilage tissue. After the reshaping within the nose is done, doctor will place the mucosa back on the septum. So the surgeon would not do not reshape nose itself but intervenes in the internal structure of the nose.

If the structural issues in the cartilage are not operable only through internal intervention, the cartilage is reshaped also from the outside of the nose. The technique used in such cases is also called as “open technique.” In these cases, the curvature of the nose does not stem only from the inner parts of the nose. Septoplasty can also be performed together with rhinoplasty, which refers to the aesthetic operation to change the outer shape of the nose.

The plastic surgeon will place soft wads or splints to prevent bleeding, forestall wounding within nose and fix the position within the nose. The splints will stay up to two weeks but the soft wads will remain for three days at most. In some cases, doctor may only make dissolvable stiches within the nose, which will go away in the foreseen time.

Preparation for Septoplasty

Patient will be asked about his or her ongoing or past medication by the doctor. Besides medication, non-prescription drugs, supplementary items and herbs should also be known to doctor. The doctor will advise the patient to stop taking certain drugs such as ibuprofen, aspirin, naproxen and the drugs which cause blood thinning. The patient shall be asked about his or her allergies and bleeding issues. The break for ongoing medication should begin two weeks before the surgery.

After learning the medical history and medication of the patient, the doctor might take some radiographic visuals and views inside the nose. According to the collected data, the doctor will decide general or local anesthesia. General anesthesia has some advantages of over the local anesthesia regardless of the complexity of case. It gives comfort to patient and enables the doctor to perform the surgery smoothly.

The patient will be advised to not eat or drink anything after the midnight prior to the procedure if the surgery will be conducted under the general anesthesia. Otherwise the patient might vomit or choke during the sedation.

A family member or close friend had better accompany you before and after the surgery. It is due to fact that the patient might get drowsy or nauseated and would need someone to drive home safely. Before and after photos will be taken to compare the results with the original condition.

Eligibility Criteria for Septoplasty

First of all, there is a minimum age limit, which is 16-17 for girls and 17-18 for boys. It is required to wait until the puberty age because the cartilage and bone structure develop until that time. There is no upper age limit for septoplasty. In some exceptional situations, children can also undergo septoplasty. These cases are so extreme that a child might have serious inhaling problems through nose. In such cases, a child might have apnea or abnormal mouth-jaw-tooth growth. The surgical intervention in such cases will be performed carefully and only to required extent. The growing parts of the septum will not be intervened. In some of these cases, the second surgical procedure will be needed at the age of 17-18.

The septoplasty operation can be performed in all seasons but it is advised to conduct surgery when the patient do not have allergies. It is taken into account in the sense that some patient might have seasonal allergies. The patient that have extreme sensitivity to particular season(s) might have edema, bleeding and sneezing problems as a result of allergy.

Is There Any Risk of Septoplasty?

The complications and risks after septoplasty are not likely and rare. One risk is the failure of blood clotting during the surgery and excess bleeding as a result. This outcome would be the case if the patient had not stopped taking blood thinning medications prior to the surgery. In such rare situation, the doctor might decide to abort the septoplasty operation.

Infection might be another concern after the septoplasty surgery. This could be caused by lack of sterility in the nose. There could be more severe types of infection albeit being rare. The symptoms of infection are fluctuations in blood tension and heart rate, discoloring in skin and rise of body temperature. Doctor should be informed about these complications as soon as they are noticed.

Leakage in spinal column can be another rare complication associated with the septoplasty surgery. This might occur due to the proximity of the top of the septum to the skull. Since skull and brain is covered with a protective cerebrospinal fluid, there is slight risk of penetrating this protective layer. Meningitis, which is a severe health condition defined by the membrane inflammation on brain and spinal cord, could develop as a result of leakage in spinal column.

Hematoma could be seen after the surgery in exceptional cases. This condition is defined as the swelling triggered by blood clotting in tissue or a bag of purulence in body. There can also a rare development of numbness in above areas of teeth and lip or nose tip after the septoplasty surgery. That emanates from the over stretch or damaging of nerves leading to gums and teeth at the front. In most cases, this numbness will go away several weeks after the septoplasty surgery.

A hole in septum structure can be defined as a rare possibility after surgery. The hole in septum, which is also called as perforation, do not lead to syptoms, doctor would treat it as unnecessary issue. But if the perforation causes obstruction or crusting within the nose, the plastic surgeon might decide to perform another surgery to eliminate the perforation and place a synthetic substance on it.

Tasting and smelling functions as well as quality of voice might change after the septoplasty. The rare unwanted complications can be accompanied with uneven appearance on nose or the collapse of nose bridge. All these problems can be corrected with a second surgery.

The last potential but unlikely risk after septoplasty surgery is the lack of improvement in breathing. What some call as “memory of septum”, the septum might return back to original form despite the surgical intervention in such cases. However as mentioned before, the vast majority of the patients are content with the results of the septoplasty when it comes to breathing.

