Aesthetic concerns
- A crooked or deviated nose.
- A nasal hump.
- A drooping, broad, asymmetric, or poorly supported tip.
- Visible changes following an injury or previous surgery.
Septorhinoplasty addresses the external shape of the nose and, at the same time, the internal structures that may interfere with breathing. The aim is not to combine two unrelated operations, but to plan an aesthetically balanced, stable, and functional nose as a whole.
What is septorhinoplasty?
It is surgery that combines rhinoplasty with functional correction of the nasal septum. Depending on the diagnosis, it may also address the turbinates and nasal valves. It may be appropriate when an aesthetic concern—a crooked nose, a hump, a drooping or disproportionate tip—coincides with breathing obstruction or a structural deformity that should be corrected as part of an integrated plan.
The nose consists of bone, cartilage, and soft tissue. Its shape and function can change through development, aging, injuries, previous surgery, or disease. Septorhinoplasty therefore involves more than simply “repositioning the septum”: it requires understanding how the bridge, tip, septum, turbinates, and nasal valves interact.
In this guide
Rhinoplasty, septoplasty, and septorhinoplasty: the differences
These terms describe the main aim of each procedure, although in practice planning must be tailored to each patient’s actual anatomy.
| Procedure | Main aim | What it can address | What not to assume |
|---|---|---|---|
| Rhinoplasty | Change the shape, proportions, and support of the nose. | The bridge, hump, tip, width, external deviation, and effects of injury. | It is not necessarily “cosmetic only”: sound planning always respects nasal function. |
| Septoplasty | Correct a deviated or deformed septum. | Obstruction caused by the septum and problems with its support. | It does not, on its own, correct every breathing problem or every external deviation. |
| Septorhinoplasty | Integrate external appearance and breathing function. | The nose and septum; where indicated, the turbinates and nasal valves too. | It is not the same operation for everyone: the plan depends on the diagnosis and agreed goals. |
When may septorhinoplasty be appropriate?
It may be suitable when aesthetic and functional concerns are connected, or when correcting one without addressing the other would compromise the outcome. Common situations include:
Functional problems
- Persistent nasal obstruction caused by a deviated septum.
- Narrowing or collapse of a nasal valve.
- Associated enlargement of the turbinates.
- A post-traumatic deformity that narrows the airway.
Septal surgery does not resolve every nasal obstruction
Rhinitis, chronic inflammation, turbinate enlargement, nasal valve problems, and other causes can coexist. Before recommending surgery, it is essential to identify which structures are responsible for the symptoms and which component may improve with medical treatment.
How we assess breathing function
Planning begins with a detailed medical history: how long the obstruction has been present, whether it affects one or both nostrils, how it changes during sleep or exercise, and any history of injury, allergies, or previous surgery. We then assess the nose externally and internally.
Anatomical examination
We assess deviation, tip support, symmetry, the septum, turbinates, and the behavior of the nasal valves during inhalation. Nasal endoscopy or other tests are reserved for cases in which they provide useful information.
Aesthetic planning
We take standardized photographs and study the nose in relation to the forehead, lips, chin, and face as a whole. Simulations help us discuss goals, but they are not an exact promise of the outcome.
Septum, turbinates, and nasal valves
Good breathing depends on several structures. Correcting only the most obvious problem may leave another important area untreated.
Nasal septum
This is the wall of cartilage and bone separating the nostrils. A deviation can narrow the airway and may also contribute to a crooked appearance.
Turbinates
They humidify and filter the air. When enlarged, they can worsen obstruction; treatment should preserve their function as much as possible.
Nasal valves
These are the narrowest segments of the nasal airway. If they lack support or collapse during inhalation, specific techniques or grafts may be needed to reinforce them.
How septorhinoplasty is performed
It is usually performed under general anesthesia. Surgery may take between two and five hours, depending on complexity, previous injuries or operations, and the need to reconstruct nasal support.
