Septoplasty is a common surgical procedure performed to correct a deviated septum, a condition where the thin wall separating the nasal passages is displaced. This structural issue often obstructs breathing, leading to chronic congestion or difficulty inhaling properly. The surgery is designed to restore normal airflow and improve respiratory function.
The Functional Goal of Septoplasty
A deviated septum occurs when the nasal septum—made of cartilage and bone—is shifted away from the midline. This deviation narrows nasal passages, interfering with the movement of air. Symptoms often include snoring, facial pain, frequent sinus infections, and chronic nasal obstruction.
The surgical objective of septoplasty is functional: to straighten this wall to open the airway. Surgeons access the septum through the nostrils, making incisions inside the nasal cavity to lift the mucosal lining. They trim, reposition, or reshape the crooked cartilage and bone to create a straight central partition.
Once structural repositioning is complete, the mucosal lining is laid back over the straightened septum and secured. This process is confined to the internal structures of the nose, addressing the underlying cause of breathing obstruction without altering the external nasal framework.
Septoplasty and Changes to Nasal Appearance
The primary concern for many patients is whether a stand-alone septoplasty will alter the external appearance of the nose, making it appear bigger or wider. A pure septoplasty is an internal operation and does not typically change external dimensions, such as width, projection, or height. The surgeon works exclusively on the internal dividing wall, leaving the external nasal bones and overlying soft tissues undisturbed.
The bony and cartilaginous framework that defines the external shape of the nose—including the bridge and lateral nasal walls—remains intact during a standard functional septoplasty. Since the procedure does not involve fracturing nasal bones or removing tissue from the outer structure, there is no mechanism for permanent external size alteration. Modifications are restricted to the internal lining and supporting structures necessary for airflow correction.
The misconception that the nose appears larger immediately after surgery is due to post-operative edema, or swelling. This temporary inflammatory response is a natural part of the healing process, sometimes giving the impression of increased size. This swelling is not a permanent structural change.
Initial swelling subsides significantly within the first few weeks following the procedure, though residual swelling can take several months to fully resolve. As this temporary edema dissipates, the nose returns to its pre-operative external dimensions, confirming that septoplasty did not result in a lasting increase in size.
Understanding Septorhinoplasty
Confusion often arises because septoplasty is frequently performed concurrently with rhinoplasty, a procedure that does change the nose’s external shape. When combined, the procedure is termed septorhinoplasty. This surgery addresses both functional impairment caused by a deviated septum and aesthetic concerns regarding external appearance.
Rhinoplasty is the component of the surgery designed for cosmetic alteration, allowing the surgeon to modify the size, shape, and contours of the nose. This can involve reducing a dorsal hump, narrowing the bridge, or refining the nasal tip. Unlike a pure septoplasty, rhinoplasty involves manipulating the external bony and cartilaginous framework.
A surgeon might recommend septorhinoplasty if the patient has both a significant breathing obstruction and a desire for aesthetic improvement. In complex cases, a patient’s deviated septum might be so severe that structurally correcting it to improve breathing necessitates simultaneous manipulation of the external nasal pyramid for stability or symmetry. This is a deliberate choice to change the appearance, not an accidental outcome of functional correction alone.
Understanding the distinction is important. Septoplasty corrects internal function, while rhinoplasty is responsible for any external cosmetic changes, including making the nose appear smaller, larger, or reshaped.