Rhinoplasty Forum and Chat

Support Forum, Chat, and Message Board for Patient's Questions and Answers Nasal Obstruction, Deviated Septum, Septoplasty, SMR, & Submucous Resection 4

Explore what others have to say about Nasal Obstruction, Deviated Septum, Septoplasty, Septorhinoplasty, and Plastic Surgery with answers by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

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Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Rhinoplasty Nasal Surgery Important Information

Question: Re: Nasal Obstruction

I've written before, and you were very quick to get back with me. I appreciatethat!

This time, however, I'm going to be brief and ask only a couple of questions that you might could help me with.

1. What causes turbinate swelling to occur all the time, day or night, and regardless of the environment (outdoors, home, work, vacation, the beach)? No matter where I am, it's always one nostril blocked, and the other one partially blocked. Sleeping at night is rough! Sprays (NasalCrom, Flonase,saline solutions, etc) don't work. I can't figure it out. What do you think?

S>

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Nasal obstruction can be from allergies, medical problems or mechanical in nature. Sometimes the problem is a combination. Some of the sprays you mention tend to lessen the impact of allergic materials. Without an examination, I cannot guess what is your problem.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD



Question: Re: My nose altitude

HI. I am flying to Kathmandu , Nepal to go hiking in the Himalayan MTs for 2 weeks, the highest altitude we will be trekking is about 6,000 meters. I had my 2nd rhinoplasty this past May and still have problems breathing. Do you suggest I take anything special with me , I heard it is more difficult to breath up there.

Regards,

D

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

If you have lung problems "problems breathing", ask your medical doctor if there will be problems. If your still have problems with nasal obstruction, ask your surgeon who did your surgery. Extreme altitude has lower oxygen pressure and can increase the work it takes to get oxygen into your body. Someone who is marginal in getting oxygen to the brain at sea level may be at risk at the higher altitudes. Most minimal nasal obstructions should have no problems with the altitude.

The dryness can be a problem with someone who is minimally compensated. Turbinates moisten the air as it passes through the nose. Extreme altitude can make some uncomfortable. Nasal moisturizers can increase comfort. Ask your surgeon if this is a factor for you.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Deviated Septum

Dr. Bermant, I'm a 47 year old female, smoker, no allergies. I'm told I sleep with my mouth open and snore very loud. A few years ago a doctor told me that I have a deviated septum and asked me if my nose had ever been broken. Well, no, my nose was never broken, so it appears I was born this way. So, embarrassing to admit but true, I've spent all these years not knowing that I don't breathe as good as other people; which explains some of my overall lack of energy, etc. As a surgeon, can you give me an opinion ... is it too late for surgery? does this surgery only help if someone's nose was broken? I've not seriously consulted a doctor yet, but it would be great to be able to breathe twice as good as I can now. Thanks, S

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

It is hard to give an opinion without an evaluation and examination. People older than you have benefited from nasal obstruction correction surgery. Poor airway can cause a number of problems but "overall lack of energy" is rarely caused by a nasal obstruction. You see, when someone does not breath well through the nose, the open their mouth and get the air they need. Unless you have no mouth, or can't stop talking, nasal obstruction is compensated with the mouth. For the fatigue answer you may have to look elsewhere. Improved breathing through the nose can be a real pleasure and that is why mechanical obstruction corrective surgery has value.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Thanks so much. S


