Septoplasty Surgery by Dr Turner in Sydney & Brisbane

The ability to breathe freely through your nose influences numerous aspects of daily well-being, from sleep quality and physical endurance to cognitive clarity and general health. When a misaligned nasal septum creates persistent obstruction, these fundamental functions become compromised. Septoplasty is a targeted surgical intervention that realigns the central nasal partition, restoring balanced airflow and relieving the cascade of symptoms that accompany chronic nasal blockage.

Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) with clinics in Sydney and Brisbane, bringing focused expertise to functional nasal surgery. Dr Turner’s approach prioritises both the structural correction necessary for improved breathing and the preservation of external nasal aesthetics, ensuring patients achieve comprehensive outcomes from their surgical procedure.

Understanding Septoplasty Surgery

What is the Nasal Septum?

The nasal septum forms the vertical partition that divides the nasal cavity into two distinct airways. This structure comprises both cartilaginous and osseous components working together to maintain nasal architecture. The anterior portion consists primarily of the quadrangular cartilage, which provides the flexibility necessary for normal nasal movement and contributes to the external nasal shape. The posterior segment incorporates rigid bony elements, including the perpendicular plate of the ethmoid superiorly and the vomer inferiorly, anchoring the septum firmly to the skull base and palate.

A delicate mucous membrane envelops the entire septal surface, housing an intricate network of blood vessels and sensory nerves essential for nasal function. This mucosal lining helps condition inspired air and contributes to the nose’s role as a first-line defence against airborne particles and pathogens.

Functions of the Nasal Septum

The septum serves several interconnected physiological purposes:

• Airflow Distribution: By creating two parallel nasal passages, the septum facilitates organised airflow patterns. This bilateral configuration enables the alternating nasal cycle, where one nostril predominates while the other rests, optimising mucosal health and respiratory efficiency.
• Structural Foundation: The septum provides essential support for the external nasal framework, contributing to dorsal height and tip projection. Any significant septal deviation can therefore influence both internal function and external appearance.
• Air Conditioning: Working alongside the turbinates, the septum helps warm, humidify, and filter inspired air before it reaches the lower respiratory tract.
• Olfactory Function: Appropriate airflow patterns directed by the septum deliver odorant molecules to the olfactory epithelium in the superior nasal cavity, enabling the sense of smell.

What is a Deviated Septum?

A deviated septum occurs when the nasal partition shifts away from the midline, creating asymmetry between the left and right nasal passages. Research suggests that approximately 75-80% of individuals demonstrate some degree of septal deviation, though many remain asymptomatic. The deviation may present as a simple C-shaped curve, an S-shaped double curve, or as localised spurs and ridges projecting into one or both airways.

Several mechanisms can produce septal deviation:

• Congenital Factors: Developmental variations during foetal growth or compression during passage through the birth canal can establish septal asymmetry from the earliest stages of life.
• Traumatic Injury: Direct nasal trauma from sporting activities, accidents, or falls represents a common cause of acquired septal deviation.
• Differential Growth: The septum continues developing through adolescence and early adulthood. Uneven growth rates between cartilaginous and bony components can produce progressive deviation over time.

Signs You May Need a Septoplasty

When septal deviation reaches a degree sufficient to compromise nasal function, various symptoms may emerge:

• Persistent Nasal Obstruction: Chronic difficulty breathing through one or both nostrils that fails to resolve with decongestant medications or nasal sprays.
• Sleep-Disordered Breathing: Snoring, mouth breathing during sleep, or symptoms suggestive of obstructive sleep apnoea.
• Recurrent Nosebleeds: Turbulent airflow around septal deviations creates localised drying of the nasal mucosa, predisposing to epistaxis.
• Chronic Sinusitis: Blocked sinus drainage pathways secondary to septal deviation can promote recurrent or chronic sinus infections.
• Facial Pressure and Headaches: Septal spurs contacting the lateral nasal wall can trigger referred pain and pressure sensations.
• Diminished Olfaction: Reduced airflow to the olfactory region may impair the sense of smell and, consequently, taste perception.

