Nose Surgery & Nasal Repair FAQ
Dr. Houtan Chaboki is board-certified in Otolaryngology and specializes exclusively in facial plastic and reconstructive surgery. To learn more about Washington, DC reconstructive nose surgery, contact us online or call our office at 202-741-3409. Dr. Chaboki serves men and women in Washington, DC, Northern Virginia, and Maryland.
1. Where is Nose Surgery & Nasal Repair performed?
Dr. Chaboki practices facial plastic surgery at several DC area surgical facilities to accommodate his patients. Minor procedures with local anesthesia are performed in the DC office. Surgical procedures with IV (twilight) sedation or general anesthesia are performed at accredited facilities with a board-certified anesthesiologist.
- Georgetown University Medical Center
- The George Washington University Medical Center
- Sibley Memorial Hospital
- MedStar Surgery Center
2. What is recovery like after Nose Surgery & Nasal Repair?
Downtime after cosmetic procedures may be a few hours to several days, depending on the specific procedure and areas treated. Office procedures are performed under local anesthesia, if any anesthesia is required. Surgical procedures are performed with either IV (twilight) sedation or general anesthesia and require a longer recovery period. Anesthesia normally wears off within the first 24 hours after surgery. Septoplasty is an outpatient procedure, with most people returning to work within a few days. A small cotton pad may be placed in the nose for a day. Patients are seen both the next day and one week following surgery. While most patients may have improved breathing immediately, normal swelling inside the nose after the procedure takes some time to resolve. A majority of patients do not have the shape of their noses changed with surgery. However, septoplasty performed as part of functional rhinoplasty or septorhinoplasty will change your appearance. Dr. Chaboki will inform you of expected outcomes for your procedure.
3. Will smoking affect my recovery after Nose Surgery & Nasal Repair?
Smoking adversely affects your recovery. One may develop pneumonia, and treated areas don't heal as well or may become infected. The blood vessels that supply oxygen and nutrients to the tissues shrink up and prevent the necessary healing of the area. Patients must stop smoking for a minimum of two weeks prior to surgery to decrease the risk of these complications, and continue smoking cessation after the procedure.
4. What health conditions threaten a successful recovery after Nose Surgery & Nasal Repair?
Dr. Chaboki performs a complete history and physical on all patients prior to undergoing cosmetic treatments. Washington, DC nose surgery and nasal repair may usually be safely performed on many chronic, stable medical conditions. However, nose surgery and nasal repair may be delayed or cancelled as needed for patient safety. Dr. Chaboki will work with his patients to help find a safe, appropriate plastic surgery option for them.
5. How long is the procedure?
Nose Surgery & Nasal Repair is relatively quick surgical procedure. The length of surgery may range from 30 minutes or longer.
6. Will I need time off work after Nose Surgery & Nasal Repair?
Most patients plan at least a few days off from work. A longer period of recovery may be necessary for combined procedures.
7. When can I resume regular exercise after Nose Surgery & Nasal Repair?
Strenuous activities or exercise after plastic surgery will increase the risk of bleeding, swelling, and bruising, until an appropriate healing time has been allowed. This restriction during the recovery period varies based on the operation performed and patient's medical condition. Light activities, such as slow walking, may be performed soon after anesthesia. Heavy activity, such as aerobics, yoga, cycling, running, heavy lifting, or similar vigorous activities are allowed after 2 weeks from the procedure. Contact sports are generally allowed after 6 weeks from surgery.
8. Can I combine Nose Surgery & Nasal Repair with other facial surgery?
Yes, it's generally preferred to combine procedures. First, by combining surgery, insurance may cover a portion of the procedure, and you may save money on fees. Secondly, tissue modified from one area may be used for another surgical area, such as fat transfer and face lifting. Lastly, the recovery process following surgery would only be once, and you minimize downtime by avoiding two separate procedures. Commonly combined procedures with nose surgery & nasal repair include the following: • Rhinoplasty • Facial Sculpting • Botox Cosmetic
9. How much time passes between the initial consultation and Nose Surgery & Nasal Repair?
Generally, a minimum of 2 weeks are allowed from the consultation to prepare for surgery. Select procedures may be performed earlier. Non-surgical procedures may be performed at the same time as the initial consultation.
10. Does insurance cover Nose Surgery & Nasal Repair?
Dr. Chaboki provides the finest in both cosmetic and reconstructive plastic surgery at affordable prices, and participates with most insurance plans. Plastic surgery covers a broad area of medicine, which includes both reconstructive procedures and cosmetic procedures. If your procedure is medically indicated, some portion of the cost may be covered. The office accepts insurance in applicable cases and will, if you wish, contact your insurance company to find out if your procedure will be covered. Insurance coverage varies greatly for patients, however, Nose Surgery & Nasal Repair may be partially or fully covered.
