Septorhinoplasty: what is it, what can it change

This is the seventh step of your 8 part journey into the exclusive guide on rhinoplasty types.

Septorhinoplasty is a surgical operation that brings together septoplasty and rhinoplasty. It is an opportunity that is too good to miss for people who seek to improve both their breathing quality and their appearance

After reading this article, you will have all the information you need to know before going into the surgery such as the benefits of getting a septorhinoplasty, the techniques used during the operation, the complications and risks that are likely to happen, and how to avoid them. 

What is septorhinoplasty?

Septorhinoplasty is a dual-purpose operation that encompasses both septoplasty and rhinoplasty. Septorhinoplasty is performed in patients who want to enhance their breathing function and the appearance of their nose at the same time. Problems with the nasal structure that are caused by an injury or that are present since birth can also be treated by septorhinoplasty.

During the surgery, surgeons operate on the bones and cartilage which give your nose its shape and structure. A damaged septum is what causes breathing problems and an unbalanced facial appearance likewise. In order to tackle these issues, surgeons have many options in their armamentarium.

What can septorhinoplasty change?

In a septorhinoplasty operation, the main goal is to better your breathing performance in a way that also improves your appearance. Surgeons accomplish this by:

  • Correcting the deviated septum, which is the wall between the nostrils
  • Modifying the size and contour of the nose
  • Reconstructing the nose to improve facial symmetry and balance.

Can septorhinoplasty affect the voice?

According to the latest findings, the answer appears to be yes. After a nose job, voice quality alterations are likely to happen. Even subtle changes can be detected by the trained ear (1). However, these alterations do not typically appear to interfere with patients’ daily lives.

Nonetheless, for people who depend on their voice for work-related reasons, the surgeon should address these changes with the patient beforehand and take more conservative surgical operations into consideration.

The pros of combining septoplasty and rhinoplasty

Septorhinoplasty has many benefits for patients. Since it is a mix of two types of procedures, we can say that the benefits septorhinoplasty has to offer to the patients are doubled.

  • You will get to enhance your looks and your well-being in a single operation.
  • You will be able to fix many of your facial inconveniences like a deviated septum, nasal swellings, or birth defects that are preventing you from breathing properly.
  • Septorhinoplasty can also be used to treat other related issues such as snoring and sleep apnea.
  • Septorhinoplasty saves you money since it is a two-birds-with-one-stone procedure, you will not need to pay for a septoplasty and a rhinoplasty separately.
  • From a psychological point of view, septorhinoplasty is a great opportunity to boost your self-confidence.

What are the risks and complications of septorhinoplasty?

For the majority of patients, septorhinoplasty is a safe treatment with positive results. However, the results of a septorhinoplasty can be uncertain, and the treatment itself can be challenging sometimes. 

Here are some potential risks that you should look out for:

Nosebleeds: Mild nosebleeds during the first week after surgery are always a possibility. Sitting upright and using ice packs will help you reduce the bleeding. However, if bleeding does not cease after the first week, you should see your doctor immediately. 

Infection: Infections are not very common among rhinoplasty patients. They are the results of blood clots and grafting materials within the tissues.

Weakening of the nasal septum: Chances of suffering from a septal perforation, which means a hole in the septum, is weak. Usually, a perforation doesn’t exhibit major symptoms. However, you may experience whistling, bleeding, or a sensation of nasal blockage to a certain degree.

Negative reaction to anesthesia: Some patients may display a negative reaction to general anesthesia with respect to their health condition. The pre-operative consultation is essential to avoid any kind of complications related to this.

Temporary numbness: Temporary numbness is a common complication patients go through after a nose job operation. Numbness occurs when the main nerve is damaged during the surgery. Fortunately, the numbness is likely to wear off in a year.

Can a septorhinoplasty cause breathing problems?

No, septorhinoplasty cannot make any breathing problems, in fact, one of the goals of the surgery is to fix any functional problem. Septorhinoplasty offers you to have an aesthetically pleasing and functionally working nose.

Who is a good candidate for septorhinoplasty?

If you are planning to get a septoplasty because you are having a hard time breathing, then you should consider yourself a fitting candidate for a septorhinoplasty as well.

The reason why you are struggling with breathing might be the fact that you have a deviated septum. In this case, a septoplasty may be required. A rhinoplasty, on the other hand, is used in such cases as a drooping nose tip, thick nasal skin, a bump on the nose bridge, and a broken nose to improve the appearance of your nose.

Should I consider septorhinoplasty?

As we mentioned earlier, people who have breathing problems and seeking to improve the appearance of their nose at the same time should use the opportunity of getting a septorhinoplasty. In addition to these, unmanageable nosebleeds and excessive snoring can be important signs of septorhinoplasty.

However, there are some things you need to take into consideration before you rush into a nose surgeon’s office:

  1. Health condition

  2. Smoking status

  3. Your expectations

What should I look for when choosing a surgeon for septorhinoplasty

We know finding the right person is never easy, whether in life or in rhinoplasty. But luckily, we can help you find the right surgeon for you so that your nose will be in safe hands. Here are the most decisive factors that you should look for in a surgeon: 

Experience

When selecting a surgeon for septorhinoplasty, it is important to seek a surgeon who has experience performing septorhinoplasty procedures. By taking the time to research and ask about their success rate, and complication rate, you can increase your chances of achieving a successful outcome and feeling confident in your decision.

