Functional Open Septorhinoplasty

Table of Contents

Functional Open Septorhinoplasty Introduction

Functional open septorhinoplasty is a surgical procedure that addresses both internal and external structural problems of the nose to improve airflow and breathing. This surgery is considered when nasal obstruction is caused by a deviated septum, nasal valve collapse, or other deformities of the nasal framework. It is called an “open” approach because a small incision is made at the base of the nose (columella) to allow full access to the nasal structures.

  • Septoplasty corrects a deviated nasal septum (the internal wall that separates the nostrils).
  • Rhinoplasty reshapes or reconstructs the external nasal structures for functional (and sometimes cosmetic) purposes.
  • Nasal valve repair may also be included to support weak areas of the nose that collapse during breathing.

The goal is to improve nasal airflow, relieve obstruction, and restore stable nasal support.

Reasons for surgery

You may be recommended for functional open septorhinoplasty if you have:

  • Persistent nasal obstruction or difficulty breathing through the nose
  • Previous nasal trauma or surgery that affected nasal structure
  • Collapsed nasal valves (internal or external) causing airway narrowing
  • A crooked or twisted nose that impacts nasal function
  • Symptoms that have not responded to medical treatments like sprays or antihistamines
  • The need for structural repair that can only be addressed through open access
  • Snoring or unable to tolerate CPAP in patients with Obstructive Sleep Apnoea (OSA)

Benefits of the procedure

  • Improved nasal airflow and easier breathing
  • Correction of structural deformities such as a deviated septum or collapsed nasal sidewalls
  • Reduced snoring and mouth breathing in some cases
  • Long-term relief from nasal obstruction symptoms
  • May also improve nasal appearance

Please note that although functional benefits are the main goal, cosmetic improvements may occur but are not the primary aim. Dr Phillips does not perform rhinoplasty for purely cosmetic concerns.

Risks & complications

As with any surgery, there are potential risks. Most are rare and manageable. These may include:

  • Bleeding
  • Infection
  • Bruising or swelling around the eyes and nose
  • Temporary Pain
  • Temporary numbness of the nasal tip or upper lip
  • Poor wound healing or visible scar (typically minimal)
  • Septal perforation (a hole in the septum)
  • Nasal asymmetry or dissatisfaction with appearance
  • Nasal blockage or breathing issues not fully resolved
  • Need for revision surgery
  • Reaction to anaesthetic

Dr Phillips will discuss these risks in more detail and answer your questions before the procedure.

Alternative treatments

Depending on the cause of your nasal symptoms, alternative treatments might include:

  • Nasal steroid sprays to reduce swelling
  • Nasal strips or valve dilators
  • Lifestyle changes or allergy management

However, these options may not be effective for structural problems, in which case surgery is often the best long-term solution. Dr Phillips will assess your specific needs and outline suitable options.

Pre-operative instructions

Medications

Please inform Dr Phillips of all medications you take. You may need to stop blood thinners (e.g. aspirin, warfarin, or certain herbal supplements) before surgery.

Fasting

If your surgery is under general anaesthetic, you must fast (no food or drink) for at least 6 hours prior. Follow all instructions from your anaesthetist or hospital.

Illness

If you develop a cold, flu, or any illness before your procedure, contact the clinic. Surgery may need to be postponed for your safety.

Procedure details

This surgery is performed under general anaesthetic and takes approximately 3 hours.

  • A small incision is made at the base of the nose to allow full access to the cartilage and bone.
  • The nasal septum is straightened and reshaped as needed.
  • Nasal bones may be realigned if required
  • Structural grafts may be added to support weak or collapsed areas, often using cartilage from your nasal septum or rib cartilage
  • Once corrected, the skin is re-draped and the incision is closed with fine sutures.
  • Internal splints and an external nose splint are placed to support healing.

You will wake up in recovery with dressings in place and will usually be able to go home the same day.

Post-operative care & recovery

Hospital Stay

Usually performed as a day surgery. Some patients may stay overnight if needed.

Pain

Mild to moderate discomfort or pressure in the nose is common and you will feel quite congested and tired, like having a cold or flu. In most cases this can be managed with regular pain relief such as paracetamol or ibuprofen.

Bleeding

A small amount of ooze or bleeding is normal for 3-4 days post-op. Significant bleeding is uncommon. If bleeding is heavy or persistent, seek medical attention.

Swelling and Blockage

Facial swelling and nasal blockage are expected for the first 1–2 weeks. Most of the swelling improves within 4–6 weeks, though subtle swelling can last longer (up to 12 months)

Nasal Care

  • Use saline spray (FESS or FLO) 4–6 times a day to keep the nose moist.
  • Do not blow your nose for at least 10–14 days.
  • Sneeze with your mouth open and avoid touching or bumping the nose.
  • The external splint is usually removed after 7 days; internal splints (if used) within 1–2 weeks.

Diet

No special restrictions, but avoid very hot food or drinks for several days post-op to reduce bleeding risk.

Activity

  • Rest for the first few days.
  • Avoid exercise, heavy lifting, or bending over for 2 weeks.
  • Most people return to work within 1–2 weeks, depending on their job and recovery.

What to watch for

Contact our clinic or seek urgent care if you notice:

  • Heavy or prolonged bleeding
  • Fever over 38.5°C
  • Significant or increasing facial swelling
  • Severe pain not relieved by medication
  • Persistent clear fluid leaking from the nose
  • Vision changes

Follow-up instructions

A review appointment with Dr Phillips will be arranged about 1 week after surgery to check healing and remove any splints or sutures.

Frequently asked questions (FAQ)

  • Will this change how my nose looks?

    It may. While the surgery’s main aim is functional improvement, some changes in appearance may occur, especially if structural support is added or reshaped.

  • Can the problem return?

    The results are generally long-lasting. However, ongoing issues like allergies or trauma can affect nasal function again in the future.

  • When can I travel or fly?

    Avoid flying for at least 2 weeks after surgery, or until cleared by Dr Phillips.

Book a consultation

If you’d like to discuss this procedure or explore suitable treatment options, please get in touch with Dr Nicholas Phillips’ clinic.