Is the septum usually removed and then sutured back in an Open Rhinoplasty?

Is the septum usually removed during an open rhinoplasty and then sutured back? Or can surgeons most of time time cut it out in a nice fashion and leave a nice l strut without removing it?

Doctor Answers 9


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You are asking good questions.  The septum is not incidental but structural.  It is critical for the nose to have a strong, straight septum along the bridge and to hold up the tip.  What you are describing "extracorporeal septoplasty"  is usually reserved for only the most ireegular septum. Generally a strong strut along the bridge can be achieved with pieces of cartilage to reinforce and straighten it when crooked. Proper attention to the septum is a critical part of rhinoplasty.

Septum removal during rhinoplasty?

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It is most common for the septum to be left inside the nose during surgery and modified in place, but in some instances the whole septum may be removed and then replaced back inside. This second approach is not commonly done in the US.

Technique for septorhinoplasty

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The answer to your question depends on what your septum and external nose looks like.  Depending on many different factors (all of which are related to the anatomy of the nasal structures), the septum may need to be removed and/or reconstructed to make it straight.  The technique used will differ for each patient depending on their anatomy. 

Sunny Park, MD, MPH
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Septum & Open Rhinoplasty

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There are any number of techniques for performing a septoplasty. Determining the right one is going to depend on the individual. Without assessing you in person, it is literally impossible to say which would be right for you so my best advice would be for you to schedule a consultation with a board certified plastic surgeon in your area to be assessed in person.


Kouros Azar

Is the septum usually removed and then sutured back in an Open Rhinoplasty?

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In some very select situations the septum may be removed (extracorporeal septoplasty) if the septum or nose cannot be straightened by traditional approaches. By taking it out you are able to flip it around in different ways and put it back straight. In those situations where it is needed, it can be very helpful.

Jeffrey Watson, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Removal of Septum in Open Rhinoplasty

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It is possible to remove the septum and then replace it whether or not the open technique is used. However this is rarely necessary; the septum can be modified without removal in most cases.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Septoplasty and removal of the septum

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There are many techniques for septoplasty, from removal to replacement, to adjustment of the bony portion of the septum, to no removal at all with placement of spreader grafts, etc.  

An experienced surgeon can guide you as to which procedure might suit your individual case best.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Is the septum usually removed and then sutured back in an Open Rhinoplasty?

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Dear Katherine

The septum and its management is an independent component and is performed on a case by case basis. It can be partially removed, repositioned and can be completely taken out and placed back in as needed. Regardless, the surgeon needs to make sure that at least a stable and properly positioned framework (L-strut) is in place.

Rhinoplasty: addressing the nasal septum

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Rhinoplasty is a surgery to improve the shape of the nose for breathing or appearance.

Septoplasty can be a component of rhinoplasty surgery. It may mean harvesting nasal septum cartilage for grafting, removing a crooked portion of the nasal septum, or completely removing and reconstructing it again. Most frequently, the L-strut is maintained to keep adequate support of the nose without removing the entire septum. 

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.