Choosing options for nose surgery to improve breathing
May 4, 2018 8:16 PM Subscribe
I'm planning to get surgery on my nose to improve my breathing. I'm wondering about people's experiences with this type of surgery, and how they weighed options for different combinations of procedures.
I found out that my life-long sleep problems are caused by a type of sleep apnea (RERA-predominant) that probably comes from not being able to breathe through my nose. I'm a mouth breather and thought that not getting air through my nose was just part of life, but now I'm looking at ENT surgery to improve my nose breathing and my sleep. Using breathe-right strips and nasal dilators has allowed me to have restful sleep for the first time that I can remember, so I want to breathe well all the time.
The ENT says that my nostrils are freakishly narrow, I have a deviated septum, and my turbinates are large. The possible surgical options are straightening the septum, turbinate reduction, and Batten grafts with auricular cartilage grafts (adding cartilage to my nose to stiffen it and keep my nostrils from closing when I breathe). The ENT says that I could do some or all of these, and suggested doing the turbinate reduction and cartilage grafts "to start with" and see how it goes.
I'm strongly leaning toward having surgery in some form so that I can sleep. There's some appeal to doing everything so that another surgery wouldn't be likely if the more modest one doesn't work. On the other hand it seems that septoplasty has a more difficult recovery than the other procedures.
The previous questions on breathing-related ENT surgery are mostly old and not quite about this. I'm curious to hear about experiences with surgeries of this type, how you found the recovery, and how you weighed the options on different procedures.
I found out that my life-long sleep problems are caused by a type of sleep apnea (RERA-predominant) that probably comes from not being able to breathe through my nose. I'm a mouth breather and thought that not getting air through my nose was just part of life, but now I'm looking at ENT surgery to improve my nose breathing and my sleep. Using breathe-right strips and nasal dilators has allowed me to have restful sleep for the first time that I can remember, so I want to breathe well all the time.
The ENT says that my nostrils are freakishly narrow, I have a deviated septum, and my turbinates are large. The possible surgical options are straightening the septum, turbinate reduction, and Batten grafts with auricular cartilage grafts (adding cartilage to my nose to stiffen it and keep my nostrils from closing when I breathe). The ENT says that I could do some or all of these, and suggested doing the turbinate reduction and cartilage grafts "to start with" and see how it goes.
I'm strongly leaning toward having surgery in some form so that I can sleep. There's some appeal to doing everything so that another surgery wouldn't be likely if the more modest one doesn't work. On the other hand it seems that septoplasty has a more difficult recovery than the other procedures.
The previous questions on breathing-related ENT surgery are mostly old and not quite about this. I'm curious to hear about experiences with surgeries of this type, how you found the recovery, and how you weighed the options on different procedures.
Oh, and the recovery wasn’t as bad as I expected — and I’m a wuss about pain. I took a week off work, slept a bunch, took nice drugs, and then the morning I was supposed to get the splints removed, I woke up early and sneezed them out.
posted by armeowda at 8:41 PM on May 4, 2018
posted by armeowda at 8:41 PM on May 4, 2018
I had septoplasty and turbinate reduction together. Recovery was fine. I had to take it easy for a few weeks but I live alone and had no problem looking after myself and the house and cats.
I didn't have breathing issues as bad as you but I pretty much only breathed through my mouth so I got endless sore throats. That's all gone. Best thing I ever did.
posted by kitten magic at 8:51 PM on May 4, 2018
I didn't have breathing issues as bad as you but I pretty much only breathed through my mouth so I got endless sore throats. That's all gone. Best thing I ever did.
posted by kitten magic at 8:51 PM on May 4, 2018
I had a tonsillectomy about five years ago after my second sleep test finally confirmed that I had apnea. My ENT doc said my tonsils were the biggest she'd ever seen! I had turbinate reduction and septum correction, too, which makes this relevant to your question.
I was a lifelong mouth-breather who often woke up gasping for breath, with the other unpleasant side effect of snoring like an asthmatic dinosaur. Not very attractive.
I woke up after the surgery with a purple tongue, very sore throat, and a feeling like my nose was too big for my face. It turns out that the doc had put two little surfboard-shaped splints up my nostrils to support them, or maybe hold them open during healing? I can't remember now.
Recovery was tough; I won't lie, but it definitely gets better after a few days. You will get lots of meds, and you should set an alarm to take them on schedule, or you will be hurting.
