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Penn Medicine Becker ENT

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  • Cape May, NJ: (609) 899-7200
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Penn Medicine Becker ENT
  • About Us
    • Our Providers
      • Physicians
      • Nurse Practitioners
      • Audiologists
      • Speech-Language Pathologists
    • Reviews
  • Services
    • Allergy
    • Head & Neck
      • GERD
    • Nose & Sinus
      • Septoplasty
      • Sinus Surgery
      • Turbinate Surgery
      • Balloon Sinuplasty
      • Nasal Valve Surgery
      • New technologies
    • Pediatric ENT
      • Pediatric Snoring & Sleep
      • Ear Infections
      • Tonsil Infections
      • Allergy
      • Airway Problems
      • Pediatric Asthma
      • Symptoms
    • Snoring & Sleep
      • Snoring
      • Sleep Apnea
    • Ears and Hearing
    • Voice & Swallowing
      • Voice Disorders
      • Professional Voice
      • Swallowing Disorders
  • Locations
    • Cape May Court House, NJ
    • Freehold, NJ
    • Hillsborough, NJ
    • Lawrenceville, NJ
    • Monroe, NJ
    • Mt. Laurel, NJ
    • Mullica Hill, NJ
    • Philadelphia, PA – South Street
    • Philadelphia, PA – Walnut Street
    • Plainsboro, NJ
    • Princeton, NJ – Ewing Street
    • Princeton, NJ – Bunn Drive
    • Robbinsville, NJ
    • Sewell, NJ
    • Voorhees, NJ – Evesham Rd
    • Voorhees, NJ -Sheppard Rd
    • Yardley, PA
  • Patient Resources
    • Forms
    • Videos
    • Education
    • Book with Zocdoc (opens in a new tab)
  • Book an appointment
Penn Medicine Becker ENT

Septoplasty in New Jersey and Philadelphia

Nasal Blockage and Congestion

Nasal blockage and obstruction can have many causes. In some patients, allergies (“hay fever”) lead to swelling of the nasal and sinus lining, which in turn causes congestion and blockage. In other patients, blockage can be due to simple anatomic obstruction. Take the adenoids, for instance, which are masses of lymphoid tissue in the nasopharynx at the back of the nasal passage. These can be overgrown in some patients which can block the free flow of air in and out of the nose. Other patients might have polyps, which are grape-like masses that typically grow in the sinus areas and expand into the nasal passage. While still others might have blockage due to a deviated septum.

The septum is the internal “dividing wall” between the right and left sides of the nose.
Nasal blockage and obstruction can have many causes such as allergies or an anatomic obstruction.
Table Of Contents
  1. Nasal Blockage and Congestion
  2. Anatomy of the Septum
  3. The Benefits of Septoplasty (Nasal Septal Surgery)
  4. Who is a Candidate for a Septoplasty?
  5. Your Septoplasty Consultation
  6. What is septoplasty and how is it performed?
  7. Why Choose Our Specialists?
  8. Additional Procedures
  9. Septoplasty FAQs

Anatomy of the Septum

The septum is the internal “dividing wall” between the right and left sides of the nose. The back or posterior two-thirds of the septum is comprised of bone, while the front or anterior one-third is made up of cartilage surrounded by a mucosal lining. Anatomically, the bones and cartilage are connected to the maxilla and palatine bone on the bottom and the skull-base on the top. Separating the bone/cartilage and the mucosal lining is an additional lining – the periosteum (for the bone) and the perichondrium (for the cartilage) – which provides a rich blood supply to the bone and cartilage. Along the floor of the nose, the septum is held in the midline by grooves in the bone. The septum is also held in the midline by a variety of supporting connective tissues in the tip of the nose.

In a situation where a deviated nasal septum is determined to be a significant causative factor of nasal obstruction, surgical correction of the deviation may be recommended.
Anatomy of the Septum

In a situation where a deviated nasal septum is determined to be a significant causative factor of nasal obstruction, surgical correction of the deviation may be recommended. Below please find descriptions of septal surgery (septoplasty) along with answers for associated frequently asked questions.

