Still Blocked After Septoplasty? Why You Might Need a Functional Septorhinoplasty
- mrtimbiggs4
- 4 days ago
- 2 min read
Many patients hope septoplasty will finally fix their chronic nasal blockage, so it’s understandably frustrating when you’re still blocked months or even years after surgery. If you’ve had septoplasty but continue to struggle with airflow, snoring, or one-sided obstruction, you’re not alone.
As a Consultant ENT & Rhinology Surgeon in Portsmouth, Fareham and Hampshire, I regularly see patients with persistent nasal obstruction after standard septoplasty. The good news? In many cases, the cause can be fixed, but it requires a more advanced procedure: a functional septorhinoplasty, potentially with donor rib.
Why Septoplasty Sometimes Isn’t Enough
Traditional septoplasty straightens the internal septum — the wall dividing the nostrils. However, many cases of nasal obstruction involve more than just the septum.
Common reasons septoplasty may not resolve symptoms include:
1️⃣ Nasal valve collapse
The nasal valve is the narrowest part of the airway. If it collapses during breathing, airflow remains restricted, even with a perfectly straight septum.
2️⃣ External deviation or asymmetry
If the nasal bones, upper lateral cartilages or tip are twisted, the outside of the nose still blocks airflow.
3️⃣ Septum re-deviates over time
If structural support isn’t reinforced, the septum can twist back, especially after trauma, surgery, or ongoing pressure.
4️⃣ Unaddressed turbinate hypertrophy
Large turbinates can block the airway even if the septum is straight.
5️⃣ Crooked nose from old trauma
If the external framework is displaced, breathing won’t improve until both inside and outside are corrected.
This is why some patients feel no better after septoplasty; the underlying cause was multifactorial, not purely septal.
The Solution: Functional Septorhinoplasty
A functional septorhinoplasty addresses all structural causes of obstruction in a single operation.
It combines:
Septoplasty (straightening the internal septum)
Valve reconstruction (strengthening or widening the airway)
External straightening (correcting bone and cartilage deviation)
Framework support (preventing future collapse)
At Adnova Clinic in Fareham, I use modern Piezo ultrasonic and dorsal preservation techniques, which reshape bone precisely with far less trauma than traditional methods.
Benefits include:
No nasal packing — breathe immediately
Less bruising & swelling
More predictable long-term results
Improved function and often improved appearance
This is the operation patients expected the first time.
How Do I Know if I Need Further Surgery?
You may benefit from functional septorhinoplasty if you:
Still breathe poorly months after septoplasty
Only breathe well when pulling your cheek outward (positive Cottle manoeuvre)
Feel collapse on deep inspiration
Have a crooked nose externally
Rely on decongestants or nasal strips to sleep
Have been told your “septum is straight now” but symptoms persist
A specialist rhinology assessment will clarify whether the valve, septum, bones or tip are responsible.
Summary
If you’re still blocked after septoplasty, the issue is likely structural — and beyond what septoplasty alone can fix. A functional septorhinoplasty offers a comprehensive, long-term solution by correcting the internal septum, external framework, and nasal valves together.
For expert assessment in Portsmouth, Fareham, Winchester, Southampton, and across Hampshire, consultations are available with Mr Tim Biggs – Consultant ENT & Rhinology Surgeon at Adnova Clinic.
To enquire or book an assessment:
📍 Adnova Clinic
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