If you aren't having your tonsils out, I think your recovery might be a lot easier. I didn't have any facial bruising, and my nose wasn't tender to the touch -- but it was annoying not to be able to blow it, because I'm a drippy allergy-ridden creature. I could sleep normally, although obviously with my mouth open still. There were no restrictions on whether I could lie down, roll over, or anything like that.
The biggest pain of all was two weeks later, when I went back to the doc's to have the splints removed. I guess they had a couple of stitches in each of them, because she snipped something up there, and then pulled out the hunks of plastic really fast. It felt like half my brain was coming out with them -- eye-wateringly painful.
But right after that? Cool, fresh air rushed into my nose, and I could BREATHE. I actually felt as though my nose had been chopped off and there was a giant hole in my face to breathe through. And from that night on, I have slept with my mouth closed, and woken up with it closed, and I have stopped snoring. It is very much a life-changing surgery for me.
I might consider getting a second opinion on the cartilage grafts, and see how it goes with just the reduction/septoplasty. You might find that you get the results you need just from that first round of surgery.
Feel free to MeMail me if you have any other questions.
posted by vickyverky at 9:01 PM on May 4, 2018 [3 favorites]
I was a lifelong mouth-breather who often woke up gasping for breath, with the other unpleasant side effect of snoring like an asthmatic dinosaur. Not very attractive.
I woke up after the surgery with a purple tongue, very sore throat, and a feeling like my nose was too big for my face. It turns out that the doc had put two little surfboard-shaped splints up my nostrils to support them, or maybe hold them open during healing? I can't remember now.
Recovery was tough; I won't lie, but it definitely gets better after a few days. You will get lots of meds, and you should set an alarm to take them on schedule, or you will be hurting.
If you aren't having your tonsils out, I think your recovery might be a lot easier. I didn't have any facial bruising, and my nose wasn't tender to the touch -- but it was annoying not to be able to blow it, because I'm a drippy allergy-ridden creature. I could sleep normally, although obviously with my mouth open still. There were no restrictions on whether I could lie down, roll over, or anything like that.
The biggest pain of all was two weeks later, when I went back to the doc's to have the splints removed. I guess they had a couple of stitches in each of them, because she snipped something up there, and then pulled out the hunks of plastic really fast. It felt like half my brain was coming out with them -- eye-wateringly painful.
But right after that? Cool, fresh air rushed into my nose, and I could BREATHE. I actually felt as though my nose had been chopped off and there was a giant hole in my face to breathe through. And from that night on, I have slept with my mouth closed, and woken up with it closed, and I have stopped snoring. It is very much a life-changing surgery for me.
I might consider getting a second opinion on the cartilage grafts, and see how it goes with just the reduction/septoplasty. You might find that you get the results you need just from that first round of surgery.
Feel free to MeMail me if you have any other questions.
posted by vickyverky at 9:01 PM on May 4, 2018 [3 favorites]
I had a one sided turbinate reduction to deal with some recurring sinus crud and my recovery was super simple. I did not have splints or packing material. I took painkillers for maybe a day and a half and I have been nearly sinus-infection free since the. I really should have done it a lot sooner.
posted by jessamyn at 9:10 PM on May 4, 2018 [2 favorites]
posted by jessamyn at 9:10 PM on May 4, 2018 [2 favorites]
I am still in the recovery period just over a month from septoplasty and one-sided turbinate reduction surgery. I can't really speak to WHAT to have done, but I can speak to WHETHER to have something done. I was conflicted about going forward with the surgery right up until I was being prepped for surgery. After all, I was only plugged up on one side, and only for a few months. It seemed like people had put up with much worse for much longer. Now I am super glad I decided to go ahead with it. The surgery and recovery has been no huge deal with not a lot of pain and totally manageable minor discomfort. And it is wonderful to be able to breath normally again. You may have been living with this for so long you will have forgotten what normal breathing is like, and let me tell you, it is glorious.
At my first follow-up appointment, my surgeon showed me a picture of the giant impacted snot ball she surgically removed from my sinuses. She asked if I was the one who wasn't sure about the surgery. She said that it's a good thing I had it done, that thing was NOT going to go away on its own.
posted by rekrap at 9:58 PM on May 4, 2018 [2 favorites]
At my first follow-up appointment, my surgeon showed me a picture of the giant impacted snot ball she surgically removed from my sinuses. She asked if I was the one who wasn't sure about the surgery. She said that it's a good thing I had it done, that thing was NOT going to go away on its own.
posted by rekrap at 9:58 PM on May 4, 2018 [2 favorites]
I had a septoplasty and turbinate reduction two years ago. Recovery wasn't bad. I took a week off work. The first the first day, my husband took our big, crazy dogs to daycare and my Mom came and sat with me while he was at work. Basically she just fixed me lunch, and talked to me in between naps. I was fine. Stay on top of the pain with meds for the first 48 hours or so. Ask for some anti-nausea meds because the drainage can definitely make you queasy.