Closed or open approach
In a closed approach, the incisions are inside the nostrils. An open approach adds a small incision across the columella—the skin separating the nostrils—to improve exposure of the structures. Neither approach is best for every case: we choose the one that provides the control required with the least reasonable tissue disruption.
Bone, cartilage, and grafts
After carefully lifting the skin and soft-tissue envelope, we reshape or reposition bone and cartilage. When needed, we use grafts—often from the patient’s own septum—to support the tip, straighten the nose, or maintain open nasal valves.
Osteotomies and ultrasonic rhinoplasty
Osteotomies are controlled cuts in the nasal bone that allow it to be narrowed or repositioned. Ultrasonic technology can perform this bone work very precisely, but it does not replace diagnosis, septal correction, or the other components of surgery.
Integrated functional correction
Septoplasty is tailored to the specific deformity and must preserve adequate support. Where the diagnosis calls for it, conservative turbinate treatment and nasal valve reinforcement are included.
Our protocol at Dr. Aso Clinic
These are our team’s usual guidelines after septorhinoplasty. They may be adjusted when the reconstruction or a patient’s recovery calls for a different approach.
An external splint for one week
We keep it in place for approximately seven days to protect and stabilize the bones. We only omit it when no osteotomies have been performed, which is uncommon in our practice.
Internal silicone splints
After septorhinoplasty, we usually keep them in place for one week. In complex reconstructions, they may remain for up to two weeks.
Packing with an airway channel
We use cylindrical silicone splints with a hollow central channel as nasal packing. Unlike traditional solid packing, this design allows air to pass through, although swelling and secretions can cause congestion during the first few days.
They have three purposes: they help control bleeding, limit movement and displacement of the septum as healing begins, and keep internal surfaces apart to reduce the risk of scar adhesions.
What are nasal synechiae? They are abnormal scar adhesions between the septum and the lateral nasal wall or turbinates. They can narrow the nasal passage and cause persistent obstruction.
Hollow splints are not the same as routine solid packing
The literature questions the indiscriminate use of solid packing after septal procedures. Our protocol refers to hollow internal splints in septorhinoplasty: they stabilize the septum and maintain an airway without completely blocking it.
Septorhinoplasty recovery and postoperative care
Recovery varies with the type of surgery, extent of osteotomies, reconstruction performed, and individual response. This timeline is a guide; your team’s personal instructions always take priority.
The first 48–72 hours
Swelling, bruising around the eyes, congestion, and moderate discomfort are expected. Pain is usually controlled with the prescribed medication.
The first week
We recommend taking things gently, walking at an easy pace, and sleeping on your back with your head elevated. The external splint and usually the internal splints are removed around the seventh day.
Between 7 and 14 days
Much of the bruising and visible swelling subsides. Many people can return to office work and social activities, although the nose does not yet show its final result.
The first few weeks
Do not blow your nose until your team gives permission. You can breathe gently through it; sneezing with your mouth open avoids a sudden pressure increase.
Physical activity
Exercise is resumed gradually. Strenuous activity, contact sports, and anything that risks a blow to the nose require more time and individual advice.
The following months
Residual swelling, particularly at the tip, decreases slowly. Final definition may take between 12 and 18 months after complex surgery or in patients with thick skin.
Care that can help
- Apply cold packs around the eyes and cheeks without putting pressure on the nose.
- Sleep with your head elevated and initially avoid sleeping on your side or stomach.
- Keep the incisions clean as instructed.
- Avoid knocks, glasses resting on the bridge, and direct sun exposure until your team gives permission.
- Use rinses, humidification, and medication only as prescribed.
What to avoid
- Blowing your nose or adjusting the splints yourself.
- Self-medicating or routinely applying antibiotic creams.
- Strenuous exercise and exertion that increase bleeding.
- Judging the outcome by the appearance of the first few days.
- Comparing your recovery with that of a much simpler or more complex operation.