Before and After Photos

During the evaluation, your surgeon should take photos of your nose from multiple angles to analyze the structure of your nose. This gives him/her an idea about the problem you have with your nose and the techniques that should be used during the operation.

Pictures of Previous Patients

A surgeon’s history of success can be helpful before undergoing the surgery. You might want to look through some of the pictures of previous patients that are taken before and after their surgery. This way, you can see for yourself what to expect from this particular surgeon.

Personal comfort

Every patient has different needs and treatments. Thus, your surgeon should pay attention to your surgery and recovery process on a personal level.

Lastly, a surgeon’s office should have a comforting appearance and energy. You should make sure that they have enough facilities to meet your expectations.

How should I prepare for a septorhinoplasty surgery?

Before a septoplasty and rhinoplasty surgery, you will be asked to do a few things to ensure that you are able to undergo such a surgery.

First of all, you will be taking pre-assessment medical tests for general health and your suitability for anesthetic agents.

Then your doctor will take photos of your nose. This will help the doctor better analyze your nose’s anatomy and provide you with the necessary treatment. 

And finally, if you smoke, you will be asked to stop smoking two weeks before the surgery.

How does the surgery work?

A standard septorhinoplasty procedure takes two or four hours to complete and general anesthesia is preferred after the patient’s health condition is evaluated.

Most surgeons usually utilize the open technique which makes it easier to operate on the internal parts. In this approach, a little cut is made across the columella, the lower part between the nostrils. And then the surgeon makes further incisions inside the nostrils and the skin is raised off of the supporting cartilage and bones.

The surgeon can then perform surgery on the bones and cartilages to alter the shape of the nose. If necessary, your surgeon can take cartilage from different body parts for better support. The wound is then stitched up, and gauze is placed into the nostrils to cease the bleeding.

Recovery from septorhinoplasty

Knowing what to expect after a rhinoplasty and septoplasty operation can be crucial before undergoing the surgery. It will make your decision-making process easier and healthier. It will also provide you with some invaluable tips for a successful recovery period.

Let’s talk about what you should expect during the time of recovery.

If you had a successful surgery, you should walk out of the hospital on foot by yourself, but you may have to find someone to drive you home since you won’t be able to drive yourself yet. You may feel free to get back to your normal life after two days, but with some caution, of course. However, you should consult your doctor before you start working again.

For the first two or three days, you will feel some amount of pain around your nose and headaches; you will also experience swelling and bruising around the eyes. These swellings can make your nose look bigger and make it feel numb, and it can take several weeks to heal. Your doctor will prescribe the necessary medications to reduce these pains and swelling. Also, sleeping with your head elevated and applying a cold press will make you feel better.

After the surgery, you may experience numbness and changes in sensation on your face, but this will improve over time. You’ll notice blood crusts in your nose, which your doctor will clear with nasal douches. Drainage and stuffiness are normal for a few weeks. Nasal packing may be used but will be removed after a few days, while other dressings will be removed by your surgeon after one or two weeks.

Tips for a successful recovery

Patients’ aftercare is as important as the success of the surgery. The outcomes of a successful operation can easily be spoiled due to a patient’s negligence. Here are some important tips to avoid any serious complications and have a successful recovery period.

  • Hot food and drinks can cause bleeding. Stay away from them.
  • Do not take showers, take baths. And do not use hot water since it can cause bleeding.
  • Avoid blowing your nose for the first two days. After your doctor’s permission, you may blow your nose gently one side at a time.
  • Do not lift anything heavy.
  • Sneeze with your mouth open.
  • Do not touch your incisions.
  • Stay away from areas where there is smoking and people with colds and flu.
  • Keep your plaster dressings dry.
  • The skin of your nose will grow a sensitivity to the sun. Always wear sunscreens in the first year.
  • Stay away from strenuous activity.

What to do if complications arise

Because it is operated on a very fragile part of the face, septorhinoplasty surgery always carries the risk of complications. If you experience any of the following indications, you should reach out to your doctor.

  • Severe pain despite the medications
  • High temperature
  • Infections

References:

(1) Bakhshaee M, Jahanian M, Khazaeni K, Sobhani D, Mashhadi L, Rasoulian B. Potential Effects of Rhinoplasty on Voice in Professional Voice Users. Aesthetic Plast Surg. 2021 Oct;45(5):2280-2286. doi: 10.1007/s00266-021-02250-2. Epub 2021 Apr 19. PMID: 33876285. Link

(2) Chisholm E, Jallali N. Rhinoplasty and septorhinoplasty outcome evaluation. Ear Nose Throat J. 2012 Mar;91(3):E10-4. doi: 10.1177/014556131209100315. PMID: 22430341. Link

-Sasindran V, Harikrishan B, Mathew N. Cosmetic and Functional Outcomes of Septorhinoplasty. Indian J Otolaryngol Head Neck Surg. 2020 Jun;72(2):194-199. doi: 10.1007/s12070-019-01756-1. Epub 2019 Nov 5. PMID: 32551277; PMCID: PMC7276476. Link

-Kokubo LCP, Carvalho TBO, Fornazieri MA, Gomes EMC, Alves CMF, Sampaio ALL. Effects of septorhinoplasty on smell perception. Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1247-1250. doi: 10.1007/s00405-019-05356-1. Epub 2019 Feb 26. PMID: 30806808. Link

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