Septoplasty

According To Dr. Shah | Chicago, IL

What Is Septoplasty?

Septoplasty is the alteration of the nasal septum to straighten the airway and/or remove cartilage for cartilage grafting. The nasal septum is a structure composed of cartilage in bone in the middle of your nose. Ideally, the septum divides the nose in half so that equal and symmetric airflow can occur. In 80% of the population, the septum is deviated, meaning a portion of the septum goes into the airway. One-third of those patients are symptomatic with signs such as mouth breathing with sleep, exercise, snoring, and a dry mouth. Patients often seek septoplasty to alleviate persistent symptoms affecting their quality of life, such as facial pain, nasal congestion, or nasal obstruction.

Septoplasty effectively addresses these issues by realigning the nasal structures, thereby enhancing the functionality of the nasal passages. This realignment not only reduces facial pain but also mitigates nasal congestion, which is often a result of the abnormal positioning of the nasal septum. In 80% of the population, the septum is deviated, meaning a portion of the septum goes into the airway. One-third of those patients are symptomatic with signs such as mouth breathing with sleep, exercise, snoring, and a dry mouth.

Why Opt for Septoplasty? Types of Septoplasty Potential Risks and Side Effects Recovery Process Frequently Asked Questions About Us

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Unlock Better Breathing with Septoplasty

Struggling with nasal blockages or breathing issues? Dr. Anil Shah offers professional Septoplasty in Chicago to resolve these problems. This procedure not only improves airflow but also enhances nasal structure, leading to better health and comfort.

Septoplasty is more than just a surgical procedure; it’s a path to improved quality of life. This process, expertly performed by Dr. Anil Shah in Chicago, corrects deviated nasal septums, ensuring better airflow and enhanced nasal symmetry. Patients experience significant relief from chronic nasal blockages, contributing to overall well-being.

Improved Airflow and Breathing

Septoplasty by Dr. Anil Shah efficiently corrects nasal blockages, ensuring smoother and more comfortable breathing.

Enhanced Nasal Structure

The procedure not only improves breathing but also aligns the nasal structure, resulting in a more balanced facial appearance.

Relief from Chronic Nasal Blockages

Patients experience lasting relief from discomfort caused by chronic nasal blockages, enhancing daily life and sleep quality.

Why Opt for Septoplasty?

Combatting Sinus Infections and Sleep Apnea

Under the care of Dr. Anil Shah, a leading nose surgeon in Chicago, septoplasty becomes a strategic choice for patients suffering from chronic sinus infections or sleep apnea. These conditions are frequently linked to issues within the nasal anatomy, such as a blocked nasal airway or swollen nasal passages. By rectifying these anatomical irregularities, septoplasty can play a significant role in reducing the occurrence of sinus infections and alleviating the symptoms of sleep apnea.

Enhancing Nasal Breathing and Airway Function

The primary goal of septoplasty, especially in Dr. Anil Shah’s practice, is to enhance nasal breathing and improve overall nasal airway function. Patients experiencing breathing difficulties, often caused by an internal nasal deformity or septal deviation, find relief post-septoplasty. The surgery meticulously corrects the degree of deviation in the septum, leading to improved airflow and better oxygen intake, crucial for overall health and well-being.

Types of Septoplasty

SMR Septoplasty

There are many variations of septoplasty techniques. Perhaps the most common form of nasal septoplasty is a submucous resection commonly called an SMR. This is where the surgeon removes a window of cartilage, presumably the deviated portion in an effort to correct the breathing, most typically preserving an L-shaped strut. Dr. Shah does not subscribe to this standard SMR incision because he believes it is too destabilizing to the nose. He performed a study demonstrating that certain areas of the nose are necessary for support and appearance. Many surgeons may not recognize this as most do not routinely take photographs of patients for septoplasty.

