Nasal surgery provides two basic benefits to patients:
improved appearance and/or improved nasal function.

The nose consists of two basic components: bone and cartilage. The bone supports the upper part of the nose, while the lower part of the nose is supported by cartilage. Inside of the nose is a hollow cavity, or the nasal cavity. The nasal cavity is divided into two sections or passages by the septum. The nasal septum is the part that divides the nose.

When considering nasal surgery, doctors and patients must consider both the appearance and function of the nose. If the size of the nose is reduced to improve its appearance, the function of the nose may also be changed. The size of the breathing passages is sometimes reduced when the size of the nose is altered. Each case must be considered independently based upon the internal structure of the nose.

Function & Problems:
Function: Several factors can impact nasal function. Some of these factors include allergies, deviated septum, mucosal swelling, enlarged turbinates, polyps, and structural problems. Any one of the items above can impact an individual's ability to breathe, sleep, or conduct daily activities. Some of the factors may also contribute to headaches.

Mucosal swelling: The interior lining of the nose is swollen and enlarged. Allergies are the main culprit for causing this swelling. Deviated septum: With a deviated septum, the cartilage dividing the nose is crooked. The crooked cartilage can interfere with breathing and draining of the sinuses. In many cases surgery is recommended to correct the septum, and improve breathing. This surgery is called Septoplasty. When the septum interferes with either of the nasal cavities, Septoplasty is usually recommended.

The Surgery:
With Septoplasty, some type of anesthesia will be needed. You will be adviced as to which type of anesthesia is recommended for the surgery: local anesthesia or general anesthesia.

Local Anesthesia: With local anesthesia, the patient is awake during the surgery. The nose and the area surrounding the nose will be numb. Sedatives are usually provided before and during the operation to help patients relax. In order to numb and shrink the mucosal lining of the nose, liquid medication is spread inside the nose. The patient may also receive an injection of local anesthetic to close off the nerves surrounding the nose. However, it is important to note that with the local anesthesia, the patient will be able to hear tapping and grinding sounds throughout the entire operation.

General Anesthesia: General anesthesia puts the entire body asleep. The patient will be unable to feel, hear, or see anything throughout the operation. Usually an injection placed into the vein to put the patient to sleep. Additional medication can be provided though an IV tube for people to tend to have upset stomachs after general anesthesia is performed. The medicine may be able to prevent vomiting after the operation.

In addition to the IV tube, a tube may be put into the mouth to provide oxygen to the patient and ensure the airway is clear. The tube sometimes causes a soar throat after the surgery. General anesthesia is usually more expensive than local anesthesia. Some insurance providers only cover local anesthesia for certain operations.

Location:
Usually Septoplasty is performed in a hospital or surgicenter. Surgicenters, or outpatient surgery centers, are used when patients are in and out of the facility the same day. In some cases, procedures are performed in the doctor's office. However, when anesthesia is involved, hospitals and surgicenters are recommended.

Preparation:
The doctor should be informed of any previous injury or surgery to the nose, allergies, or breathing problems.
IMPORTANT: Also inform the doctor of any medications, vitamins, or drugs being taken (including smoking). This includes herbal or natural remedies, too.

To prevent scarring, the patient may be asked to cease smoking two weeks before and after the operation. Aspirin, and other blood thinners, should not be taken for two weeks before and after the operation. A driver should be arranged to provide transportation to and from the surgery. Someone should be available to stay with the patient for 48 hours after the surgery to help with day to day activities and watch for complications.

Incision & Surgery:
Incisions for Septoplasty are usually made on the inside of the nose. The incision provides access to the bone and cartilage, while maintaining the delicate mucosal lining of the nose. The internal incision also prevents scarring. Some surgeons utilize an "open" technique, where a small incision is make across the base of the nose known as the "columella." The columella is the vertical strip of tissue that separates the nostrils. This "open" procedure may result in a small scar on the underside of the nose.
After the incision, the mucosal lining of the nose is then elevated, and the surgeon can work on reshaping the bone and septum.
Septal cartilage and bone is trimmed to improve the deviation of the septum. The deviated portion of the septum may be partially removed. A portion of the septum must be kept in order to maintain the outside appearance of the nose.
Depending on the complexity of the operation, the surgery should be complete in about two hours.

Packing & Medication:
Packing: After the operation, packing is placed into both nostrils. The packing provides two functions. It acts as a splint, keeping the septum and mucosal lining in place, and it reduces bleeding and possible internal scarring. The patient will need to breathe out of the mouth while packing is in place.

Packing used to be an unpleasant experience. There have been some improvements made to the yards of material stuffed inside of the nose. Plugs are now available that work something like tampons. Although still unpleasant while the packing is inside the nose, the plugs make removal a better experience because each plug is removed with one swift tug. Some discomfort will be experienced upon the removal of the packing. The packing is usually removed within a week of the surgery.

Medication: The surgeon may provide pain medication after the operation. Decongestants may also be prescribed to reduce internal swelling. The tip of the nose will feel some discomfort for weeks after the surgery. In addition, the nose may ache for a period of time after the surgery (usually a few days to a week). Some patients also experience headaches after surgery.

After the Surgery:
Patients will experience swelling of the eyes, nose, and sometimes face after the operation. If the bone was broken, some discoloration of the eyes may occur. Some discomfort will be experienced within the nose.

Many patients feel like needles are pricking the end of the nose, and some patients experience a dull ache in the nose. Swelling and bruising around the face may become worse a few days after the operation, but should be gone within two weeks. Cold compresses should be applied frequently for 20 minute periods. Some minute swelling may remain for a few months.

The patient's nose will bleed for a few days after the operation. In addition to the packing, most people wear a drip pad under the nose for a few days. An external splint may also be used to keep the bones and cartilage in place during the initial healing process.
For the first few days after the operation, the patient should plan on remaining in bed with the head in an elevated position.
Throughout the first two weeks after surgery, the individual should not take part in any physical or strenuous activity, especially bending or lifting. In addition, care should be taken not to bump the nose for a few months after the surgery. Any trauma to the nose could have an adverse effect on the healing process.

Care should also be taken in wearing glasses after surgery. In some cases, glasses may need to be taped to the forehead or cheeks to allow the nose to heal.

It is very important to stay out of the sun for two months after the surgery.  In some cases, the skin of the nose is parted from the bone and septum. The skin is then re-draped over the "new nose." This may cause the nose to peel after the surgery. Care should be taken with the new, sensitive layer of skin. Any exposure to the sun could cause scarring.

Also, many surgeons ask people not to blow their nose or sneeze out of their nose for the first few weeks to avoid damaging the internal tissue of the nose.

Compression techniques:
Sometimes compression exercises are recommended to help reduce swelling and keep the "narrow appearance" of the nose. With compression exercises, the patient sits in from of a mirror and presses the nasal bones together with the index fingers. The "pressing" should be held for a minute at a time, and should be conducted several times a day.

Compression exercises may also be needed to keep cartilage from going back to its former crooked state. Because the entire cartilage can not be removed, the remaining cartilage tends to want to go back to its former position during the healing process. In these cases, individuals are asked to push the cartilage of the nose to the opposite side it wants to bend. These exercises last from 30 seconds to one minute per session, and should be completed at least 10 times a day for the first month. The duration and frequency may be different with each person.

Back to Work:
Most people can go back to work one to two weeks after surgery. It will take several weeks before normal activity can be resumed, and the patient feels like himself or herself.