Totally worth it. I can breathe much easier now.
posted by Green Eyed Monster at 5:33 AM on May 5, 2018 [1 favorite]
Totally worth it. I can breathe much easier now.
posted by Green Eyed Monster at 5:33 AM on May 5, 2018 [1 favorite]
I had septoplasty and turbinate reduction 12 years ago and the recovery wasn’t bad at all. The worst part was that the anesthesia made me nauseated and I threw up once after surgery. My ENT didn’t use splints, and my nose bled during the day of the surgery and a bit the next day. I don’t think I ever took pain meds beyond Tylenol, and I was quickly annoyed that I wasn’t allowed to workout for two weeks after the surgery because I felt completely fine.
posted by capsizing at 7:47 AM on May 5, 2018
posted by capsizing at 7:47 AM on May 5, 2018
I had a septoplasty and turbinate reduction about 10 years ago due to chronic sinus infections, and I would highly recommend getting it done. Recovery really wasn't that bad-- there was a little bit of bleeding the first day, but it wasn't really painful. I just took Tylenol. The worst part for me was that I was still congested from one of my many sinus infections and I wasn't allowed to blow my nose. So that wasn't fun. But when the splints were removed, I could breathe from both of my nostrils at the same time. It was a revelation! Also, I think I've maybe only had one sinus infection since? So yeah, definitely worth it.
posted by MundaneNoodle at 8:47 AM on May 5, 2018 [1 favorite]
posted by MundaneNoodle at 8:47 AM on May 5, 2018 [1 favorite]
Hey, I was in your situation a few years ago! Diagnosed with RERA-related sleep issues, specifically UARS. My ENT had already diagnosed me with nasal valve collapse, so the cause was pretty clear. I was getting some relief from using Breathe-Rite strips, but not enough. I got the surgery and it was absolutely the right choice for me.
Recovery wasn’t that bad. If anything, I think was in less pain after the surgery —sinus congestion is a migraine trigger for me, and I had a migraine the week before that was more painful than post-surgical recovery (although in fairness, I had better drugs for the recovery).
If you have nasal valve collapse, which is presumably what’s going on given that the nasal dilators are working for you, you need the surgery to fix that. So in your situation, I’d get whatever surgery would fix it! In my case, it was the alar batten grafts, and I got the septoplasty + minor turbinate reduction at the same time. I do not regret doing all three at the same time, esp. as my surgeon’s take was that I would get a better outcome by doing all three.
One thing to note with the grafts: they may try to take the cartilage for the grafts from your own body, which means you may have a second incision somewhere. This was not a big deal for me, but it’s worth asking your surgeon about.
Also worth noting that on the recovery side: how they do post-surgical splinting has gotten better in the past few years. I had foam splints with rubber tubes in them, which allowed me to semi-breathe while things healed. They came out about 5 days later at my follow-up. Much less unpleasant than the gauze packing they used to use.
Since the surgery, I’ve had minimal migraines, and I’ve started remembering my dreams again on a regular basis. My sleep got better almost immediately -- I had no idea how bad it had gotten until it was suddenly better. I have had a few sinus infections, but it’s fewer than I did before, and they seem to get better faster.
All in all, it was 100% worth it and I would do it again. And I would do the grafts specifically — from what I understand/feel, the septoplasty and turbinate reduction alone would not have worked for my specific nose and sleep situation.
posted by pie ninja at 3:36 PM on May 5, 2018
Recovery wasn’t that bad. If anything, I think was in less pain after the surgery —sinus congestion is a migraine trigger for me, and I had a migraine the week before that was more painful than post-surgical recovery (although in fairness, I had better drugs for the recovery).
If you have nasal valve collapse, which is presumably what’s going on given that the nasal dilators are working for you, you need the surgery to fix that. So in your situation, I’d get whatever surgery would fix it! In my case, it was the alar batten grafts, and I got the septoplasty + minor turbinate reduction at the same time. I do not regret doing all three at the same time, esp. as my surgeon’s take was that I would get a better outcome by doing all three.