The Benefits of Septoplasty (Nasal Septal Surgery)

Patients with persistent nasal obstruction, blockage and congestion which has been poorly responsive to medical interventions and therapies, and who have a deviated septum as part of their blockage, may benefit from septoplasty. It is our experience that after septoplasty, patients  typically report improved nasal breathing and airflow, decreased blockage and congestion, diminished “dry mouth,” and a more complete and restful sleep. Opening the nasal passage with a septoplasty does not treat allergies, but it does allow for improved delivery of nasal sprays (nasal steroids, nasal antihistamines) which are designed to treat allergies. Also, in many patients with persistent nose bleeds, the improved airflow and diminished congestion after septal surgery leads to a decrease in the constant sniffling and nose blowing which contribute to irritation of the front part of the nose where nose bleeds most commonly occur.

Who is a Candidate for a Septoplasty?

Septoplasty is an option for patients with septal deviation and persistent nasal obstruction that has not responded to medical therapy.
Figura A. Nasal Septal Surgery

Septoplasty is an option for patients with septal deviation and persistent nasal obstruction that has not responded to medical therapy. Nasal blockage often has a component due to swelling of the nose and sinus lining, and it is beneficial to see what degree of improvement can be obtained by trying to minimize this swelling. Nasal steroid sprays, nasal antihistamine sprays, saline sprays and irrigations, and oral antihistamines may be prescribed in an attempt to diminish nasal blockage and congestion. Over the counter medications such as Mucinex (Guafenesin) may be tried. However, decongestants such as Afrin (Oxymetazoline) and Sudafed (Pseudophedrine HCL) are typically not recommended for long-term use due to their side-effect profiles. In some cases, allergy testing may be recommended as well to try to identify the specific allergens and irritants which stimulate swelling and edema.  When a patient has persistent nasal obstruction which has not responded to medical therapy, and where the deviated septum is determined to have a notable contribution to the obstruction, septoplasty may be considered as a means to help open the nasal passage and allow for improved nasal airflow.

Simply having a deviated septum does not mean you need a septoplasty. Septoplasty is indicated in patients with symptoms of nasal blockage and congestion where medical therapies have been unsuccessful and in whom the septum is determined to play a significant role in the symptoms. In these appropriately selected patients, septoplasty can have a major, positive impact on nasal breathing, congestion and quality of life.

Your Septoplasty Consultation

Your consultation will begin by your ENT physician listening carefully to your history in order to understand what symptoms you seek improvement with, as well as what treatments and medications you have tried in the past. A thorough exam will be performed. This will often include a nasal endoscopy in which a small, 4mm lighted endoscope is used to visualize the entire nasal cavity from the front all the way to the adenoid area in the nasopharynx. In some cases, testing such as a CT scan and/or allergy test may be ordered. You are encouraged to ask questions during this visit as you should have a full understanding of what next steps your ENT doctor recommends and why he or she recommends these steps. Sometimes, the next step may be surgical septoplasty, while in other cases your physician may recommend other medications to try to see if you can obtain improvement without surgical intervention. Telemedicione Septoplasty doctor available now!

What is septoplasty and how is it performed?

Septoplasty is a surgical procedure designed to correct a deviated (or “off-center”) septum which is contributing to nasal blockage. While septoplasty can be performed with a patient “awake” under local anesthesia, it is most commonly performed as an outpatient procedure in a hospital or Ambulatory Surgical Center operating room under general anesthesia. In this controlled setting, a standard septoplasty is typically completed in about an hour. During the procedure, your surgeon will usually make a small incision on the inside of the nose in the nasal lining.

 Septoplasty is a surgical procedure designed to correct a deviated (or “off-center”) septum which is contributing to nasal blockage.
Figure B. Septoplasty Incisions

Through the incision, the septum will be exposed and the deviated components identified and isolated so that they may be shaped, sculpted, and/or removed. Once this is complete, the mucosal “flaps” are sewn back together, leaving a straightened septum and an open, unobstructed nasal passage.

unobstructed nasal passage nj
This “Extracorporeal Septoplasty” is a more involved procedure and is usually accompanied by a longer recovery period.
Figure C. Unobstructed nasal passage

In some cases whereby the deviation is concentrated in a single isolated area of the septum, an “Endoscopic Septoplasty” may be performed. Using a small, 4mm endoscope, the deviated area is identified and a small incision is made just in front of the focal deviation. With specialized instrumentation, flaps are elevated and the “septal spur” is removed in a targeted fashion. In other cases, the entire septum is removed, rebuilt and re-implanted. This is more common after a trauma when the septum is deviated or broken in multiple spots and lacks the integrity to provide meaningful support. This “Extracorporeal Septoplasty” is a more involved procedure and is usually accompanied by a longer recovery period.

