By Dr Leow Aik Ming

The nose is a tripod structure consisting of nasal bones that form the side walls and a central structure separating the nose into the right and left side called nasal septum. Nasal septum can be deformed through injury, trauma, disease or sometimes a previous surgery. When the nasal septum is deformed or deviated, it can have significant consequences to the overall appearance and function of the nose.  A deviated septum can cause a blockage in the nose leading to breathing difficulties, chronic sinus infections, stagnating mucus, inflammation and irritation.

Septorhinoplasty is a surgical procedure performed to improve both the external appearance and internal breathing capabilities of the nose. The cosmetic benefits of septorhinoplasty are to improve the appearance of a crooked nose and shape of the nose thus creating a balance with other facial features. Some of its functional benefits may include relieving nasal blockages, snoring and sleep apnea.

During a septorhinoplasty, the internal lining of nose mucosa is first elevated from nasal septal cartilage and bone. The deviated septum caused by deformed nasal septal cartilage and bone can be removed or straightened. Sometimes the cartilage and bone can be reshaped. Additional cosmetic changes can also be carried out at the same time during septorhinoplasty which includes surgery for nasal dorsal or nasal tip. Once the procedure is accomplished, the mucosa lining is the laid back down and closed. Patient should be aware that septal cartilage has ‘memory’, sometimes the corrected nasal septum may tend to assume its initial shape after the surgery.

Postoperative expectations of septorhinoplasty

Patients are discharged with a cast over the nasal bridge and internal splints placed along the nasal septum. Occasionally, the nose may be packed to control nose bleeding. Recovering from septorhinoplasty usually takes about 7-14 days in most cases. The cast, splints and any external visible sutures are removed one week after 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 follow up are periodically scheduled for the year following surgery to ensure optimal healing.

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