Septoplasty is a common surgical procedure aimed at resolving breathing difficulties caused by an internal structural issue in the nose. Many people with a deviated septum also have a nose that appears crooked on the outside, which leads to the question of whether the procedure corrects the external appearance as well. The answer is nuanced, as septoplasty is primarily a functional operation, but its effect on a crooked nose depends entirely on the underlying anatomy.
The Primary Goal of Septoplasty
Septoplasty is fundamentally a reconstructive surgery focused on improving airflow through the nasal passages. The procedure targets the nasal septum, the wall of cartilage and bone separating the right and left sides of the nasal cavity. When this septum is significantly off-center, or “deviated,” it can obstruct one or both sides of the nose.
A deviated septum is a common issue that can lead to chronic nasal congestion, difficulty breathing, and problems like snoring. The core technique involves making an incision inside the nose to access the septum. The surgeon then carefully straightens, repositions, or removes portions of the bone and cartilage that are blocking the airway. This procedure is based purely on restoring proper nasal function by realigning the internal structure, meaning it is not classified as cosmetic surgery.
Separating Internal Deviation from External Crookedness
The distinction between the internal septum and the external nasal appearance is important in understanding the procedure’s results. A crooked nose, or external nasal deformity, is caused by a misalignment of the nasal bones or the external cartilage framework. These external structures are separate from the internal wall that septoplasty addresses.
Septoplasty is performed without significantly altering the nose’s outer shape, as incisions are usually made inside the nostrils. Therefore, if the external crookedness is caused by a problem with the bony pyramid or the upper cartilage, septoplasty alone will not correct it.
However, the septum can sometimes be so severely deviated that it pushes the entire external nose off-center, resulting in a visibly crooked nose. In these specific cases, straightening the septum internally can lead to a slight straightening of the external nose. This subtle cosmetic improvement is a secondary effect, not the primary goal of the septoplasty procedure.
When Septoplasty Alone Is Not Enough
For patients who require both improved breathing and a correction of their externally crooked nose, a more comprehensive procedure is necessary. If the external shape is the main concern, the required procedure is rhinoplasty, a cosmetic surgery designed to reshape the nose’s bone, cartilage, and soft tissues. Rhinoplasty addresses issues like a bump, a wide bridge, or a crooked appearance.
When a patient needs both the functional correction of a deviated septum and the cosmetic correction of a crooked external nose, surgeons combine the two operations into a single procedure called septorhinoplasty. Septorhinoplasty addresses internal breathing problems while simultaneously manipulating the external nasal framework to achieve a straighter profile.
The surgeon determines the appropriate procedure by assessing the patient’s anatomy and goals. Septoplasty is recommended if the goal is purely functional. Septorhinoplasty is typically recommended for cosmetic reasons or if complex external realignment is required.
What to Expect During Recovery
Recovery from nasal surgery involves a period of rest and healing. Immediately after the procedure, patients may have internal splints or soft packing inside the nose to support the newly repositioned septum. External splints or casts are common when the procedure includes external reshaping, as in a septorhinoplasty.
Initial downtime for a septoplasty is usually one to two weeks before returning to desk work or school. Swelling and bruising around the eyes and nose are expected, with most visible bruising diminishing within two weeks. Strenuous activity, such as heavy lifting or intense exercise, must be avoided for approximately three to four weeks to protect the healing structures.
While the initial recovery is relatively quick, the nose continues to heal internally over a longer period. Internal swelling can take several months to fully subside, and the final improvements in breathing may not be fully realized for up to three to six months. For procedures involving external reshaping, the final cosmetic results take longer, with subtle changes continuing for up to a full year.