What is Turbinoplasty and Turbinectomy?
Turbinates, also known as nasal conchae, are the bony projections that line the interior of the nose. They are part of the nose’s structure and help warm, filter, and moisten air flowing into your nasal passage. The nasal cavity is divided by three pairs of turbinates into four air passages that lead to the sinuses lying behind each cheekbone. The largest pair of turbinates is called the inferior turbinates. These turbinates are larger than the other two pairs because they provide most of the filtration for breathing through the nose. The turbinates are covered with mucus-secreting skin that helps humidify and warm air as it enters the nose. They also act as filters, trapping dust and other particles before they enter your bronchus.
Sometimes the turbinates can get larger and block the airflow through your nose. This enlargement is usually benign and needs to be removed in order for you to breathe freely. Over time, it leads to a severely obstructed nasal passage, which results in snoring and in more severe cases in sleep apnoea. While it is true that some people have larger turbinates than others, most sleep apnoea patients have overly large turbinates. An enlarged turbinate may also be the cause of breathing difficulty while awake.
Turbinectomy is a surgical procedure to remove the turbinates. Turbinectomy procedure involves partial or complete removal of the inferior turbinate. It is more radical than turbinoplasty.
Turbinectomy can be of several types:
- Total turbinectomy: This procedure involves removing the inferior turbinates completely. This procedure has about an 80% success rate. However, it is not practiced much as it is considered too invasive by some surgeons
- Partial turbinectomy: Partial turbinectomy involves the removal of mucosal membrane and bones from the anterior one-third of the turbinate
- Submucosal turbinectomy: In this technique, the bone of the turbinate is removed, leaving the overlying skin intact. Since the mucosa and submucosa are intact, the obstruction is removed without affecting the function of the turbinates
- Anterior turbinectomy: In this procedure, the turbinate head is resected
Turbinoplasty is also a surgical procedure to treat nasal obstruction. The difference between turbinectomy and turbinoplasty is that in turbinoplasty, the bones and overlying mucosa aren’t removed entirely. Instead, some of the mucosa is left that covers the area removed in surgery. It is done by altering the bone that is blocking the airway and then shaping it to create a larger opening for airflow. The purpose of Turbinoplasty surgery is to have a straight passage with unobstructed airflow. According to researchers, turbinoplasty provides consistent, robust results and gives patients long-term relief with very few requiring revision surgeries.
Why Patients Might Consider Turbinate surgery
- The hypertrophy of the turbinate bones is one of the most important causes of nasal obstruction. Turbinate surgery decreases turbinate hypertrophy and reduces nasal obstruction
- Rhinitis refers to the inflammation of the nasal mucous membranes and is associated with sneezing and congestion. Turbinate surgery can improve the symptoms of rhinitis or prevent rhinitis
- Turbinate Surgery can help patients with breathing problems and sleep apnoea
- Helps people with frequent snoring and interrupted breathing throughout the night
- Helps people with chronic nasal obstruction
- Helps to address a deviated septum
- Helps prevent recurring sinusitis
Are you a suitable candidate for Turbinate Reduction Surgery?
Turbinate surgery may be required to help treat various conditions. It is mostly a functional procedure, so people who have trouble breathing through their noses are usually the ones who are advised to consider surgery. You are a candidate for turbinate surgery:
- If you have chronic nasal obstruction
- If you have recurrent nasal discharge (rhinorrhoea)
- If you have nasal blockage
- If your nasal septum (the middle section of your nose that divides the nose into two parts) has deviated
- If your turbinates are swollen and enlarged
- If you have a snoring problem
- If you have sleep apnoea
Usually, you should be in good health to be eligible for any surgery. Since this is a minor surgery, the risks are lower, and people with comorbidities like high blood pressure can also safely get this surgery. However, turbinoplasty is still a surgical procedure and all surgical procedures carry risks, which can be discussed in full with you during your consultation. In short, anyone having a breathing problem is a candidate. For swollen turbinates, usually, some medications are first prescribed. You are eligible for turbinate surgery only after you have tried the medications and they didn’t work.
If you have undergone a septoplasty, which is an operation to widen the nostrils, and your breathing has not improved after several months, then you might consider undergoing turbinate reduction surgery.
About the Turbinate Reduction Surgery Procedure
Preparing For Your Turbinate Surgery
Clear liquids like water, clear juice, sports drinks, clear tea, and black coffee may be consumed until 5 hours before your surgery. Do not drink milk-containing products, alcoholic beverages, or drinks with pulp or solids of any kind- nothing to eat or drink after midnight. You will be asked to stop smoking a few weeks before the surgery. If you are on blood thinners, you will be asked to discontinue those 2-3 days before the procedure. Check with Dr Hunt and your anaesthetist about which medications you can or cannot take.
During a Turbinate Reduction Procedure, Dr Hunt may use several tools depending on your needs. The procedure is done in a surgical room under local or general anaesthesia and takes about two hours.
