Nasal Airway Surgery

Nasal Airway Surgery for Patients in the Bay Area, including San Francisco, San Jose and Palo Alto

Inadequate airflow through one or both sides of the nose can be due to many factors such as allergy and sinus disease. However, abnormal anatomy inside the nose can often cause a physical obstruction in the nasal passageways. We specialize in surgical treatment of the nose and have extensive experience treating all aspects of the nasal anatomy. Internal changes often include a septoplasty (straightening of a deviated septum) or widening the internal nasal valves, to improve the ability to breathe through one's nose.

Nasal airway surgery for treatment of nasal airway congestion may be combined with rhinoplasty and is often a crucial component. Only a surgeon who is experienced in nasal surgery can maintain or improve a nasal airway while making changes to the external appearance of the nose. Often, insurance coverage will offset a significant portion of the cost of the surgery when patients have difficulty breathing through the nose, a deviated septum, a septal perforation, or history of a prior broken nose.

Pre-Operative Process

Am I a candidate for nasal airway surgery?

Common reasons for seeking out this type of surgery:

  • Nasal obstruction on one or both sides of the nose
  • Deviated septum
  • Collapse of the sides of the nose when inhaling
  • No relief after using nasal steroids or decongestants
  • Not able to tolerate a CPAP (continuous positive airway pressure) machine because of nasal obstruction

Many patients seeking cosmetic enhancement of the nose or rhinoplasty also have breathing problems. It is possible to make a nose look and work better in a single surgery.

What happens during a consultation?

A consultation for nasal airway surgery or sinus surgery includes a comprehensive overview of your medical history and an examination of the external and internal anatomy of the nose. If a cosmetic change is desired along with airway improvement, time will be spent discussing your desires and expectations about such a change and cutting-edge software will be used to help communicate your goals. We feel that digital morphing software is crucial in understanding how patients want their nose to look so that nose surgery is customized to each patient.

Pictures are taken of your nose from several different angles, and the nose is examined in detail. Digital images are "morphed" to give you an idea of the appearance after surgery. We work with you to develop a customized surgical plan unique to your goals and desires. The morphed images are used as a guide/template during surgery. Although not a guarantee of results, it helps ensure that the goals of surgeon and patient are aligned.

If you elect to proceed with nasal surgery, you will be provided with detailed information reviewing the pre-operative process, the day of surgery and what to expect during recovery. In the time leading up to surgery, you are always welcome to come back to discuss things further.

Technique

How is this surgery performed?

Nasal airway surgery can be performed in several different ways depending on the cause of obstruction. Occasionally all that is required is straightening of a crooked septum (septoplasty). This procedure involves straightening the septum by recontouring or removing the deviated portions. This should create equal sized internal nasal passageways. Septoplasty alone will not change the appearance of the nose and is performed entirely through small incisions on the inside of the nose.

In certain patients, septoplasty alone will not cure an obstructed nose. For these patients a more involved approach is required often requiring mini-cartilage grafts to stent open a collapsing or narrowed nasal airway. During your consultation we spend time reviewing your anatomy and the reasons for choosing a certain surgical technique.

Post-Operative Recovery Process

What should I expect after my nasal surgery?

Patients return home the same day of surgery after recovering from anesthesia. You will need a friend or family member to drive you home following the procedure, and preferably, to stay with you for the first 24 hours after the procedure. Occasionally internal splints are kept in place for one week. The most common complaint after surgery is congestion, which begins to resolve after two to three days. Pain is often minimal and can be controlled with Tylenol alone. You can resume most normal activities a couple of days after surgery. Full exercise routines can resume three weeks after the procedure. Many patients return to work one week postoperatively.

Our philosophy is to see you early and often after surgery. So many questions arise in the first few weeks following any surgery that we believe setting up a series of appointments for that time period alleviates any anxiety a patient may have about the recovery process.

Following nasal surgery, we usually see a patient in four days to remove stitches, and at one week to remove the nasal cast. Follow-up visits most often occur at regular intervals over the next year as it takes almost a year for the swelling to resolve from most nasal surgeries. During your visits, we will do a careful exam and, more importantly, answer any questions you may have. Our core objective is to provide a safe, comfortable surgical experience that aspires to restore your appearance and aims to produce natural results and makes a positive impact in a personís quality of life.