About how thick do surgeons typically leave a septum when performing a septorhinoplasty?

Question

Hello, about how thick do surgeons typically leave a septum? Is there a standard practice? I had a septorhinoplasty with some septum cartilage used for grafting, and I feel a bending sensation/pressure when I lean my head to the side. Thank you.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. As far as I can understand from your question the thickness is depends on your nose. I cannot make a proper evaluation without any photo. If you can provide photos from front of your face, from the side of your face and 1 meter away I would be able to make a proper evaluation. Best Regards!

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question. The septum thickness in unchanged during a septoplasty. 
 A dorsal and caudal component of the cartilage has to be maintained, however, to optimize stability and structure of the nose profile -- this is called an L-strut and should be about 1.5cm wide along the dorsal and caudal aspect of the septum.  I am unsure about the bending sensation/pressure you're experiencing as you lean your head to the side -- you may have some residual congestion or sinus pathology.  I would suggest an ENT evaluation where a fiberoptic exam of your nasal passages may be helpful.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Jeffrey Lisiecki, MD · Answer

The thickness of septal cartilage that is left behind is the thickness of your own septal cartilage--that dimensions is typically not modified in any way. You should see your rhinoplasty surgeon (or another specialist) regarding the symptoms you are having.

Hong Ryul Jin, MD · Answer

Typically, they leave at least 1-1.5 cm at the dorsal and caudal sides. You may feel a little bit bending sensation at early postoperative times, but I assume it will go away if your surgeon left enough cartilage in the septum. Thank you.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hello! There isn't a standard size as the thickness can vary. The plane should be submucoperichondrial. This preserves the normal anatomy. If performed properly, the risk of perforation or deformation to the septum is low. A bending or pressure sensation might not be related to the surgery. I would have your surgeon evaluate inside your nose and check your ears as well. Hope this helps!

About how thick do surgeons typically leave a septum when performing a septorhinoplasty?

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