- Submucous resection: This procedure is performed under general anaesthesia. It can be done in combination with other larger surgeries. A small cut is made in the lining of the inferior turbinates, and the lining tissue is lifted off a thin bone that forms the structural support of the inferior turbinate. The bone is removed and then allowed to heal back smaller
- Radiofrequency turbinate reduction: Radiofrequency turbinate reduction is usually done under local anaesthesia. Many types of devices are used for this procedure. The most common type is an electrosurgical device that uses heat delivered through radio-frequency energy to perform the procedure. Dr Hunt will use a device to apply radiofrequency energy on the turbinate tissue, which will heat the tissues beneath the skin surface and effectively damage the bone in a controlled manner. While the bone heals, it becomes smaller, making the inside of the nose larger
- Endoscope: Endoscope is a small thin tube-like scope with a light on the tip. It is used to visualise hard-to-see structures. Endoscopes can be used to remove turbinate bones. The theory is the same as submucous resection
- Microdebrider for turbinate surgery: Microdebrider is a surgical instrument. This instrument is popular for its ability to make precise cuts and incisions with minimal bleeding and scarring when compared to other techniques. Before microdebrider, turbinate surgery was performed under general anaesthesia and required large incisions. But now it’s mostly done with local anaesthesia
Recovery after Nasal Obstruction Surgery
- You will be given gauzes or nasal packs in your nose for at least a week. It helps to stabilise the septum
- There might only be mild discomfort after turbinate surgery
- You may also experience swelling of the nose, cheeks, eyes, and lips. You may be prescribed pain medication to help with soreness and numbness. It is not recommended to apply an ice pack directly onto the skin
- You might be given a nose splint to help maintain the new shape of the nose
- You may experience a dull headache, swelling around the eyes, and/ or bruising around the eyes. This is normal and should go away within a few days. Your vision may be blurry for several days after surgery. This will improve as the swelling goes down
- The nostrils may bleed a little. Numerous small, burst blood vessels can appear on the skin’s surface as tiny red spots. The affected skin may be very sensitive to the touch
- Washing the nose with nasal saline is recommended. This helps keeping the nose clean and gently washes away all loose debris such as dried blood
- You can also use a nasal decongestant to reduce the swelling faster. Try using it regularly for one or two days at bedtime for optimal results
- You can return to school or work within a week or so after getting turbinate surgery. However, make sure not to exhaust yourself too much
It’s a day surgery, so you can leave on the day of the surgery. Your nose will be sore for a few days. Make sure to wear the nasal splints or gauges placed in your nostrils by your doctor. Take lots of vitamin C. Turbinate surgery usually doesn’t leave scars.
Download Dr Hunt's Guide
The rhinoplasty guide has been created by Dr Hunt and his team as a useful tool to help you plan and consider these procedures.
Throughout the guide, we will discuss the ins and outs of different types of surgery what makes a suitable candidate, pre-surgery planning answers to the most frequently asked questions received from patients.
How to find the right Turbinoplasty Surgeon in Sydney
Before you commit to a nose surgeon, do extensive research on your own. This will make you feel more comfortable with your decision. Once you have chosen a surgeon book a consultation to get to know more about the surgeon and his/her expertise.
Why should you choose Dr Jeremy Hunt?
Dr Hunt is a Fellow of the Royal Australasian College of Surgeons (FRACS) and a spokesperson for the ASPS – Australian Society of Plastic Surgery. He is performing nose surgery regularly and has helped hundreds of patients get the aesthetic results they desired.
Real Patient Results for Nose Surgery
Always Do Your Research
- Browse our FAQs page
Book Your First Consultation
- Your Surgeon Consultation Fee is $400
- You will need a Referral from your GP
- Phone the team or email to Book your consultation
Prepare for your Plastic Surgeon Consultation
- Bring a friend or relative to help discuss the information.
- Take lots of notes and read the documents provided.
- Dress in simple clothes as you may need to undress.
- Bring your GP Referral and your test results.
FAQs for Turbinoplasty Surgery
Can turbinates grow back after reduction?
It is not uncommon for some turbinate tissue to regrow after surgery. Usually, the tissue grows back because it was not completely removed during the procedure. But, some people’s turbinate tissue just grows back even after successful surgery, and you may need repeat surgery.
How do I clean my nose after turbinate surgery?
Usually, you will need to wash your nostrils with saline water. Use copious amounts of water to gently wash the blood without rubbing the wound site. It is important to use a germ-free solution, so you would want to use the nasal wash recommended by Dr Hunt’s team.
How painful is turbinate reduction?
Turbinate reduction or turbinoplasty is done under anaesthesia. So it generally is not too painful. However, your nose will feel sore for a few days and will be given pain relief medication.
What should I eat after a turbinate reduction?
You can eat almost everything after this surgery as it is not a major one. However, take plenty of vitamin c to help the healing process.
How long does a turbinate reduction take to heal?
You can return to your normal activities after a day or two of the surgery. The swelling will need a week or so to go down. There may be a very thin scar inside of your nose.
What are Risks and Complications of Nasal Obstruction Surgery
All surgery has risks. Dr Hunt will explain the risks and complications in detail during the consultation. Some possible complications can include:
- Regrowth of the inferior turbinates
- Dry and crusty nose
- Altered sense of smell
- Failure of the turbinates to reduce in size: happens very, very rarely
- Formation of sinus or hole in the septum
Further Reading & Medical Sources
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PLASTIC SURGEON SYDNEY
About Dr Jeremy Hunt
Dr Hunt has worked with thousands of patients across his 20-year career. This is reflected in his role as Spokesperson for the ASPS – Australian Society of Plastic Surgery. Dr Hunt is also a Fellow of the Royal Australasian College of Surgeons (FRACS) and Supervisor of Plastic Surgery Training at Sydney Children’s Hospital.
Dr Hunt has a strong interest in helping his patients achieve their desired results by employing the most appropriate practices for each individual patient.