When are external incisions needed for a Septoplasty?

The vast majority of septoplasty surgeries utilize a hidden internal incision. More complex repairs may require an open approach using a columellar incision. This is especially the case when the portion of the septum closest to the nostrils (caudal septum) is deviated and requires reconstruction.

The columellar incision heals very well in my experience and very rarely needs scar revision. You should be able to find out what type of septoplasty approach you would need after consulting with your nasal surgeon.

In 90% of the septoplasty surgeries we perform, the incisions are located internally, along the edge of the septum. It would be very rare to see this incision after it was healed unless the surgeon did a poor job suturing it closed. In the other 10% of cases we choose to perform a transcolumellar incision to improve exposure in cases where the caudal (very end) septum is broken, very crooked or there is need to reinforce the caudal septum with a graft. As in the internal approach-if the external incision is carefully closed by your surgeon it should heal well and be difficult to see.

I hope this helps...

A septoplasty, by definition, is surgery to correct a deviated septum, which is the vertical cartilage that divides the nose into two sides.  For many patients a deviated septum will cause airway obstruction but does not necessarily affect the external appearance of the nose.  In these cases, a septoplasty can typically be performed through an internal nasal incision.  If the deviated septum causes an external nasal deformity, then most plastic surgeons would recommend a “septo-rhinoplasty” which refers to treatment of both the internal and external nasal deformity.  Many surgeons use an open approach for septo-rhinoplasty, which requires a small external incision between the nostrils.