If you experience these symptoms persistently despite conservative management, evaluation by Dr Scott J Turner at his Sydney or Brisbane clinic can determine whether septoplasty represents an appropriate intervention.

Combining Septoplasty with Rhinoplasty Surgery

Many patients present with concurrent concerns regarding both nasal function and external nasal appearance. Functional rhinoplasty is a comprehensive surgical approach that integrates septoplasty with cosmetic rhinoplasty, addressing internal breathing obstructions and external aesthetic refinements in a single operative session.

Dr Turner emphasises the importance of addressing functional and aesthetic concerns simultaneously when both exist. Patients who undergo isolated septoplasty and later decide to pursue rhinoplasty face significant challenges. During septoplasty, portions of septal cartilage are typically removed or reshaped. This cartilage serves as valuable grafting material in rhinoplasty surgery for structural support and contour refinement. When it has already been harvested or modified, subsequent rhinoplasty becomes more complex, potentially requiring alternative cartilage sources such as rib or ear cartilage, extending operative time and recovery.

Advantages of Combined Surgery

• Unified Recovery: One healing period rather than two separate recovery phases.
• Preserved Cartilage Resources: Septal cartilage removed for functional correction can be utilised immediately as grafting material for rhinoplasty.
• Harmonised Outcomes: Simultaneous adjustment of internal structure and external form allows for balanced, coordinated results.
• Cost Efficiency: Single anaesthetic and facility fees rather than duplicated expenses for separate procedures.

Turbinate Reduction

The inferior turbinates are curved bony projections along the lateral nasal walls, covered by vascular mucosal tissue that helps regulate airflow. Chronic inflammation, allergies, or compensatory changes in response to a deviated septum can cause enlargement of the inferior turbinate (inferior turbinate hypertrophy), further compounding nasal obstruction.

In functional rhinoplasty procedures combining septoplasty and cosmetic rhinoplasty, Dr Turner typically recommends deferring turbinate reduction for approximately six months. This approach allows the nasal architecture to heal completely and the septum to stabilise in its corrected position before addressing turbinate volume, ensuring optimal long-term outcomes.

Am I a Suitable Candidate for Septoplasty?

Dr Scott J Turner conducts thorough medical evaluations at his Sydney and Brisbane clinics to determine suitability for septoplasty, reviewing symptom history, examining nasal anatomy, and discussing realistic expectations. Appropriate candidates for septoplasty surgery generally meet the following criteria:

• Documented Functional Impairment: Symptomatic nasal obstruction that interferes with breathing, sleep, or quality of life, confirmed by clinical examination.
• Adequate Medical History: Good general health without uncontrolled conditions that might compromise wound healing or increase surgical risk.
• Realistic Expectations: Understanding that septoplasty addresses structural obstruction but cannot guarantee complete symptom resolution, particularly when mucosal inflammation or allergies contribute to congestion.
• Non-Smoking Status: Smoking and vaping severely impair tissue healing and increase complication risk. Candidates must cease tobacco and nicotine products for a minimum of six weeks before and after surgery.
• Psychological Assessment: As mandated by Australian regulations effective 1 July 2023, patients considering cosmetic surgery must undergo a psychological evaluation to confirm emotional suitability and realistic expectations.

Who May Not Be Suitable

Septoplasty may not be appropriate for individuals with active nasal or sinus infections requiring treatment before surgery, uncontrolled bleeding disorders or anticoagulation that cannot be safely modified, severe medical conditions precluding general anaesthesia, or those unable to commit to smoking cessation requirements. Conservative treatments, including nasal corticosteroid sprays, antihistamines, and decongestants, should typically be exhausted before surgical intervention is considered.

How is Septoplasty Performed?

