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Functional nasal surgery
The nose is a key part of the respiratory system, and is necessary for comfortable breathing, sleep and exercise. If you have difficulty breathing through the nose, this can be due to structural problems with the shape of the nose and septum, impacting on nasal airflow.
Mr Jacques is a nose-specialised ENT surgeon (rhinologist), with comprehensive experience in all aspects of nasal function, including functional nasal surgery and medical conditions such as rhinitis and allergy.
Functional nasal surgery includes both septoplasty and septorhinoplasty, depending on the individual anatomy of the patient and whether they also have concerns regarding the aesthetic appearance of the nose.
The decision to have surgery to change the appearance of your nose is a highly personal one. It is essential to work with your potential surgeon to discuss your aims and wishes in detail, and to have a full understanding of the procedure and its limitations. You should take all the time you need to arrive at a decision, and feel confident that your surgeon understands your aims, and is able to meet your expectations.
About septoplasty and functional septorhinoplasty
Septoplasty and functional septorhinoplasty are both procedures that aim to improve the nasal airway, where it is affected by a curvature of the septum, the external nasal framework, or both. These procedures can be performed for breathing alone, with minimal or no change in the external shape of the nose, or alternatively they can be combined with cosmetic changes according to the patient's wishes.
Mr Thomas Jacques is highly specialised in nasal surgery and has performed over 1,000 rhinoplasty and septorhinoplasty procedures. He has extensive experience of functional, post-traumatic and reconstructive procedures.
Consultations take place in Chelsea, Belgravia and Marylebone. Surgical procedures are performed at Cadogan Clinic and HCA Lister Hospital, both in Chelsea. Mr Jacques is recognised by all major insurers for nasal airway surgery. Please note that (where requested by the patient), cosmetic surgical changes to the nose are separately charged as a self-funded procedure.
AT A GLANCE
Anaesthetic
Duration
Hospital stay
Dressing removed
Back to work
Exercise
General
30-90 mins
Day case
1 week
2 weeks
4 weeks
Surgical technique
Patients with a mild-to-moderate deviated nasal septum in an otherwise well-aligned nose will often respond well to septoplasty: this procedure is performed internally and does not affect the external structure of the nose. Patients with more severe or complex septal deviations, and/or external deviation of the nasal framework may require functional septorhinoplasty, where an external approach is used. This allows for more flexibility in mobilising and supporting the septum in the midline.
In septoplasty, there are no external incisions as the procedure is performed entirely within the nasal cavity. In functional septorhinoplasty only external incision is across the thin strip of skin between the nostrils (the columella): this incision heals extremely neatly, and is very difficult to see in the vast majority of cases.
Surgery is performed under general anaesthesia. Patients are able to go home the same day, a few hours after surgery ends. They are discharged with all the medication required for their recovery, following a review with Mr Jacques and the nursing team.
Patient journey
The surgical journey starts with an outpatient consultation in one of our clinics in Central London. We allow plenty of time for an unhurried and detailed consultation about your nasal concerns, a thorough examination and photography if needed, followed by a discussion about what can be achieved in your case. Information about the procedure, its risks and limitations in your case are all covered in this consultation.
A second consultation is usually arranged before surgery takes place if the patient has additional aesthetic concerns.
Dressing removal and clinic follow-up appointments will be arranged by Mr Jacques's team prior to your surgery. We are available for any questions around the time of surgery and throughout your journey.
Recovery and aftercare
Mr Jacques is dedicated to providing a reassuring and smooth journey through surgery, with the minimum discomfort possible. He does not utilise nasal packing or internal nasal splints. A moulded plastic dressing protects the nose after surgery and is removed after one week.
Patients are provided with pain relief medication, antibiotics, decongestant nasal medication and antibiotic ointment, for regular use during the first two weeks after surgery. Small stitches placed in the columellar incision dissolve on their own over approximately a week, and so do not need to be removed. Our patients typically report limited discomfort, and favourable levels of swelling or bruising compared to average or expected amounts.
Patients are able to self-care throughout the recovery period, and should feel ready for work after two weeks. There is some swelling present at this time, which will recede significantly over the first six weeks. It is unusual for other people to notice the presence of nasal swelling. Some milder swelling remains for up to a year. In functional septorhinoplasty, there should be minimal change to the overall shape of the nose, but this will be discussed on an individual basis.