A friend of mine had Revision Functional Septo-Rhinoplasty surgery that took 5 hours. Her Doctor did not use splints. Now 4 weeks later she can not breath out of her right nostril and her left is not much better. What could be the problem?
Post Septoplasty/Rhinoplasty - Doctor Didn't Use Splint: Can't Breath Out of Right Nostril
Doctor Answers (6)
Can't breathe through nose after septorhinoplasty
Yikes, I've performed Rhinoplasty for over 20 years including very tough Revision cases and have never spent anywhere near 5 hours on a Rhinoplasty. I'd think the amount of swelling after such a long case would be a possible factor of why the airway, inside the nose, is swollen nearly closed. Time should make that better.
I almost never use intranasal splints or packing. Unless something has become displaced this is probably still swelling. Saline sprays may be helpful but check with your doctor first.
Nasal Splints after Rhinoplasty
Nasal splints are not used by all rhinoplasty surgeons ; some physicians use them all the time - I rarely use them. Your friend is having trouble breathing because of the temporary post-op intra-nasal swelling. This will resolve just as the external swelling that you see on the surface will decrease with time.
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Unable to Breathe After Septorhinoplasty
Septoplasty surgery helps improve a deviated nasal septum, which may or may not be combined with rhinoplasty. Typically, nasal surgeons will place absorb able sutures inside the nose, which slowly dissolve over time. Sometimes sutures or internal silicone splints may need to be removed about one week following nasal surgery. In addition to internal sutures and splints, the nose produces more mucous and crust in the early postoperative period. Lastly, mucosa swelling contributes to nasal congestion. Saline rinses may help improve the congestion symptoms from all of these.
While many patients have improved nasal breathing early after septoplasty, some patients don't appreciate the gradual improvement until a few weeks after surgery. Any concerns should be brought to the attention of your surgeon, and follow his/her care instructions.
No septal splint
Dear Concerned friend,
As Dr. Johnson stated the edema(or swelling) of tissue occurs both inside and outside of the nose. The use of a septal splint isn't a dogma and some surgeons do not use it at all or replace the splint with absorbable sutures. The edema in the nasal passages can last a significant time but does subside eventually. I usually suggest the use of saline sprays (NOT Sudafed or medicated sprays) to alleviate the sensation of “stuffiness.” The airways will open up and your friend should feel much better over time.
Internal nasal swelling after rhinoplasty
Swelling does not occur on the outside of the nose only, the lining tissue will also swell, and typically the airway is restricted or congested for several weeks after rhinoplasty. Splints and packing do control swelling, though most of us have trended away as patients are uncomfortable. The airway and breathing is excellent until the packing and split is removed, and then the expected swelling will set in and the airway feels as if the packing was never in place. Tell your friend that the airway will improve but it will take some time.
Best of luck,
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.