Open Septorhinoplasty for Nasal Blockage Since Birth: A Case Example
A 19-year-old came to Dr Manali Kakadia in Rajkot with a nose that had been blocked for as long as he could remember. This page explains how his treatment was planned, what the surgery involved, how recovery went and what other patients can learn from his case.
In short: breathing was the priority, appearance was the second goal, and both were treated in a single operation (open septoplasty with rhinoplasty). Swelling was less than expected for his age, and the final result settled over about three months.
Case at a glance
- Patient
- 19-year-old male
- Main problem
- Severe nasal blockage since birth
- Priority
- Breathing first, with an improved external appearance
- Procedure
- Open septoplasty with rhinoplasty (open septorhinoplasty)
- After surgery
- Front nasal packing for 24 hours, nasal cast for 10 days
- Final result
- Settled over at least 3 months
The concern: a lifelong blocked nose
The patient had severe difficulty breathing through his nose since birth. For him, the main aim was functional: to breathe comfortably through his nose. His family also hoped the outside of the nose would look better, so the plan had to address both how the nose worked and how it looked.
This combination is common. When the septum (the wall dividing the two sides of the nose) and the external nasal framework are both involved, correcting only one of them may not give the patient what they actually need.
Setting a realistic goal
Before surgery, Dr Kakadia agreed a realistic goal with the patient and his family: much easier breathing, together with a clearly improved external appearance that suits his own face. A goal like this gives the patient a clear picture of what the operation is meant to achieve, and avoids expectations that no surgery can meet.
"One must never ask for a nose like a particular actor or actress. Everyone's facial features are completely different, so the outcome should be based on your ethnicity and your own facial features."
Dr Manali Kakadia
Why breathing and shape were treated together
Septoplasty
Straightens the septum inside the nose so that air can pass freely through both sides. This is the part of the operation aimed at breathing.
Rhinoplasty
Reshapes the external framework of the nose. Here it was planned to improve appearance in a way that stays in proportion with the patient's face.
Open approach
In an open approach, the surgeon can see the nasal framework directly, which helps when both the inside and the outside of the nose need careful correction in one operation.
Combining both in a single operation meant one anaesthetic and one recovery period, instead of two separate procedures.
The particular risk in this case
The main consideration was the patient's young age. Younger patients have a relatively higher chance of swelling (oedema) after nasal surgery, which can make recovery slower and the result take longer to show. This was discussed before surgery.
In his case, swelling turned out to be less than expected.
As with any operation, septorhinoplasty carries general risks, which vary from patient to patient. These are explained individually during consultation, before any decision about surgery.
Recovery timeline
- First 24 hours
Packing in the front of the nose, removed after 24 hours.
- First 10 days
A nasal cast protects the new shape and is removed at around 10 days.
- Weeks to months
Swelling gradually settles. The nose continues to refine as healing progresses.
- About 3 months
The final result took at least 3 months to settle in this patient.
Recovery differs between patients, depending on the surgery performed, skin type, age and healing.
What other patients can learn from this case
- Breathing comes first. If you have a long-standing blocked nose, ask for the cause to be assessed, not only the appearance.
- One operation can address both. When both function and shape need attention, a combined septorhinoplasty may avoid a second operation.
- Agree a realistic goal before surgery. Knowing what the operation is meant to achieve makes it easier to judge the result.
- Be patient with the result. Swelling takes time to settle; in this case the final result took at least three months.
- Don't copy someone else's nose. The best result is one that suits your own face and features.
Questions to ask before nasal surgery
- What is causing my blockage, and can it be treated without surgery?
- Do I need septoplasty, rhinoplasty or both?
- What is a realistic result for my nose and face?
- What are the risks for someone my age and with my anatomy?
- How long will packing, a cast and swelling last, and when can I return to work or college?
Frequently asked questions
Can breathing and the shape of the nose be corrected in the same operation?
Yes, in suitable patients. In this case, open septoplasty (for breathing) and rhinoplasty (for shape) were performed together in one operation. Whether this is right for you depends on your examination.
How long does recovery take after septorhinoplasty?
In this case, nasal packing was removed after 24 hours and the cast after 10 days. Swelling then settled gradually, and the final result took at least three months. Recovery varies between patients.
Does age affect recovery after nasal surgery?
It can. Younger patients have a relatively higher chance of swelling after surgery. This patient, at 19, had less swelling than expected, but every patient heals differently.
Can I ask for a nose like a celebrity's?
Dr Kakadia advises against it. Facial features differ from person to person, so the result should be planned around your own face and ethnicity, not someone else's.
Will my result be the same as this patient's?
Not necessarily. This case is shared to explain the process. Results depend on each patient's anatomy, skin, healing and follow-up care.
Have a blocked nose or concerns about its shape?
Book a consultation with Dr Manali Kakadia in Rajkot to find out what is causing your symptoms and whether treatment is suitable for you.