Nasal Sutures to Straighten Septum?

Nasal sept straight but deviated to left. Primary rhino doc used closed approach and spreader graft along with a mattress suture. Looking to revision as deviation wasn't adequately addressed. My questions are (1) is suture just a piece of thread and (2) if an off-set suture is used to tie the setpum and upper lateral cartilage together is that something that will hold over time, and is that suture permanent (i.e. will not dissolve?). Is that the only thing holding them together?

Doctor Answers (7)

Sutures to straighten septum

+1

The sutures used during septoplasty and spreader graft placement are usually dissolveable. The tissues normally heal together thanks to scar fibrosis so the sutures wouldn't be needed long term.

To get a better idea of your options you should visit with a revision nose surgery expert.

To learn more about septum surgery you can check out my web reference link below.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Not just an issue of sutures

+1

Sutures, ie stitches, can be dissolvable or permanent.  Common dissolvable sutures in septorhinoplasty can last 4-6 months, and permanent sutures can be prone to infection.  4-6 months is probably even longer than the sutures need to last.  The scar tissue that forms over this time is what holds things in place.  There can be many reasons for a persistent deviation of a septum after initial surgery, and some cannot be straightened perfectly.  You may need some other grafts in the septum in addition to placement of sutures.  No surgeon will know what you need until her/she gets in and can see the problem (through an open approach most commonly). The problem can be multifactorial and often is.  I referenced some information in the link below.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Revision rhinoplasty

+1

 Most surgeons use a type of suture  that are dissolvable inside the nose, and usually take 4-6 months to dissolve. Permanent sutures tend to get infected and  create stitch abscesses. Without pictures, examination, and consultation is impossible to give any advice regarding  your nose, since revision rhinoplasty is extremely complicated. Best to seek out an experienced rhinoplasty surgeon to obtain optimal results.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

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Rhinoplasty and sutures

+1

Sutures placed during rhinoplasty for the most part or dissolvable over a long period of time. Each surgeon is a bit different.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Rhinoplasty is complicated, revision is more so.

+1

First, rhinoplasty is difficult to do well consistently.  Revision rhinoplasty is more difficult because of the altered anatomy, especially if your septal cartilage was removed for the deviated septum and used as a spreader graft.

The question is, are you happy with the aesthetic shape of the nose and bothered by the residual deviated septum (did he do a septoplasty?) or are you bothered by the shape of your nose and the deviated septum as well.

If I were you, I would get a second opinion by a plastic surgeon, who has experience with primary and secondary (revision) rhinoplasty.  I always perform an open rhinoplasty to be able to control all of the factors involved in shaping the nose.   In my opinion, a closed rhinoplasty technique often leads to inadequate correction.  Good luck.

 

Tae Ho Kim, MD
New York Plastic Surgeon
5.0 out of 5 stars 2 reviews

Sutures Will Not Straighten a Crooked Septum

+1

Yes, sutures are a essentially a piece of thread, and no, permanent sutures do not hold things permanently. If you use sutures alone to try and straighten a deviated septum you will almost always be disappointed. In order to get a straight septum you need to straighten the bone and cartilage. Sutures are sometimes used to secure a portion of the septum once it has been straightened but will not cause any long term straightening by itself.  

Michael R. Menachof, MD, FACS
Denver Facial Plastic Surgeon
4.5 out of 5 stars 11 reviews

Nasal Sutures to Straighten Septum

+1

The septum must be mobilized to be straightened; sutures can then be used to secure the septum in it's new location. Sutures alone will not secure a long lasting result because cartilage has a memory and will return to the original location if the spring is not broken by surgical interruption. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

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.