Septorhinoplasty

What is a septorhinoplasty?

A septorhinoplasty (or ‘nose job’) is an operation to improve the appearance of your nose (rhinoplasty) and to improve how you breathe through your nose (septoplasty).

It involves operating on the bones and cartilage that give your nose its shape and structure and making your septum straight. The septum is the cartilage and bone inside your nose that separates your nostrils.

What are the benefits of surgery?

Your nose should be the size and shape you want, and you should be able to breathe through both nostrils.

Most people who have a successful septorhinoplasty are more comfortable with their appearance.

Are there any alternatives to a septorhinoplasty?

If you have a blocked nose caused by a deviated septum, you may be able to have only a septoplasty.

A rhinoplasty is the only way to change the appearance of your nose. If you have a blocked nose because your nasal bones are crooked or damaged, a rhinoplasty (usually along with a septoplasty) is the only option to improve the way you breathe.

What does the operation involve?

The operation is almost always performed under a general anaesthetic. The operation usually takes 1 to 2 hours.

Your surgeon will make a cut on the mucosa (the skin-like lining of the inside of your nose) and lift it off the cartilage and bone. They will remove the parts of the cartilage and bone that are bent and they will put the rest back in a straight position.

Your surgeon can refine the tip of your nose by removing some of the cartilage. If you have a hump (dorsum) on your nose, they will shave it down.

Your surgeon can also straighten and narrow the nasal bones by breaking and then setting them (infracture).

Your surgeon may need to support or rebuild part of your nose using a cartilage graft, a bone graft or an artificial implant.

Your surgeon may pack the inside of your nose to prevent bleeding, and place a splint and strapping on the outside of your nose for support.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Smoking stops your nose clearing mucus properly and this can increase the feeling of a blocked nose.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight. Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• venous thromboembolism (VTE)
• chest infection

Specific complications of this operation

• adhesions, where scar tissue forms deep inside your nose and can obstruct airflow
• bleeding caused by infection
• unsightly scarring of your skin
• developing a collection of blood (haematoma) or an abscess between the layers of your septum
• damage to nerves that supply the skin at the tip of your nose
• nasal obstruction
• making a hole in your septum
• toxic shock syndrome, which is an infection of your bloodstream
• cosmetic problems
• problems at the donor site
• graft rejection
• reduced sense of smell
• Watery eye

Consequences of this procedure

• pain
• redness
• bruising and swelling of your nose and under your eyes

How soon will I recover?

You should be able to go home the same day.

If you had some packing in your nose, it will usually be removed the next morning.

You will need to stay off work and away from groups of people for 2 weeks. This is to avoid catching a cold, which could result in an infection.

Your surgeon will remove the splint and strapping after a week.

Do not exercise, have a hot bath or bend down for 2 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

It can take many months for your nose to settle and for the final appearance to develop.