Standard SMR Incision (shown in red)

Dr. Shah Variant of Incision (shown in red)

Why is this concept flawed of SMR for every deviated septum? Simply removing the cartilage from the nose in this location will not correct the majority of septal deviations. Unfortunately, many surgeons use this as their approach to all septal deviations.

A well-thought-out approach to the location of the septal deviation is necessary. If it is located in the anterior portion of the nose, This deviation must be corrected or the patient will likely not have enough of an improvement postoperatively. Surgeons need to straighten the nose so that the portion responsible for the deviation is corrected.

An analogy that can help understand septal deviation is to think of the septum as a wood deck. The surgeon’s goal is to use a technique that is the least invasive to create a stable and straight deck. In some cases, this might mean removing a portion of the deck to try and straighten it. In other cases, it may involve trying to sand down a portion or using cables in an attempt to straighten it. Placement of stronger pieces of wood or steel may help straighten the deck as well. Finally, in some cases, removal of the entire deck and replacement with a new structure may be necessary.

There are a variety of procedures the surgeon can do to straighten this including a swinging door, modified swinging door, and total septal reconstruction, scoring, and placement of sutures.

Swinging Door Technique

A swinging door technique is where the anterior portion of the septum is crooked and the surgeon attempts to swing the septum from one side to the other. There are a few variations of this technique. In the most commonly used variation, the surgeon removes a segment of cartilage along the floor of the nose creating a gap along the floor. The surgeon then either tries to move the septum to the midline or the opposite side.

Dr. Shah believes that this is too destabilizing to the nose and advocates a variation of this technique. He suggests freeing the inferior portion of the septum from the floor of the nose and preserving the cartilage before swinging the cartilage to the opposite side. This allows for more support and less chance of loss of nasal tip support. While the swinging door technique can be powerful, it is best used in specific circumstances. This is when the anterior portion of the septum is straight and does not have a significant bend within the shape of the cartilage itself. If there is a prominent bend in the cartilage, the septal cartilage will retain this bend, and swinging the cartilage from one side to the other will not significantly improve the airway.

Cartilage Scoring and Suture Placement

Some surgeons use scoring and sutures to help straighten septal deviations. This may be appropriate in milder cases of deviation, but will not work in severe deviations. In our deck analogy, we can see that using procedures to weaken the septum must be due judiciously as it may interfere with structural support. Long-term use of sutures or absorbable plates such as PDS plating in straightening septums is not known. Structural, septal cartilage has a high resilience, and more often these techniques are not to be used in major structural deviations.

Use of Nasal Grafts

Sometimes, the placement of cartilage grafts alongside the septum can help straighten out a septal deviation. The concept here is similar to the warped deck where the placement of a stronger material is sutured to the weaker material. This may be strong enough to straighten the nose in cases where the septum has a stronger bend anteriorly or along the bridge of the nose. Such grafts include caudal extension grafts and spreader grafts. Dr. Shah uses a variety of grafts here to straighten the nose, many of which have not been described in the scientific literature to help straighten the nose.

Septal Cartilage

This is the ideal source of material for grafting on the face. Most surgeons with backgrounds in Otolaryngology prefer this graft due to their experience in performing septoplasty. The challenge in harvesting this graft is that the septum is covered by mucoperichondrium on both the left and right sides. The mucoperichondrium is highly fragile and a delicate technique is required to prevent perforation. In some cases, the nose has poor physiology which must be improved to allow the lining of the nose (mucoperichondrium) to improve and become stronger.

Surgeons harvesting septal cartilage do so by either an open rhinoplasty approach, kilian incision, or hemitransfixion incision. An open rhinoplasty approach allows the surgeon to widely separate the cartilage from the septum and can be useful in certain rhinoplasty operations and types of septal deviation. A kilian incision is an incision on the inside of the nose which is on the septum and is useful for deviation in the back of the nose. A hemitransfixion incision is where the incision is made closer to the caudal margin or anterior portion of the nose and allows better access to the anterior portion of the nose and can be used in both open and closed rhinoplasty.

