6 months post op septoplasty and I have worse breathing than before surgery. Considered failed? What are my options?

Question

I refuse to accept the answers this is just due to being "swollen". My breathing was perfect the first couple weeks after surgery then just declined. Saw another surgeon for 2nd opinion said 80% blocked left nostril and 50% right. My nose seems wider due to spread grafts, still curved and worse breathing than before surgery. I feel this is not my fault but now burden of a revision what are my options?

Kevin Ende, MD · Answer

It is hard to determine what you or the second surgeon mean by a 50 percent blocked nose or an 80 percent blocked nose as this is not proper medical terminology for a nasal evaluation.  How would this doctor even know what you started with having never met you prior to your surgery?  I would seek consultation with a board certified facial plastic surgeon.

Gerald Minniti, MD, FACS · Answer

Hello,You are correct, if your nasal airflow was better early in recovery, when swelling was worse, than this problem you have is not due to swelling. Unfortunately, the most effective and predictable way to perform this surgery, open structural rhinoplasty using multiple grafts to re-establish structural integrity, is not commonly or correctly performed. You'll need to visit a revision rhinoplasty surgeon to evaluate not only static structural blockage, but also dynamic issues that you may have (swelling actually creates structural rigidity, keeping airways open).

Ronald J. Edelson, MD · Answer

it isn’t clear the extent of surgery you had done, specifically with regard to narrowing the nose.  Obviously an examination would be necessary to determine exactly what is causing breathing problems.  A possibility is that you have enlarged turbinates that were not addressed.  If so there are ways to reduce the turbinates that are quite simple and reliable.  I reduce turbinates  in most rhinoplasties I perform.  It can even be done in the office using a radio frequency device.  Worth checking into.

William Portuese, MD · Answer

A thorough internal examination of the nose is going to be required to make a determination about how best to proceed. There are many issues on the inside the nose that can cause breathing difficulties such as a deviated septum, valve collapse, vestibular stenosis, turbinate hypertrophy, chronic sinusitis and allergies.

Michael Elam, MD (retired) · Answer

Dear Nodeviation9130, An in office evaluation will be needed to determine the exact cause of the current obstruction. It sounds from the secondary opinion that you still have a deviated septum that needs addressing and their could be other issues that are adding on to the breathing obstruction. Seek some expert opinions and then you will be fully informed of your choices. Best regards, Michael V. Elam, M.D.

6 months post op septoplasty and I have worse breathing than before surgery. Considered failed? What are my options?

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