Question: Re: Deviated Septum in youth

My daughter is 13 years old. Two years ago she had her tonsils removed because of constant strep and viral sore throats. For six months she was fine, and last November she began with constant sore throats again - but viral this time. By January she was so sick she couldn't get out of bed, losing weight because she found eating difficult with her sore throats and after many different doctors, she was diagnosed as having Epstein Barr. She was on home teaching for several weeks, but even after she began to feel better, her sore throats were still a problem. We went back to the ENT again, and he ordered a CAT scan and found she has a severe deviated septum. Originally he had indicated that if her problem was from a deviated septum - she would have to wait until she's15 or 16 before having the surgery. After seeing the CAT scan, he indicated she should have the surgery immediately. He had also referred her to an allergist - she did not have any severe allergies and the allergist indicated that he felt the physical obstruction should be dealt with first since she could have shots for years and not get any relief because of the septum problem. I went for a second opinion, and was told under no circumstances should the surgery be performed before she's 15 because of the danger of deformity to the nose, and to use different nasal sprays (vanacene[sp?] or Nasalcrom) - none of which are giving her much relief. She woke up this morning, with her third sore throat in a month - partial laryngitis and what she says feel like knives in the lower part of her throat). I don't know who to go to, or what to do to relieve her sore throat pain - gargling doesn't reach down where her throat hurts. She's upset at the thought of being sick all winter again (which the first ENT had indicated she would be without the surgery) and I don't know what to do. The pediatrician attributes some of the problem to Epstein Barr - which also won't go away. Any advice would be appreciated.

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Septorhinoplasty surgery in the not fully grown nose can be controversial. The growth of the nose may be altered with surgery. The conservative surgeon is showing caution with a possible problem. Having a young patient live with a severe deformity, nasal obstruction, or infections related to mechanical problems also does not make sense. Some suggest that for severe problems early surgery is a very good idea. Intermediate deformities will have a relative indication for surgery. Without an examination and evaluation, it is hard to say what is best for your child. I am uncertain about the association of the nasal obstruction with sore throats, it is associated with sinus infections and problems. Sinus infections can cause inflammation of tonsils.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Nasal Polyps

How serious are nasal polyps and how soon should surgery be done on them? How fast can they turn cancerous. Please e-mail me back at ....

Thank you

S

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Nasal polyps are usually a reaction to irritation and allergies. They can be treated medically but not without an examination and evaluation by someone who usually treats this problem. Cancerous degeneration of a nasal polyp is not common.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Septum recovery

Hello Dr. Berment,

Thanks for putting together such an informative site, and thanks for being available to take questions. I have one, and hope you can find the time to answer. I'm 40, male, and suffer from OSA. CPAP is ineffective, as my nasal passages were too constricted to allow meaningful airflow from the machine. I was refered to an ENT, who performed surgery for a deviated septum, and sub mucous reconstruction. The surgery was 10 days ago, and the packing (what a nightmare!) came out 6 days ago. So far, I don't feel any different. Breathing is still labored, right side is still worse than left. If I "plug" either side, I can barely get any air through the other. On the positive side, I do feel like I get adequate airflow while resting, I didn't before. Well meaning friends (3) who have had the very same surgery tell me they felt dramatic improvement the moment the packing came out. Alas, I have not. My Dr. says to be patient, it could take a few weeks for the swelling to subside, and to feel improvement. I know I should listen to my Dr., but since 3 people have said the same thing, I'm nervous I went through this for nothing. Thank you in advance........

-- S>

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Thank you very much about your comments about my plastic surgery web site.

Every patient is different. Each surgery has its own characteristics. I use special techniques and am generally able to avoid packing for most of my patients. When needed, packing removal usually does result in immediate air passage. In cases of excessive swelling or nasal obstruction, there may still be obstruction until the swelling goes down. Your doctor knows your case best.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: septoplasty and polyp removal

Dear Dr Bermant

You must be a dedicated doctor to offer such an informative service.My ENT in South Africa says I should consider septoplasty and polyp removal.I have constant sinus and sore ears.What is the success rate of this operation?Is there a statistical survey perhaps?

Thanks

J

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Thank you for your kind comments.

Septoplasty works very well for mechanical obstruction. Polyp removal also helps mechanical obstruction but does not change what caused the polyps in the first place. If the polyps were caused by environmental allergies, they can recur. Both mechanical obstruction and polyps can obstruct sinus openings. Statistics are a function of the problem being solved, and are best answered by the doctor who has had a chance to examine and evaluate you.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: SINUSES

DR. will your sinuses cause you not to be able to smell if you have an infection ?

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Sinus infection can cause swelling in the nasal passages. Such swelling can disturb the airflow over the nerves that perform the function of smelling.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Septoplasty & turbinectomy

Dear Doctor:

Today is Saturday, --. It's about 4 AM in the morning. We live in the foot of the Berkshire Mountains in Western Massachusetts in a little rural town called .... It's been sleeting & snowing all day. We've got about 8 inches now. The man who plows our driveway just finished. He's a cop in ... also. His little daughter, about 5 yrs old is with him in the truck. I got up and put the spotlight on so he could see better to do his plowing.