Why Choose Our Specialists?

  • Dr. Daniel G. Becker, Founder and Medical Director of The Penn Medicine Becker ENT & Allergy Center, is a highly trained, board-certified specialist who graduated magna cum laude from Harvard College in 1986.  
  • Dr. Samuel S. Becker, Director of Rhinology at The Penn Medicine Becker ENT & Allergy Center, is a highly trained, board-certified specialist who graduated from Amherst College in 1991 and attended medical school at the University of California San Francisco.
  • Dr. Kenneth Rosenstein is a highly trained, board certified otolaryngologist who attended medical school at Mcgill University, and completed his residency training at the prestigious New York Eye and Ear Infirmary.
  • Dr. Naomi Gregory is a highly trained, board certified otolaryngologist who specializes in the diagnosis and treatment of diseases of the ear, nose, and throat. Dr. Gregory completed medical school at the Philadelphia College of Osteopathic Medicine in Philadelphia PA.
  • Dr. Michael Lupa, MD is a highly trained, board certified otolaryngologist with additional training in sinus surgery and allergy treatment as well as advanced skull base surgery. He studied Biology at Tufts University and went on to complete medical school at Case Western University School of Medicine in Cleveland, Ohio. 
  • Dr. Robert Mignone is a highly trained, board-certified otolaryngologist-head and neck surgeon who attended medical school at New York College of Osteopathic Medicine. 
  • Dr. Aubrey McCullough is a highly trained otolaryngologist, facial plastic and head and neck surgeon who completed medical school at Midwestern University Arizona College of Osteopathic Medicine.
  • Dr. Luke Kim is an otolaryngologist who specializes in the diagnosis, medical management, and surgical treatment of diseases of the ear, nose, and throat. Dr. Kim graduated with honors and with distinction from Cornell University and completed his medical studies at the Perelman School of Medicine at the University of Pennsylvania.

Additional Procedures

In some cases, the septum is just one of several anatomic factors contributing to nasal blockage, and it may be best to address some of these other abnormalities at the same time as septoplasty. The inferior turbinates, for instance, are tube-like structures along the sides of the nasal passage which swell and shrink. In patients where these turbinates are enlarged, it may be beneficial to reduce the size of the turbinates to improve nasal airflow. This is discussed in more detail elsewhere on this website. Other structures which may contribute to nasal blockage and congestion include nasal and sinus polyps, enlarged adenoids, hypertrophied middle turbinates (concha bullosa), masses and tumors. Functional blockage (e.g., nasal valve collapse) occurs when the outside of the nose collapses inwards with inspiration. This may also be surgically addressed at the time of septoplasty, or at another time as a separate procedure.

I had been accidentally hit in the nose, after which I had difficulty breathing through my nose. Over-the-counter decongestants were not effective. After seeing Dr. Becker, I felt more comfortable about a septoplasty to relieve the problem, as the medicines that he prescribed prior to surgery relieved the sinus pressure a little but not totally (about 5 on a scale of 10). I am very satisfied with Dr. Becker’s professionalism, and I would certainly recommend him!

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Septoplasty FAQs

Can I be awake for my septoplasty?

In most instances, septoplasty is performed under general anesthesia. In some cases, the procedure may be performed with the patient “awake” under local anesthesia. You should discuss this with your surgeon so that the best decision can be made for your circumstances.

Is there nasal packing?

Several years ago, it was standard for patients to have several feet of Vaseline-infused gauze “packed” into their nose at the end of surgery and left there for one week while the patient healed. This was unpleasant and uncomfortable. Fortunately, very few surgeons use packing any more. Some use “septal splints” in place of packing; however, this is also noted to be quite uncomfortable and studies have shown that splints and packing do not provide improved outcomes. With this in mind, many surgeons perform septoplasty without packing or splints. It is advisable to ask your surgeon what their standard practice is.