Resection and Replacement

In cases of severe septal deviations, the septum may need to be resected and replaced. A new L-strut is created and placed in the nose. This is a more invasive procedure but may be necessary in select individuals with major septal deviations.

Before (left) and After (right) of a patient with crooked nose deformity
*Actual Patient

Intraop photographs of a patient with severe septal deviation (left) and with new L-strut (right)
*Actual Patient

Dr. Shah’s belief is to use the least invasive procedure to provide the straightest version of your nose. Dr. Shah frequently sees patients who have had a septoplasty in the past but still can not breathe well. This is why a thorough evaluation of both the anatomic and medical workup of the nose is necessary to help determine the cause of difficulty breathing.

Some quick background: Prior to my revision rhino/septoplasty with Dr. Anil Shah approximately 1 year ago, I had been modeling on a very infrequent level and got booked for only about a photoshoot a month, largely due to the huge amount of time I had to dedicate to contouring my nose before photoshoots and because I couldn't ever take shoots where I'd have to come in with a fresh face (no makeup). Today, I’ve been chosen to represent major brands (including from Microsoft and Mercedes-Benz) and average about 3-4 shoots/week, if not more.

Real Patient

Potential Risks and Side Effects of Septoplasty

Septoplasty carries certain risks, though they are generally rare:

Bleeding: A common risk post-surgery, usually manageable with minimal intervention.
Infection: Preventative measures are taken, but there’s a small risk of postoperative infection.
Adverse Reaction to Anesthesia: Preoperative assessments help minimize this risk.
Change in Sense of Smell: Rarely, patients may experience altered smell.
Nasal Septal Perforation: A rare complication that may require further treatment.
Nasal Appearance: Slight changes in appearance are possible, discussed beforehand.

Recovery Process Post-Septoplasty

The recovery period following septoplasty is crucial for ensuring the best possible outcome and minimizing complications. Dr. Anil Shah provides detailed postoperative care instructions, which typically include the following:

Rest and Activity

Patients are advised to rest with their heads elevated to reduce swelling. Strenuous activities, heavy lifting, and vigorous exercise should be avoided for several weeks post-surgery.

Managing Discomfort

Mild pain and discomfort are normal in the first few days following the surgery. Dr. Shah may prescribe pain medications or recommend over-the-counter pain relievers to manage this.

Nasal Care

To prevent dry nasal passages and promote healing, the use of nasal saline sprays and gentle cleaning of the nasal passages are often recommended.

Avoiding Nasal Trauma

Patients must be cautious to avoid any injury to the nose while it is healing. This includes avoiding blowing the nose vigorously and wearing glasses that rest on the bridge of the nose.

Follow-Up Visits

Regular follow-up appointments with Dr. Shah are essential to monitor the healing process and address any concerns promptly.

Septoplasty FAQ

In cases of severe septal deviations, the septum may need to be resected and replaced. A new L-strut is created and placed in the nose. This is a more invasive procedure but may be necessary for select individuals with major septal deviations.

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What is septoplasty?

Septoplasty is the alteration of the septum to straighten the airway and/or remove cartilage for cartilage grafting. The most common form of this is a submucous resection. This is where the surgeon preserves an L-shaped strut of cartilage to not change the nasal appearance. The surgeon then removes the cartilage which is presumably causing the nasal obstruction.

Why is this concept flawed?

Simply removing the cartilage from the nose in this location will not correct the majority of septal deviations. Unfortunately, many surgeons use this as their approach to all septal deviations. A well-thought-out approach to the location of the septal deviation is necessary. If it is located in the anterior portion of the nose, This deviation will be corrected or the patient will likely not have enough of an improvement postoperative. There are a variety of procedures the surgeon can do to straighten this including a swinging door, a modified swinging door, and a total septal reconstruction. Some surgeons use scoring and sutures. This may be appropriate in milder cases of deviation, but will not work in severe deviations. The most difficult area to address is if the dorsal (top) part of the septum deviates. Commonly spreader grafts can be placed aside the septum to attempt to straighten it. Sometimes, total septal reconstruction is necessary to straighten the septum. For this reason, many surgeons have difficulty with crooked nose deformities. Even if the septum is completely replaced, it still may be crooked postoperative.

