Nasal airway surgery with Dr. Henry Sandel
Septoplasty
Septoplasty straightens the wall of cartilage and bone that divides your nasal passages. It is done to improve breathing, not to change how the nose looks.
At a glance
Surgeon
Dr. Henry Sandel
Purpose
Improve nasal breathing
Basis
Typically outpatient
Incisions
Inside the nose
External change
None on its own
Congestion
One to two weeks
Insurance
Out-of-network; may reimburse
Why septoplasty is recommended
The septum is the partition of cartilage and bone between the left and right nasal passages. Some degree of deviation is very common and most people never notice it. It matters when the deviation narrows a passage enough to obstruct airflow, and when that obstruction has not responded to medical treatment.
Chronic congestion, often worse on one side
Difficulty breathing through the nose, particularly at night
Mouth breathing or disrupted sleep
Recurrent sinus pressure or infections
Nosebleeds from a dry, exposed septum
Obstruction that began after a broken nose
Septoplasty is internal work. The incisions are inside the nose and the external shape is left alone. When the appearance of the nose is also a concern, the two can be performed together as a septorhinoplasty.
Who is a good candidate?
You may be a candidate if nasal obstruction is affecting your breathing or sleep and medical treatment has not been enough.
Symptoms not relieved by sprays, antihistamines, or allergy treatment
In good overall health
A non-smoker, or willing to stop nicotine use as directed
Clear that the goal is breathing rather than appearance
Interested in addressing shape at the same time, if that also applies
Dr. Sandel’s approach
A septoplasty that improves breathing but weakens the nose is not a good outcome. Enough cartilage and bone has to stay behind to hold the shape of the nose over the long term.
Insurance
Insurance does not cover surgery to change the appearance of the nose, but typically does cover treatment that is medically necessary. Dr. Sandel is an out-of-network provider, so where your plan offers out-of-network benefits, you would be reimbursed by your insurer directly. We provide the medical notes, procedure codes, and diagnostic codes to support that claim.
What the surgery may involve
Depending on the anatomy, septoplasty may involve:
Incisions placed inside the nose, leaving no external scars
Lifting the lining away from the deviated cartilage and bone
Straightening, trimming, or repositioning the deviated portion
Preserving enough cartilage and bone to keep the nose supported
Reducing enlarged turbinates when they also contribute
Repairing nasal valve collapse when it is present as well
Recovery
Septoplasty is typically performed as an outpatient procedure. Expect congestion before you expect improvement — the passages swell before they settle.
Congestion and stuffiness through roughly the first one to two weeks
No nose blowing for the period you are given
Saline rinses to keep the passages clear
Desk-based work usually resumes within about a week
Strenuous activity held for roughly two weeks
Breathing continuing to improve as internal swelling resolves
The early congestion is swelling, not a sign that the surgery did not work. Most patients judge the result some weeks out, once the lining has settled.
Recovery
A congested fortnight, then clear breathing.
Septoplasty heals from the inside, so the first two weeks feel worse than they look. The congestion and crusting are the healing, not a complication.
This is the guidance we give every patient, alongside the general instructions that follow any surgery. Your own sheet and Dr. Sandel’s instructions govern your case. Call the office on (410) 266-7120 with any question about your healing.
The first 48 hours
Cold compresses to the cheeks and under the eyes, and your head elevated to about thirty degrees. Expect drainage for roughly four hours; change the drip pad under your nose as needed and do not tape it tight.
The morning after
The cotton in your nose comes out.
The first week
Do not blow your nose, and sneeze with your mouth wide open. Saline spray as directed. Bruising around the eyes becomes more noticeable over the week before it fades.
One to two weeks
Congestion, drainage and crusting inside the nose, with scabbing as it heals. This is the stage patients ask about most, and it is entirely expected.
Smell
A temporary change in your sense of smell, which returns as the swelling settles.
When to call
Severe pain that the medication does not relieve, or a fever.
Septoplasty FAQs.
Have your breathing evaluated.
A consultation includes an examination of the inside of the nose, a review of what you have already tried, and a discussion of whether the obstruction is coming from the septum, the turbinates, the nasal valve, or a combination of them.