Septopasty - Worth it? NHS or Private?

[ShastaBeast]

I’ve been offered surgery for a wonky septum, or deformity as the consultant delightfully labelled it. I’ve always struggled with breathing through my nose but only realised why recently due to dry mouth at night exacerbated by medication. I was born with a wonky nose, perhaps due to forcepts delivery. Externally it’s fine, slight bump but I’d never have surgery just for that. I do have a wobbly tip, it moves more one way than the other and I can’t use an electric toothbrush because my nose tip vibrates.

My biggest worry, from research so far, is changing the appearance of my nose. I suspect the NHS won’t consider this aspect so much, which to an extent is fair enough. We have the resources to go private and consider the plastic surgery route. I don’t think I’d need a full nose job but I’d at least be able to get them to consider the appearance of my nose and get a modest improvement, rather than potential negative change. I also feel like I’d have more right to ask questions about the surgery and understand the risks and aesthetic impact.

[MmeButtox]

It's shameful that the system is such that a patient should have to accept the risk of a 'potentially negative change' right in the middle of her face, even being afraid to ask questions to fully understand what she's agreeing to out of some sort of cultural perception that she's lucky to get any care at all.

Have you seen the NHS consultant though? Most plastic surgeons take great pride in the aesthetic of their outcomes so I should hope s/he will be happy to put your fears to rest. They are generally the same surgeons you'd be seeing privately, just in a different setting.

[anon135]

I had one on the NHS a couple of years ago. The care I received was fantastic and I can now breathe through my nose! My nose shape only slightly changed as they don't do a rhinoplasty with it, so you'd probably have to go private if you actually wanted to change the shape of it

[MmeButtox]

I would surely hope that if the shape would be impacted negatively by the procedure that you'd be warned. My father needed his upper eyelids lifted due to sight issues and his consultant advised him to pay privately for a matching lower lid procedure so as not to look odd.

[NerdyBird]

I had an operation to correct a deviated septum. All the work was internal, no outward change at all. It was worth it for breathing properly!

[ShastaBeast]

I really do feel like the nhs are doing me a favour and I have less right to expect full explanations and to consider appearance. I’ve been fobbed off a lot with my own health and my eldest child’s and DH’s in fact. We’ve ended up going private a few times and I was totally right there was an issue when initially denied (spinal surgery and SEN diagnosis for example).

The NHS would be an ENT procedure rather than plastic surgery. The consultant was initially dismissive when I reported the asymmetry and reassured me my nose looked fine (from the outside), it seemed like he was thinking I was after a nose job. My nose is fine and I don’t “need” a nose job at all, I just worry about this risk after doing some online research, I also saw that revision surgery is far harder so want it right first time, even if it costs a few £ks. A small tweaking of the tip might be nice at most.

I’m coming round to the idea of going for it as it really impacts on my sleep - I drink so much water in the night for dry mouth and it’s affecting my teeth/gums. I just hate GA, it’s terrifying, although I’m much less scared since the spinal op.

There’s a Transform clinic nearby, I could enquire about surgery there, a particular surgeon was mentioned on a forum. Or there’s a NHS Hospital with private services, or otherwise Harley Street options. I have a follow up in a few months so have time to consider my options and research carefully. It’s good to hear it works and doesn’t negatively change the appearance. The recovery and time off work is another factor to consider.

[Tinysarah1985]

I have had to fight for nearly 16 years to get an appointment for a ent consultation for the exact same thing. One GP fobbed me off with a steriod spray! But since i’ve started working in a GP practice i’ve got my referral.
Here’s hoping my deviated septum gets fixed. I have the same problems as OP- drinking gallons of water due to dry throat, nose permantly blocked and unable to breath through one side of it.

[PerfectlyDone]

Any NHS ENT surgeon will want to do a cosmetically pleasing result and OF COURSE you have every right to ask as many questions about every aspect of your surgery/anaesthetic as you need!

I'd suggest you see the NHS surgeon, armed with information and a written list with questions, take somebody with you (another set of ears), keep notes you can reread at home.