11. What is a Deviated Septum?
The nasal septum is a sheet of cartilage and bone that divides the nose into right and left chambers. A deviated septum is a condition where the septum is severely shifted away from the midline, bent, crooked, or misshaped. Some degree of septal deviation is very common, as roughly 80 percent of all nasal septums are deviated. The most common symptoms resulting from a deviated septum are nasal congestion, nasal obstruction, difficulty breathing through the nose, and snoring. Nasal congestion and breathing symptoms may be worse on one side, or alternate sides. Symptoms may occur all day or primarily at night. In some patients, the drainage of the sinuses is inhibited, resulting in repeated sinus infections or post nasal drip. A deviated septum may be present at birth, caused by an injury, or result from damage from previous treatments or surgery.
12. What are the Nasal Turbinates?
Turbinates are normal structures in the nasal passages. There is an inferior, middle, and superior turbinate on each side of the nose. The turbinates are highly vascular tissue, consisting of bone, spongy erectile tissue, and mucous membrane outer lining. The turbinates, along with the septum and nose, humidify, warm, and clean the air we breathe. These structures also contribute to smell. The inferior turbinate is a largest turbinate, and the primary contributor to nasal and allergy symptoms. This turbinate, about the size of your finger, runs the length of the nasal airway, The inferior turbinate can change size dramatically. Temperature change, lying down, infection, allergies, hormones, emotions, and dust all may increase the size of the turbinate. Large turbinates, alternatively known as hypertrophied turbinates, contribute to nasal symptoms. In some patients, the nasal turbinate remains persistently enlarged and obstructs the airway and causes a congested feeling. Usually, when the underlying problem is treated, such as allergy or infection, the turbinate will shrink back to its normal size. However, in some people, the inferior turbinate will remain swollen & enlarged, even if the underlying problem is corrected. The most common symptom from large turbinates is nasal congestion, nasal obstruction, difficulty breathing through the nose, and snoring. The symptoms may be worse on one side, or alternate sides. Symptoms may be all day, or primarily at night. In some patients, the drainage of the sinuses is inhibited, resulting in repeated sinus infections or post nasal drip.
13. Does a Deviated Septum affect the appearance of the nose?
The nasal septum is the foundation of the nose and contributes to its appearance. Deviated septums are very common. However, most patients are not aware of having a deviated septum, as their external nose is symmetric. A deviated septum may present itself on the external nose as a big or large nose, crooked or twisted nose, a overprojected nasal tip, a rounded nasal tip, or a hump.
14. How is a Deviated Septum diagnosed?
Determining if a patient has a deviated septum is straightforward by a specialist, such as Dr. Chaboki. After discussing your symptoms and medical history, he performs a physical exam of both the external and internal nose, cartilage, bone, and mucous membranes. This exam involves a bright light and a nasal speculum (an instrument that gently spreads open your nostrils) and an endoscope (high resolution video camera) to inspect the inside surface of each nostril. An anesthetic nasal spray is used prior to the endoscopic exam to reduce the minimal pressure during examination. Additional testing may be required in some circumstances, such as a CT scan. CT imaging combines special x-ray equipment with sophisticated computers to produce multiple pictures of the internal nose.
15. What causes Nasal Obstruction and Difficulty Breathing?
The sensation of nasal congestion may be due to a variety of conditions. A deviated septum is the most common cause of nasal obstruction. Enlarged turbinates is the second most common cause of breathing difficulty, and usually associated with a deviated septum. Other structural problems with the nose, such as small nostrils, weak nostrils, scarring, narrow or collapsed nasal valve may also contribute to nasal obstruction. Many other conditions, such as medication side effects, allergies, irritants, chronic sinusitis, and systemic illnesses can contribute to nasal breathing problems. The metropolitan Washington DC area is especially problematic for people with allergies to pollen. These conditions can be treated with medicine and may not require surgery. As a rhinoplasty surgeon with extensive training in nasal surgery, Dr. Chaboki is able to identify and correct such problems. His comprehensive approach enables him to address all of the issues contributing to nasal obstruction.
16. What is the difference between Allergies and Deviated Septum?
More than 150 million people suffer from allergies in the United States. Environmental allergens, such as pollen and mold, are especially worse in northern Virginia, Maryland, and downtown DC. Allergic symptoms are sometimes indistinguishable from a deviated septum. Patients may suffer from nasal congestion, snoring, post nasal drip, runny nose, fatigue and tiredness, and facial pressure from either condition. Nasal allergies cause the mucous membranes of the nose and sinus cavity to swell up and create more mucous. A deviated septum is a structural condition of the nasal cartilage and bone. Both a deviated septum and allergies may occur at the same time. Only through complete testing can one differentiate the cause of symptoms for a particular patient. Many patients think they may have an allergy to dust, pollen, mold, trees, or pets but their nasal symptoms are primarily due to a deviated septum and/or large turbinates. Allergy patients may be treated with immunotherapy (allergy shots), in addition to antihistamines and allergy medication. These allergy shots are a series of injections that patients with allergies may choose in order to improve their health, by reducing allergic symptoms and reducing the need for allergy medication. Allergy shots are specific for each particular patient, with injections performed in the office under medical supervision. While Dr. Chaboki, a facial plastic surgeon, does not treat allergies with shots directly, he works closely with many metropolitan Washington DC, northern Virginia, and Maryland allergists.
