Septorhinoplasty | Functional Nasal Surgery

Septorhinoplasty is performed to improve both the external appearance and internal breathing capabilities of the nose. Functional septorhinoplasty is among the most common procedures performed within the realm of Facial Plastic and Reconstructive Surgery. Improving nasal airflow remains the fundamental goal of the procedure. Whereas rhinoplasty surgery focuses exclusively on the shape of the nasal exterior, septorhinoplasty incorporates modification of the nasal septum (the midline partition dividing the nose into left and right breathing chambers) into the surgical plan. Cartilage safely obtained from the septum is precisely sculpted into structural grafts; these grafts are then incorporated into the nasal exterior framework to improve airflow. In the course of obtaining these grafts, an oftentimes “deviated septum” is simultaneously corrected.

Goals of Surgery

Form and function are inextricably linked during surgery, for the esthetically pleasing nose must also breathe well. Areas of functional concern that are successfully and commonly improved with functional septorhinoplasty include:

  • Correcting the “deviated septum”
  • Straightening the "crooked" nose
  • Augmenting the width of the nasal bridge
  • Augmenting the height of the nasal bridge
  • Supporting the “droopy” nasal tip
  • Supporting “floppy” nostril cartilages
  • Increasing nasal projection
  • Increasing the width of the nasal base
  • Improving nasal breathing

Pre-Surgical Consultation

During the pre-surgical consultation, a detailed examination and analysis of the nose is performed. Digital photographs of the nose are reviewed on our advanced computerized imaging software to facilitate communication of the changes desired and to illustrate the expected post-surgical outcomes. A comprehensive surgical plan customized to address each patient's cosmetic and functional concerns is ultimately developed and carefully explained.

Surgical Approaches

Dr. Dresner routinely performs Initial (primary) septorhinoplasty and revision procedures for patients who have had previous nasal surgery. There are two basic approaches, or methods, to surgically access the nasal framework. "Endonasal" approaches use incisions placed exclusively inside the nose. "Open" approaches also employ a small "gull wing" incision shaped like an upside-down letter "V" on the strip of skin in between the nostrils. The specific approach is determined for each individual patient by the techniques required to achieve the surgical goals discussed during the pre-surgical consultation.

Post-Surgical Course

Septorhinoplasty surgery is generally performed on an out-patient basis under either conscious sedation or general anesthesia. Patients are discharged with a cast over the nasal bridge and internal splints placed along the nasal septum. The nose is not formally "packed." A physician on our care team is always available to answer any post-surgical questions that may arise. The cast and splints are removed one week after surgery, along with any sutures placed during open approach surgery. Most patients return to work one week after surgery. Any bruising around the eyes that may occur typically resolves within two weeks post-operative. Swelling peaks two to three days after surgery and gradually subsides thereafter. An appreciable reduction in swelling is evident at one month, but the nose will continue to heal for a full year after surgery. Routine post-operative office visits are periodically scheduled for the year following surgery to ensure optimal healing.