Then make the decision whether to see another surgeon, plastics or ENT, privately and pretty much do the same thing. Having a consultation with somebody in the private sector does not automatically mean that you have to have your surgery done by them.

The vast majority of surgeons working in the private sector are also NHS surgeons and you are unlikely to get any 'better' work done privately, the advantage is mainly that it is usually quicker.

[PerfectlyDone]

I obviously don't know anything about the clinic near you or the surgeon mentioned, but bear in mind that Transform are a profit-making enterprise (nothing wrong with that as such, but....) and therefore are more likely to recommend more extensive surgery which is not necessarily a Good Thing.

Do your homework.

Do not be blinded by nicer decor.

[Stormy76]

I had one in 2014 on the NHS because my septum had collapsed and I had one large nostril. It was a spontaneous collapse and I was told it was due to a deformity as well. It was just very curved and then basically fell over lol. The surgery bit is quick but the recovery......was not fun at all. I have been told that it could collapse again and to be honest I would have to have a very long hard think about getting it fixed a second time.

[ShastaBeast]

I had to try a steroid spray too. But only for a few weeks. I found a GP who I trust more, he doesn’t mind the fact I research a lot and will admit he doesn’t know. I will get lots of questions prepared and have time to do this. As it was the first time it was confirmed it was actually an issue I didn’t feel able to decide there and then. The recovery is worrying, although less traumatic than a full nose job it seems.

The private option pushing for unnecessary work is something I’ve worried about previously but so far unfounded, I guess plastic surgery may be more open to this as it’s mostly unnecessary anyway. The other option could be a private ENT, perhaps within the NHS hospital. At least for this work there are online reviews of specific surgeons.

I really didn’t want surgery initially, hoped for another option, like those nose strips sports people sometimes wear. But if I can understand and mitigate the risks it is probably worth it - I’m awake with a super dry mouth right now. I’m sure it causes nightmares due to dehydration too. It’s a shame as it could’ve been corrected as a newborn much more easily. It’s actually a subluxation on one side and deviation to the other side. I have the letter now, he didn’t use these terms at the time. He said something about opening it up like a book in the surgery. I guess the layers of skin and cartilage. I need to understand the procedure better and suspect I’ll be watching videos of the surgery over the coming months. Much more squeamish than spinal surgery for sure.

[UAEMum]

I had septoplasty on the NHS twice. My septum could be seen in one nostril. The first time i woke up and nothing had changed so i had a repeat op about a year later which was excellent.

[Stormy76]

Oh yes it's not as bad as a full nose job but I do think that the level of pain post surgery is vastly underestimated, I struggled quite a bit with the pain and then it was causing migraines..... but every one is different. They do say it take about a year to fully heal, I went back to work too soon I should have taken 6/8 weeks off but went back after 4 when I was still swollen.

[123Buckle]

Hi I had this done on the NHS years ago although not for breathing purposes . Didn't change the appearance of my nose at all and I was reassured before hand that it would not. But as PP said, mine too was a painful recovery. I also developed a very bad infection afterwards that was luckily caught early. Ultimately, if I had the choice again I would have it done again but it was not a pleasant recovery and it's definitely something to bear in mind. Everyone is different and it's important to discuss everything with your consultant and make the choice that is right for you!

[ShastaBeast]

I’m surprised at such a long initial recovery. I was hoping for just a week off week, two max. I’m in a small company so aware at the impact of my absence, although I can work from home.

I’m still seeing stories of changes in appearance and if it does hurt that much I may as well benefit with some aesthetic improvement. I could ask my GP for a recommendation for a private surgeon.

The photo is similar to my nose now, so tidying it up, as in the after pic, would be nice. I don’t have a hump to shave down, it’s just the end which makes it appear so due to the wonky cartilage, although I don’t mind that.

I suffer with fairly severe chronic pain so wonder if that impacts how I would deal with the post op pain. I already have strong meds on hand. I’m guessing they don’t offer morphine post op but can see there are facial nerves close by.

Thanks for sharing your experiences.