How Many Types of Septoplasty Incision Techniques Are Offered?

Are there any benefits of one type of septoplasty procedure versus another type?

Doctor Answers 5

Most common septoplasty incisions are known as the “hemi-transfixion” or “complete transfixion” incisions

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The most common septoplasty incisions are known as the “hemi-transfixion” or “complete transfixion” incisions. 

The use of a complete transfixion incision, which goes from one side of the septum all the way through to the other side, will most often result in a reduction of the height of the nasal tip by 1-2 millimeters.  If this is desirable, because the projection of the nose away from the face is slightly greater than ideal for your face, then this would likely be the best approach. 

Alternatively, a hemi-transfixion incision technique employs an incision on 1 side of the septum only so that there is little change in the nasal tip post-operatively.  The incision may also be made in the immediate area of the deformity in the nasal septum; however, I use this approach less commonly since I have less control of its effect on the other side of the septum, in this case.  I generally prefer to use a hemi-transfixion incision, unless there is a desire to drop the height of the nasal tip.

Septoplasty incisions

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The septoplasty incision is no more than a ½ inch long incision on the inside of the columella also known as a hemitransfixion incision.  It is usually performed on the left side, the septoplasty is performed, and then 2-3 small dissolvable stitches are placed to close the incision.  There is no packing placed inside the nose.  The septoplasty operation is done under general anesthesia.  

Septoplasty incisions? Two are commonly performed

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Traditionally, there are two approaches to the septum:

  •    One is just within the nostril ahead of the edge of the septal cartilage
  •    The other commonly located septoplasty incision is further back and directly over the    cartilage itself 

The decision is made based on where the cartilage buckles, previous surgery, scar tissue and etc.

Understand that a septoplasty incision is always internal if only the septoplasty is being done.  Both types of incisions heal very well. 

Robert Kotler, MD, FACS

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 89 reviews


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Each septum is different.  However, about 90% of septums can be done with an incision just inside the nose.  Occasionally it is done with an external incision, but this is almost always combined with an open rhinoplasty.  However, with a septoplasty alone, this won't need to be done.  Using a laser to make the incision has no added benefit.                   

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

Are there any benefits of one type of septoplasty procedure versus another type?

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The method of Septoplasty and the incision would depend on what your surgeon is trying to accomplish as well as what he faces with your septum. Each procedure on the septum carries its own set of specific complications in addition to those of nose surgery and those of anesthesia in general.

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.