Does a septoplasty change the appearance of my nose or face?

No. A simple septoplasty does not change the outside appearance of the nose or face. In cases where a patient would like a change in appearance of their nose, this may be performed along with a cosmetic rhinoplasty.  If it is your aim to have a change in your nasal appearance as well as function, you should discuss this with your surgeon.

Will I have black eyes or bruises after surgery?

In a standard septoplasty, a patient will not have black eyes or facial bruising. In some cases, when septoplasty is combined with other procedures (e.g., nasal fracture repair, functional or cosmetic rhinoplasty), a patient may have black eyes depending on the techniques used and procedures performed. You should ask what to expect from your surgeon.

The septoplasty was highly effective.

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Are there stitches?

In most cases, sutures are used to sew the incision site and flaps together at the end of surgery. Sutures are typically dissolvable and do not require removal. In some cases (e.g., Endoscopic Septoplasty), no sutures are used.

How painful is the surgery?

While every patient is unique, most patients will find that their post-operative pain in easily managed with low-dose narcotic medications (e.g., Tylenol with codeine) for 1-2 days, after which they transition to regular or extra-strength Tylenol for another week or so.

How long will I need to take off from work?

Septoplasty is typically a minor, minimally-invasive outpatient procedure. Patients will typically take several days to a week off from work. This can vary based on individual recovery and details of each person’s unique surgery, as well as recovery from general anesthesia. Most patients are advised to refrain from heavy lifting or vigorous activity for 1-2 weeks, although specific details should be discussed with your surgeon.

When can I eat and shower after surgery?

After surgery, there is no restriction on eating or bathing. There is typically a list of blood-thinning medications to refrain from for a brief period after surgery, but you should discuss this with your surgeon. In general, however, you may eat whatever you feel like eating.

What septoplasty office is near me?

If you live in the states of New Jersey or Pennsylvania, Penn Medicine Becker ENT & Allergy Center offers septoplasty among its services. For a full list of services, please visit our Locations page.

Last Modified 03/17/2022 by Samuel S. Becker, MD, and Medically Reviewed by:

  • Kenneth Rosenstein, MD
  • Naomi Gregory, DO
  • Daniel G. Becker, MD
  • Michael Lupa, MD
  • Robert Mignone, DO
  • Aubrey McCullough, DO
  • Luke Kim, MD

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Cape May Court House, NJ

307 Stone Harbor Blvd, Unit 1
Cape May Court House, NJ 08210
Phone: 609-899-7200

Freehold, NJ

303 W Main St, Suite 500
Freehold Township, NJ 07728
Phone: 732-375-9550

Hillsborough, NJ

719 US-206, Suite 101
Hillsborough, NJ 08844
Phone: 908-271-2102

Lawrenceville, NJ

2 Princess Road, Suite E
Lawrenceville, NJ 08648
Phone: 609-303-5163

Monroe NJ

350 Forsgate Drive, Suite 103
Monroe Township, NJ 08831
Phone: 609-831-0779

Mt. Laurel, NJ

5000 Dearborn Circle, Suite 100
Mt Laurel, NJ 08054
Phone: 609-949-5940

Mullica Hill, NJ

199 Mullica Hill Road
Mullica Hill, NJ 08062
Phone: 856-478-3111

Philadelphia, PA

1740 South Street, Suite 401
Philadelphia, PA 19146
Phone: 215-671-6330

Plainsboro, NJ

5 Plainsboro Road, Suite 360
Plainsboro, NJ 08536
Phone: 609-831-0807

Princeton, NJ

256 Bunn Drive, Suite A
Princeton, NJ 08540
Phone: 609-354-5445

Robbinsville, NJ

One Union Street, Suite 203
Robbinsville, NJ 08691
Phone: 609-436-5740

Sewell, NJ

570 Egg Harbor Road, Suite B-2A
Sewell, NJ 08080
Phone: 856-589-6673

Voorhees, NJ

1001 Sheppard Road
Voorhees Township, NJ 08043
Phone: 856-772-1617

Yardley, PA

111 Floral Vale Blvd, Suite A
Yardley, PA 19067
Phone: (267) 399-4004

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