Septoplasty is performed under general anaesthesia in a fully accredited private hospital facility in Sydney or Brisbane with continuous monitoring by a qualified consultant anaesthetist. The procedure typically takes 1 to 2 hours, depending on the complexity of the deviation and whether additional procedures are performed concurrently. Most patients are discharged home the same day following appropriate recovery monitoring.

Surgical Technique

Incision Approach: When performed as an isolated procedure, septoplasty utilises internal incisions made along the caudal (front) margin of the septum, entirely within the nasal cavity. No external incisions are required, meaning no visible scarring results. When septoplasty accompanies open rhinoplasty (functional rhinoplasty), the septum is accessed through the standard rhinoplasty incisions, including a small external incision across the columella.

Mucosal Elevation: The delicate mucoperichondrial membrane covering the septum is meticulously elevated from the underlying cartilage and bone. Preserving mucosal integrity is paramount, as bilateral mucosal tears can increase the risk of septal perforation.

Septal Correction: Deviated portions of cartilage and bone are methodically addressed. This may involve removing obstructing segments, reshaping and repositioning cartilaginous components, or excising bony spurs. Care is taken to preserve adequate cartilage along the dorsum and caudal edge to maintain structural support and prevent external deformity.

Cartilage Harvesting: When combined with rhinoplasty, excess septal cartilage is preserved for use as grafting material—spreader grafts to support the internal nasal valve, batten grafts to reinforce the lateral nasal wall, or columellar struts to enhance tip support.

Closure and Splinting: The mucosal flaps are returned to their anatomical position and secured with absorbable sutures. Soft silicone internal splints are placed bilaterally to support the septum during initial healing and prevent adhesion formation. These splints are typically removed at the first post-operative visit, approximately five to seven days following surgery.

Recovery and Aftercare

Most patients return home the same day following septoplasty. The first week involves nasal congestion from internal splints, mild discomfort managed with prescribed medications, and breathing through the mouth. Dr Turner removes the internal splints at your first post-operative appointment (days five to seven), often providing immediate relief. During the first two weeks, patients should keep their heads elevated, use saline rinses as directed, and avoid bending, straining, or blowing their noses. Most people resume desk-based work within 1 to 2 weeks, with strenuous activities restricted for 4 to 6 weeks.

Nasal breathing progressively improves as internal swelling resolves over the following weeks, though fluctuating congestion is usual during this period. Complete internal healing takes several months, and the full benefits of improved airflow typically become apparent by three to six months post-operatively. Regular follow-up appointments allow Dr Turner to monitor your progress and address any concerns throughout recovery.

Risks and Complications

All surgical procedures carry inherent risks. Septoplasty is generally considered a safe operation with low complication rates when performed by an appropriately qualified Specialist Plastic Surgeon in an accredited facility. During your consultation, Dr Scott J Turner will discuss these risks comprehensively, ensuring you make a fully informed decision.

Potential risks and complications include:

• Bleeding: Minor post-operative bleeding and blood-tinged drainage are common and expected. Significant bleeding requiring intervention is rare but possible.
• Infection: Uncommon with appropriate antibiotic prophylaxis and post-operative care.
• Septal Haematoma: Blood accumulation beneath the mucosal lining may require drainage to prevent cartilage damage.
• Septal Perforation: A hole in the septum can occur, particularly when bilateral mucosal tears coincide.
• Altered Nasal Shape: Changes to external nasal appearance are uncommon with septoplasty alone but possible if significant structural modification is required.
• Diminished Sense of Smell: Temporary olfactory impairment is common during healing; permanent reduction is rare.
• Nasal Adhesions: Scar tissue bands can form between the septum and lateral nasal wall, potentially causing obstruction.
• Numbness: Temporary altered sensation in the upper teeth or palate may occur; permanent numbness is rare.
• Incomplete Correction or Recurrence: In some cases, symptoms may persist or recur if the deviation cannot be completely corrected.