The fact is tho' I can barely sleep after getting this septoplasty & turbinectomy done. I went in for outpatient surgery on Wed. They decided I could stay over night if I wanted to ....thank God!!!! Because I felt like hell...really crummy. I was snoring thru my mouth all night------well of course, but nostrils were packed. I woke up every hour on the hour. I went in to have a deviated septum fixed from many moons ago. I am 47 years old. Anyway, after release from the overnight stay, on Thursday Nov 13th, my packing was still in . That was fun, a new form of torture. So, yesterday, Friday, Nov 14th I had the packing taken out at the doctor's ofc by the doctor but i still have to see him monday again. I thought he said not all the packing is out yet????

I've taken Anatomy & physiology in college not too long ago along with microbiology But A & P was a power course to say the least. I was going to go into nursing, but changed my mind & decided to get my Master's in Social Work so I could work with Aids patients in hospice.

ANYWAY----I know it take's the human body about 2 to 3 weeks to heal back to normal when it's opened like that. Mine was all done by laser and endoscopy. No outside cuts at all...no bruises around my eyes or anything like that...to look at me you would never have thought anything was done.

But it's the beginning of the 4th day now, and I feel like scabs are forming in my nostrils. I still cannot breathe thru my nose....only thru my mouth and this is frustrating to me. I cannot taste hardly anthing either. cant smell at all yet. How long will it take before my nose is back to normal & healed up to the point where i can breathe thru it? I imagine now it is still swollen and will be for at least a week if not 2 wks from the work done and shock of it to my system.

Just be frank with me please.

Sincerely,

D

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Nasal packing is never fun but sometimes necessary. I try to avoid packing as much as possible for that reason (look here for the packing avoiding techniques Dr. Bermant uses). Swelling and raw surfaces can continue discomfort. I prefer to close as much as possible in nasal surgery, the patients are just more comfortable.

The mucosal lining of the nose tends to heal much faster than skin. Primary healing (edges healing directly together) heals much faster than secondary healing (edges have to fill into gaps). There are many techniques that can minimize open areas and mucosal damage inside the nose to quicken healing time.

If you have areas burned inside the nose, these can take a while to heal. Once the raw areas have been recovered by healing, the swelling comes down. With reduced swelling, the air can usually get back to other sections of the nasal airway that are now blocked by that swelling. On my patients I can give an estimate. On another doctor's patients ----- you are better off asking your doctor. The answer is just too procedure and anatomy related.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: nasal fracture septoplasty

I just came from seing an ENT doctor for the first time. I am age 47, female and use a CPAP machine. I have been told I have a warty growth that should be removed. I also had exrays taken and they showed a deviated septum. At about age 4, I broke my nose in a sliding board accident. Parents, feet first on your stomach is not the way to let a kid go down a slide. That is what caused mine. Anyway, the doctor said that surgury is indicated for the wart removal and he could correct the deviation at the same time. He said that my right nostril is blocked about 80%. I just wondered, how successful should I expect this surgury to be, should I get another opinion. He said everything would be handled from inside my nose. That there would be no change in appearance after the swelling goes down. He said he would remove the growth and make cut just behind that to pare down the cause of the deviation. What do you think.

Concerned in Ohio

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Septoplasty, surgery to correct septal deformity, has varying degrees of success. This surgery encompasses a number of possible operations and maneuvers to move bone and cartilage into a more central position. This surgery is most often done through incisions inside the nose. Success this surgery depends on the problem, how you heal, the surgeon, and what is done for the correction. My patients go through an education experience before surgery that permits them to make better informed choices. Why are you seeing one doctor and asking another questions that should have been answered by the first? The doctor who has examined you and plans your surgery has a much better chance to give you more specific answers. If you do not feel comfortable with your doctor's first consultation, call back and see if your questions can be addressed. If you still feel uncomfortable, then you will need to decide if you have the right doctor or another one might be better for you.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

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