Aftermath of Septoplasty

Following the septoplasty operation, doctor will place wadding in nose which will remain 2 days on average. However, most recently doctors prefer to use simplified items to be used as packing. The new packing models are soft and easy to remove. Furthermore, plastic waddings are also used as packing in nose and they allow breathing thanks to hole in them. In some cases, doctors use dissolvable stiches and in such cases there won’t be need for tampons. The dissolvable stiches will go away for a while after surgery.

The patient should not have concerns about the surgical marks of swelling around the eyes after the surgery thanks to the use of nostrils. But the patient might feel some pain and tenderness on the frontal nose, a hard feeling on nose because of smelling and flow of mucus and blood in nose. The swelling will go away 2-3 days after the surgery. The flow of mucus and blow will cease 2-5 days after the procedure. Doctor will take precautions against these problems by prescribing painkillers. If the medication is not prescribed, the patient can take over the counter drugs for reliving pain. Saline sprays or similar treatments can effectively deal with the drainage and congestion in nose. But if the patient has tampons on nose, he or she ought to breathe through mouth before they are disposed. The patient will have normal breathing three months from the surgery at most.

If the operation was performed under general anesthesia, oral intake of food will start 4-6 hours after the surgery. In most of the cases, packing is inserted in nose to prevent bleeding and support the nose structure. Patient is required to breathe through nose for a while until the packing are removed. Patient might experience leakage of blood from nostrils or passages into mouth occasionally and it is quite normal. There could be a tolerable mild pain for a brief period. Patient should take painkillers at that moments as prescribed by the doctor. Doctor might also prescribe antibiotics if he sees necessary.

Daily Routine in Recovery Period

Healing process does not last for same period for all patients. It takes 1-4 weeks for patient to recover fully on average. However, most of the patients can resume their normal daily routine and office work.

The first meal of the patient after the operation should be warm and balanced. After the first day, patient will be free in his or her choice of food. Patient is recommended to sleep on slightly elevated pillow and lie on back during sleep. Doctor will also prescribe nasal sprays and cleansers to regularly wash nose. There is possibility of crust formation due to leakage of blood. It is recommended not to remove these dirt and crusts by hand as it will lead to bacterial infection. Patient is advised to stay in humid environment. Electronic air humidifiers are practical solution for patient.

It is warned against blowing nose until the 10th day mark. This will exacerbate bleeding and turn the clock back in recovery. While sneezing, beware of not closing mouth in order to avoid pressure within nose. Furthermore, it is risky for triggering of bleeding in nose. If there is frequent need for sneezing, then anti-allergic drugs are recommended. Strenuous exercise should be avoided until 30th day mark. When having a shower, the water should not be hot as it will facilitate bleeding in nose. Glasses can be worn during recovery period.

If patient notices the below indications, he or she should consult with doctor:

· Rise of body temperature above 38 degrees

· Recurrent bleeding despite all precautions taken by patient

· A reeking discharge from nose

· Chronic headache that is continuing unabated despite intake of painkillers

· Difficulty in respiration

· Feeling of dizziness and disorientation

· Stiffness on neck

· Feeling of chill

Recurrence of Deviation After Surgery

It is not likely to expect recurrence of deviation after the surgery, which was performed professionally. But if patient experiences a trauma or develops complications after surgery, then there is risk of recurrence of deviation. In the hands of an inept doctor, deviation can develop again due to appliance of incorrect techniques and lack of correct fixation.

Complicated cases of deviation such as deviation on nose tip or deviation accompanied with fractures; it is necessary to switch to more comprehensive surgery techniques such as open surgery. If patient has both deviation and a crooked nose, both septoplasty and rhinoplasty should be used. This major technique is also called as septorhinoplasty.

Nasal congestion might not stem from simple factors. They might stem from enlargement in turbinate bone, presence of polyp in nose or nasal valve stenosis. These extreme cases require utmost care to address and correct the root causes of deviation. If deviation occurs despite precaution taken by doctor and all the efforts, a second surgery will be required to attain the desired results.

Cost of Septoplasty in Turkey

The expenses made during septoplasty might go up if there are additional procedures performed simultaneously. More experienced doctors and reputable clinics tend to charge more for their medical services. The scope of clinic amenities also determines the overall cost of surgery.

However, Turkey retains a favorable position compared to other countries when it comes to getting good value for money. The living standards are fairly affordable which makes secondary expenses of medical treatment cheaper than alternatives abroad. Turkish clinics also enjoy good reputation with the renowned aesthetic surgeons and high-tech capabilities. Foreign patients can also get an all-inclusive package for their treatment in Turkey. This package will include flight, transfers, accommodation, treatment, medication and translation services. The overall cost of septoplasty in Turkey is illustrated below:

Septoplasty Cost in Turkey (Price, Duration Time, Hospitalization)

Operation Session 1

Duration for Return to Work 3 weeks

Surgery Duraiton 30-90 minutes

Senstitivy Duration 3-4 weeks

Sedation General Anesthesia

Continuance of Results Lifetime

Recovery Period 3-4 weeks

Hospitalization Not Required

Cost in $ 1600

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