17. What are the treatment options for a Deviated Septum?
Various treatment options are available for patients with deviated septums. Recommended treatment will depend on severity of symptoms, degree of septal deviation, prior treatments, and your medical history.
- medication
- nasal strips
- alternative therapy
- surgery
- combination of above
Medication is used when nasal symptoms are minor (intermittent stuffy nose, minor snoring). Initial treatment usually consists of antihistamines, nasal decongestants, and steroid containing nasal sprays. Nasal strips are small, bandage-like tapes have small plastic springs and are worn over the bridge of the nose. While the strips have no effect on the septum, they serve to spread the nostrils so that breathing through the nose is easier. Alternative therapies may not cure the problem, they do address the symptoms. Saline drops and sprays are very helpful in loosening mucus, removing pollen, and moisturizing the nose. A more effective treatment is nasal lavage, often done using a small pot with a spout. Saline solution is poured into one nostril and allowed to flow out the other nostril.
18. What is Septoplasty and how does it correct a Deviated Septum?
Septoplasty is reconstructive plastic surgery performed to correct the nasal septum. Septoplasty is performed entirely through the nostrils, without external incisions. During the procedure, deviated portions of bone and cartilage may be removed entirely or they may be readjusted and repositioned. The procedure has different techniques and approaches, largely dependent on the anatomy of the nasal septum for each particular person. Dr. Chaboki has extensive experience with all methods of deviated septum surgery, including the following:
- submucous resection
- swinging door / Goldman septoplasty
- linear septoplasty
- longitudinal septoplasty
- fan septoplasty
- endoscopic septoplasty
- revision septoplasty
Deviated septum surgery may be combined with rhinoplasty, turbinate reduction, and/or endoscopic sinus surgery. For a majority of patients, septoplasty surgery does not alter the external shape of the nose, since the deviated portions of cartilage and bone are internal. Rhinoplasty, plastic surgery to reshape the nose, when performed along with a septoplasty is often called functional rhinoplasty or septorhinoplasty. These methods of rhinoplasty are performed primarily to restore nasal function, such as breathing and airflow.
19. What is revision Septoplasty?
Some patients may have persistant nasal and sinus symptoms after deviated septum surgery. There are numerous reasons for this problem, including untreated allergies, regrowth or reswelling turbinates, recurrent polyps, chronic infection, and trauma. Sometimes the nasal septum moves back, becoming crooked again, or insufficient cartilage and bone was removed from the initial procedure. Dr. Chaboki has specialized training in the anatomy, physiology, and cosmetic aspect of the nose. His expertise in both the internal and external nose will help treat your sinus nasal symptoms of allergy, nasal obstruction, snoring, nasal congestion, sinusitis, and post nasal drip. He performs minimally invasive rhinoplasty, functional rhinoplasty, revision rhinoplasty, septoplasty, deviated septum surgery, turbinate reduction, and endoscopic sinus surgery.
20. How are large turbinates reduced with Turbinate Surgery?
Turbinate surgery is designed to reduce its size, primarily of enlarged inferior turbinates. Turbinoplasty is another name for surgery on the nasal turbinates. Turbinate surgery is usually combined with septoplasty, sinus surgery, or rhinoplasty. The inferior turbinate can be reduced in several ways:
- Directly cutting a portion off
- Removing the inside portion
- Pushing the turbinate outward
- Combination of the above
Surgery on the turbinates is done with specialized equipment and endoscopic cameras. All methods of turbinate surgery is performed entirely through the nostrils, without external incisions. Occasionally, turbinate tissue will re-grow or re-swell after turbinate surgery and the procedure may need to be repeated. Dr. Chaboki has extensive experience on these various methods of turbinate surgery.
21. Can Septoplasty or Functional Nasal Surgery be combined with Cosmetic Rhinoplasty?
Yes. Combining septoplasty with rhinoplasty is beneficial for several reasons. First, by combining surgery, insurance may cover a portion of the procedure, and you may save money on fees. Secondly, cartilage modified from the nasal septum during the septoplasty may be used for grafts during the rhinoplasty. Dr. Chaboki may need to obtain cartilage from your ear or rib for grafts, if you have already had deviated septum surgery, since cartilage from the septum would not be available. Lastly, the recovery process following surgery would only be once, and you minimize downtime by avoiding two separate procedures.
