Severe Congestion After Septorhinoplasty

Question

Is this normal and when is it time to worry that this may be permanent? I have been on flonase for 9 days and don't have really any relief. My PS, a very qualified rhino expert and ENT specialist, has seen me and told me everything is well, just a lot of swelling. Seriously having the hardest time managing this clogged feeling and I'm so miserable. I can't really feel any substantial improvements; what I do notice I attribute to the Flonase maybe?

Paul S. Nassif, MD · Answer

Hello,

	 

	It is not abnormal to experience congestion for up to two weeks following your surgery. At this point, it would be best to speak with your surgeon, as he/she knows the extent of your surgery and exactly what was performed. Thank you, and I hope this helps.
	Dr. Nassif

Rod J. Rohrich, MD · Answer

It is not uncommon to have some congestion after septo-rhinoplasty for 2-3 months. Most of the congestion resolves within a few months, but one can use a low dose of Flonase if there is an allergic component.

Anthony Corrado, DO · Answer

Nasal congestion in the first few weeks after septoplasty surgery is normal. A majority of this congestion is due to swelling of the nasal lining. Allow time for the swelling to resolve, and if this is not improved in a month or two follow up with your surgeon. Good Luck.....Dr. Corrado

Houtan Chaboki, MD · Answer

Hi Dallas8303 in Dallas, TX,

	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.

	Dr. Chaboki

Steven Wallach, MD · Answer

There is some information that you did not mention.  Are you early post-op?  If you are, it is quite normal to have swelling.

Andrew Pichler, MD · Answer

You said you have a very competent PS so I assume he ruled out an organizing septal hematoma or other complications. You may well have rebound congestion if you used afrin or other type of nasal sprays. Trial of short course cortisone by mouth helps in that instance, but all of this should be obvious to your doc. All else failing you need a second oppinion. Good luck

Richard W. Fleming, MD (retired) · Answer

Nasal congestion may persist for several weeks after surgery, depending on what was done during your procedure. How long ago was the operation? Does your surgeon know that you're using the flonase? Follow his/her advice.

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