One thing to note with the grafts: they may try to take the cartilage for the grafts from your own body, which means you may have a second incision somewhere. This was not a big deal for me, but it’s worth asking your surgeon about.
Also worth noting that on the recovery side: how they do post-surgical splinting has gotten better in the past few years. I had foam splints with rubber tubes in them, which allowed me to semi-breathe while things healed. They came out about 5 days later at my follow-up. Much less unpleasant than the gauze packing they used to use.
Since the surgery, I’ve had minimal migraines, and I’ve started remembering my dreams again on a regular basis. My sleep got better almost immediately -- I had no idea how bad it had gotten until it was suddenly better. I have had a few sinus infections, but it’s fewer than I did before, and they seem to get better faster.
All in all, it was 100% worth it and I would do it again. And I would do the grafts specifically — from what I understand/feel, the septoplasty and turbinate reduction alone would not have worked for my specific nose and sleep situation.
posted by pie ninja at 3:36 PM on May 5, 2018
This may not be helpful. Had sinus surgery to remove polyps and scar tissue and trash after repeated massive sinus infections, not because of sleep issues. And my surgery was all on one side and my basic sinus structure is unchanged. But, "Cool, fresh air rushed into my nose, and I could BREATHE. I actually felt as though my nose had been chopped off and there was a giant hole in my face to breathe through."
That was my experience, too. As soon as the tampons came out.
posted by Lesser Shrew at 8:27 AM on May 6, 2018
That was my experience, too. As soon as the tampons came out.
posted by Lesser Shrew at 8:27 AM on May 6, 2018
I also had septoplasty and turbinate reduction done at once. Unfortunately, I discovered that I could not take the Rx pain killer. Those would have helped.
They stick a huge silicone splint up each nostril that really stretches out the skin - I have tiny little stretch marks on my nose now. So tiny only I can see them. So use lotion or something.
Anyway, splints stay for a week. It's not fun.
Once they were removed, it's all good.
I had the surgery due to recurring sinus infections. Results: I can fill my lungs in less than a second now. Before, if breathing through the nose, it took SEVERAL seconds inhaling at full strength.
AND I sleep like a log. I don't snore, but the dry mouth used to wake me up and I'd take sips of water. Now the water glass stays untouched. It's wonderful.
That and every time I sneeze, I feel like singing, "I got the power!"
Oh, for recovery: get yourself SEVERAL bottles of the saline mist. Not the squeeze bottles, the mist - much gentler. The more you use it, the more stuff will come out (some the size of dinosaur eggs!) , the faster you'll recover. Worth every penny.
In other words, don't fear the surgery. Results are fantastic!
posted by Neekee at 2:11 PM on May 7, 2018
They stick a huge silicone splint up each nostril that really stretches out the skin - I have tiny little stretch marks on my nose now. So tiny only I can see them. So use lotion or something.
Anyway, splints stay for a week. It's not fun.
Once they were removed, it's all good.
I had the surgery due to recurring sinus infections. Results: I can fill my lungs in less than a second now. Before, if breathing through the nose, it took SEVERAL seconds inhaling at full strength.
AND I sleep like a log. I don't snore, but the dry mouth used to wake me up and I'd take sips of water. Now the water glass stays untouched. It's wonderful.
That and every time I sneeze, I feel like singing, "I got the power!"
Oh, for recovery: get yourself SEVERAL bottles of the saline mist. Not the squeeze bottles, the mist - much gentler. The more you use it, the more stuff will come out (some the size of dinosaur eggs!) , the faster you'll recover. Worth every penny.
In other words, don't fear the surgery. Results are fantastic!
posted by Neekee at 2:11 PM on May 7, 2018
Ask your surgeon about splints/gauze. I had nothing at all - I looked and felt totally normal when I left the hospital the next day - but it sounds like that really varies.
posted by kitten magic at 5:07 AM on May 9, 2018
posted by kitten magic at 5:07 AM on May 9, 2018
I had it done and had complications from the surgery (awful infection!) and I now annually seem to have some weird recurring swollen tongue problem that I never had before. Might not be linked. YMMV. I think I breathe better at night now than I did before.
posted by dance at 6:06 AM on May 10, 2018
posted by dance at 6:06 AM on May 10, 2018
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Here’s how it might be relevant to your question: I no longer have dreams where I’m suffocating because my nose is closed off.
posted by armeowda at 8:39 PM on May 4, 2018 [2 favorites]