A septal perforation is a hole in the nasal septum. This causes airflow through the nasal cavity to crisscross through the hole in the septum, causing turbulence, which adds drag to the air as it flows through the nose, causing the sensation of obstruction.
Septal Perforation in Richmond, VA
Overview
Nasal septal perforation repair is ultra-specialized, requiring very advanced knowledge of rhinoplasty techniques, tissue advancement, and grafting. Placing sutures deep in the nose is extremely delicate and requires supreme concentration and patience. Midlothian, VA, facial plastic surgeon Matthew Bridges, MD, FACS, trained with a world-renowned expert in rhinoplasty and septal perforations. He has extensive experience and a special interest in the repair of septal perforations.
During/After Surgery
Septal perforation surgery is an outpatient procedure performed under general anesthesia. The approach used during the surgery varies for each patient, depending on the severity of the perforation. However, the actual technique used to close the hole is similar in both approaches (closed vs. open). The tissue surrounding the perforation is carefully elevated on both sides to separate the flaps and allow the hole to be closed in each flap independently. This is done with careful suturing inside the nose. An "interposition" tissue graft is placed between the flaps, and the flaps are then sewn back together, incorporating the tissue. Various tissue sources are available for grafting, including tissue from behind the ear or even from the leg. Dr. Bridges typically uses acellular dermis, or Alloderm, which is prepared donor tissue that does not require another incision for harvesting. This tissue works very well. After surgery, thin silicone sheets are kept in place on both sides of the septum for 3-4 weeks. This allows the tissue to completely heal without drying out and is very important in the overall process. The silicone sheets are typically well-tolerated by patients. With the closed approach, there is usually little to no external swelling or bruising, and external taping/splinting is not necessary. Overall, the procedure is not particularly painful.
Septal Perforation Surgery FAQ
Does septal perforation surgery work?
Should I have open or closed surgery for septal perforation?
Does insurance cover the procedure?
When can I exercise?
Does septal perforation surgery work?
The success rate of septal perforation surgery depends on the severity of the perforation. About 90 percent of patients who undergo septal perforation surgery (both open and closed techniques) experience a successful procedure with minimal risks and side effects.
Should I have open or closed surgery for septal perforation?
The technique used during the procedure depends on the size and severity of the perforation. Most patients with small or medium-sized perforations have closed septal perforation surgery, while patients with larger perforations may require open surgery. During the initial consultation, the surgeon evaluates the perforation to determine which technique would be the most successful.
Does insurance cover the procedure?
Some insurance companies may cover the cost of surgery because of the medical effect on patients suffering from septal perforation. Patients are encouraged to speak with an insurance representative before surgery to find out what will be covered by their insurance policy.
When can I exercise?
Most patients can return to routine exercise 3-4 weeks after surgery. However, you should be extremely careful not to hit or injure your nose during exercise.