Risks and warning signs
Septorhinoplasty is complex surgery. Although recovery is usually uneventful, potential complications include bleeding, infection, changes in sensation, unfavorable scarring, asymmetry, irregularities, persistent obstruction, septal perforation, changes in smell, or the need for revision surgery.
When to contact the team without waiting for your next follow-up
- Heavy or persistent bleeding that does not settle with the instructions you have been given.
- Severe pain that is clearly increasing rather than improving.
- Persistent high fever, pus-like discharge, or an unpleasant smell accompanied by feeling increasingly unwell.
- Changes in vision, severe eye pain, or rapidly increasing swelling.
- A blow to the nose or visible displacement of the splint.
Appearance and breathing outcomes
You can see a change when the splint is removed, but this is not the final result. During the first few weeks the nose is swollen, and breathing may even seem worse because of swelling, secretions, and crusting. Function improves gradually as the airway heals.
Structural changes are usually long-lasting, but they should not be described as a “permanent” guarantee: aging, an injury, and healing itself can alter appearance or function over time. Careful planning aims for a proportionate, stable nose that suits the face, not an identical shape for everyone.
How to interpret before-and-after photographs
Clinical cases are more informative when lighting, distance, position, and follow-up timing are comparable. We plan to add a selection of our own cases to this section with their clinical context; they will not replace an individual assessment.
Would you like to learn more about treatment?
Our rhinoplasty treatment page explains planning, technical options, and the consultation process. This article focuses on information and recovery rather than duplicating the purpose of the treatment page.
Frequently asked questions about septorhinoplasty
Is septorhinoplasty cosmetic or functional?
It can address both goals. It corrects the external shape and structures that interfere with breathing within a single surgical plan.
Can you breathe through the nasal packing?
Our protocol uses cylindrical silicone splints with a central channel. They allow air to pass through, although swelling and secretions can cause congestion.
When are the splints and packing removed?
Usually after around one week. In complex reconstructions, internal splints may stay in place for up to two weeks. The external splint is generally only omitted when no osteotomies have been performed.
Is septorhinoplasty very painful?
Discomfort and congestion are usually more noticeable than pain, which is generally controlled with the prescribed medication. Severe pain that continues to worsen should be reported to the team.
When can I return to work?
Many people return to office work between one and two weeks after surgery, depending on the procedure, bruising, swelling, and the demands of their job.
When will I see the final result?
The change is visible when the splint is removed, but the nose continues to refine over several months. The tip and complex surgical cases may need between 12 and 18 months to show their final definition.
What are nasal synechiae?
They are scar adhesions between internal surfaces of the nose. If they narrow the airway, they can cause obstruction; internal splints help keep these surfaces apart during early healing.
Medical transparency
Medical authorship
Jorge Aso, MD, PhD
Specialist in Plastic, Aesthetic and Reconstructive Surgery (Spanish MIR training)
Medical registration no. 2828/61062 · Madrid
Original Spanish article updated
About Septorhinoplasty: Procedure, Recovery, and Nasal Breathing: clinical information, safety and expectations. Based on the original Spanish content.
Translation does not constitute a new medical review. This information does not replace an individual medical assessment.
View profile, training and credentialsMedical sources and editorial standards Selected references for this article 6 references
References support the general medical information. Suitability, alternatives, and risks are discussed individually during consultation.
- Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty Otolaryngology–Head and Neck Surgery / PubMed
- Rhinoplasty Recovery American Society of Plastic Surgeons (ASPS)
- Rhinoplasty Risks and Safety American Society of Plastic Surgeons (ASPS)
- Information after septorhinoplasty Cambridge University Hospitals NHS Foundation Trust
- Is postoperative nasal packing after septoplasty safe? A systematic review and meta-analysis of randomized controlled studies. Rhinology / PubMed
- Evaluation of Measurement Properties of Patient-Reported Outcome Measures After Rhinoplasty: A Systematic Review. JAMA Facial Plastic Surgery / PubMed
