Septorhinoplasty in KPHB, Hyderabad

The operation is done while you are fully asleep (general anaesthetic). It takes one and a half to three hours. It is usually done through the nostrils, with no cut on the outside. Most patients go home the same day, with a small splint on the bridge of the nose. The stay is at Sinocare ENT Hospital, or at an associated hospital where an overnight bed is wiser. You are told which at the first visit. The splint comes off at about a week. Desk work at about ten days. The shape settles over months, with the tip last.

• A nose broken in an injury that healed crooked, with blockage on one or both sides
• Breathing that got little better after an earlier septoplasty, because the problem is at the nasal valve, not the septum
• A nose that is visibly bent and also truly blocked
• A nose that has fallen in or is pinched after earlier surgery
• A sunken (saddle) or twisted nose from an injury or long-standing septum disease

If the nose is straight, you breathe well and the wish is only about looks, that is cosmetic surgery. It should be talked about as that, not presented as a breathing operation. Being clear about which one you are having protects you.

The septum is straightened first. It often gives the cartilage used to rebuild other parts of the same nose. The nose bones may be moved back into place. Small pieces of your own cartilage (grafts) support the nasal valve. The valve is the narrowest part of the airway. It is also the part that most often stays blocked after a septoplasty alone.

Closed approach, the usual way here: everything through the nostrils, no scar on the outside. Open approach, for complex or repeat work: a small cut across the strip of skin between the nostrils (the columella), giving a direct view. Once healed, the scar is very hard to see.

One and a half to three hours, while you are fully asleep. A splint sits on the nose for about a week.

• A camera test of the nose (nasal endoscopy), and a check of the nasal valve. The valve is checked with the nose at rest, and during a deep breath in.
• Photographs from standard angles, for planning the surgery, stored with your consent
• A CT where sinus disease or an old break needs mapping
• A frank talk about what can be done for your nose, in your skin, with your cartilage. It is not built around other people’s results.
• Stop smoking. Skin and cartilage in the nose really do heal worse in smokers, and this is one of the operations where it shows.

First week. A splint outside, splints or a light dressing inside, breathing through the mouth, and swelling. Bruising around the eyes is expected when the nose bones have been worked on. It is worst at about day three.

Day 7 to 10. The splint and stitches come off. The nose looks swollen and a little turned up. This is not the result.

Weeks two to six. The bruising clears. Breathing gets better in stages. Glasses must be kept off the bridge of the nose, or held up, for as long as advised. No contact sport.

Three to twelve months. Swelling in the tip settles last and slowest. The final shape is judged at around a year. Anyone who says the result is final at six weeks is describing the swelling.

• The result is not exactly what you pictured. Surgery on a nose is a give-and-take with your own tissue. The shape that can be reached is limited by your skin thickness, your cartilage and how you happen to heal. No surgeon can promise you an outcome, and it is a firm rule of this practice not to. The planning session on your own photographs is where expectations are set.
• A repeat operation. A fair share of rhinoplasty patients think about one in time, and it is harder than the first operation.
• Blockage that stays, or new blockage, if the valve is not well supported or scarring forms. Supporting the valve with cartilage grafts is the main guard against it.
• Bleeding, infection, or a hole through the septum (perforation), as with septoplasty, and managed the same way.
• Numbness of the tip of the nose and the upper teeth, usually settling over months.
• Small bumps you can feel or see under the skin as the swelling goes down. Small ones are common, and most settle.
• Swelling that lasts longer, above all in thicker skin.