I just want to breathe better, will my nose look the same after surgery?

Maybe. Dr. Shah just performed a study looking at nasal tip projection with septoplasty on cadavers. All of the noses lost projection after the completion of more advanced SMR techniques. It is critical that if your nose has an advanced septal deviation, an expert in external as well as internal support of the nose can perform the surgery. Your surgeon should be able to reestablish projection in case there is a noticeable change. If he can not, consider looking elsewhere.

In addition, if you require the support of the nasal valves, your nose will likely become slightly fuller alongside the nasal tip. Usually, this is temporary fullness, but in patients with sufficient collapse requiring larger grafts, this fullness may be permanent.

My plastic surgeon wants to use an ENT to do the septoplasty and he is going to do the rhinoplasty, any concerns?

Yes, you should be very concerned. If your rhinoplasty surgeon can not perform a septoplasty he can probably not be doing a rhinoplasty. The septum plays a fundamental role in rhinoplasty. The septum lays the foundation for the rest of your nose. You would not go to a builder who could not lay down a foundation. If your septum is crooked and not corrected properly (see above) you will be left with a crooked nose.

What are septal spurs?

Along the floor of the nose, there may be bony or cartilaginous projection into the nose which can cause nasal obstruction. These can be removed by a variety of methods to open the airway including osteotomies or powered instrumentation.

If my septum is crooked, how come I can’t see it?

You may or may not be able to see it depending on what portion is crooked. If the very anterior portion (front) of the surface is crooked, you may notice on the base view or the nasal tip with slight deviation. If the dorsal portion (top of the septum) is crooked, you may notice that the nose is crooked as well.

What is a septal deviation?

A septal deviation is a septum which obstructs the airway. It can be tilted to one side, curved to one side, curved and recurved.

Why do people have deviated septums?

No one really knows. Some people speculate that birth trauma plays a role. Trauma later in life can also lead to deviation. One study cites 80% of the adult population has a deviated septum. A deviated septum in and of itself is not a problem unless it causes nasal obstruction or deformity.

What does Dr Shah do with the cartilage he removes?

In some cases, he uses the cartilage for other areas of the nose or septum to support the nose. This can support the valves of the nose, provide aesthetic improvements, or help straighten the septum. If none of these changes are necessary, Dr. Shah will crush the cartilage and place it back in the septum. He does this for a variety of reasons. Cartilage in between the flaps can help prevent floppy septum syndrome. Cartilage placed back in the nose can serve a functional or aesthetic purpose if a procedure is needed in the future due to a traumatic accident.

Should I do my septoplasty at the same time or different time than my rhinoplasty?

Patients should always do a rhinoplasty and septoplasty at the same time. First of all, some of the deviated portions of cartilage can help support the nose post-procedure and make aesthetic changes to the nose. Not having this portion of cartilage, may make a subsequent rhinoplasty more complex and may necessitate the use of either ear or rib cartilage. In addition, a combination of the two procedures allows for one recovery. Finally, it is typically less costly to perform a rhinoplasty with a septoplasty with insurance than a rhinoplasty alone.

What septoplasty office is near me?

If you live near Chicago, IL, Anil Shah Facial Plastic Surgery offers septoplasty among its services and is conveniently located at 200 West Superior St., Suite 200 Chicago, IL 60654

About Us

Dr. Shah is a double board-certified facial plastic surgeon who has written over 50 scientific articles including three landmark articles about facial anatomy revolutionizing the way plastic surgery is performed. Dr. Shah specializes in Septoplasty and takes an analytical approach to patient recovery after the procedure. Based in Chicago, IL; Dr. Shah is not only recognized as one of the top plastics surgeons not only in the city of Chicago but in the world.