Endoscopic Sinus Surgery and FESS in NYC

Yes. Functional endoscopic sinus surgery (FESS) is typically performed entirely through the nostrils using a thin endoscope and fine instruments, without any external incisions on the face. Because the work is done internally, there is usually no facial bruising and no change to the outside shape of the nose from the procedure itself. The endoscope provides a magnified, well-lit view of the sinus drainage pathways, which allows Dr. Mourad to work precisely around delicate structures. The exact areas treated are guided beforehand by your CT imaging and nasal endoscopy, so the surgery focuses on the sinuses that are actually obstructed or inflamed rather than treating everything the same way.

Most patients describe pressure, congestion, drainage, and fatigue during recovery rather than sharp pain. The degree of discomfort varies depending on how extensive the surgery is and whether other procedures, such as septoplasty or turbinate reduction, are performed at the same time. Many people manage well with the measures outlined in their aftercare plan, and discomfort generally eases over the first one to two weeks as swelling settles. Because surgery is performed through the nostrils, there are no external incisions to cause facial soreness. Dr. Mourad will discuss what to expect, including how discomfort is typically managed, based on your specific treatment plan and overall health.

Many patients return to light activities within several days, but congestion, crusting, and drainage commonly continue during the early healing period, and the sinus lining keeps settling over the following weeks. Saline irrigation, any prescribed topical medications, and in-office follow-up visits, sometimes including gentle cleaning of crusts, are important parts of healing well. Strenuous exercise and heavy lifting are usually limited at first because they can increase swelling or the risk of bleeding. The overall timeline depends on the extent of surgery and how your tissues heal, so it is more accurately described in phases than as a fixed date. You can read more in our sinus surgery recovery timeline.

A CT scan is commonly used to evaluate the sinus anatomy and the extent of inflammation or obstruction before endoscopic sinus surgery. It maps the individual sinuses and their drainage pathways in detail, which helps plan the procedure around the areas that genuinely need treatment and helps protect nearby structures such as the eye and skull base. Imaging is interpreted together with your symptoms and a nasal endoscopy rather than on its own, so the findings are placed in clinical context. A CT scan is also frequently needed to document medical necessity when surgery is submitted for insurance authorization. Whether and when imaging is obtained depends on your specific situation.

Functional endoscopic sinus surgery itself usually does not change the external appearance of the nose, because it is performed entirely through the nostrils with no outside incisions. The goal of FESS is functional, to restore sinus drainage and ventilation, rather than cosmetic. If a structural issue such as a deviated septum is contributing to your obstruction, addressing it is also a functional step rather than a cosmetic one. If you are interested in changing the external shape of the nose, that is a separate cosmetic discussion that would be planned distinctly during your consultation, including how it is performed, billed, and recovered from. The two goals are kept clearly separate.

Balloon sinuplasty uses a small balloon to gently dilate selected blocked sinus openings without removing tissue, and it tends to suit limited, well-defined narrowing of certain drainage pathways. Endoscopic sinus surgery can remove obstructing tissue, address nasal polyps, and open multiple sinus pathways, which makes it better suited to more extensive or complex disease. Neither approach is universally better; the most appropriate option depends on your diagnosis, the extent of disease, and your anatomy as shown on endoscopy and CT imaging. In some cases the two techniques are combined during a single procedure. Dr. Mourad reviews these findings with you so the chosen approach matches the underlying problem.

Yes. If a deviated septum contributes to nasal obstruction or limits surgical access to the sinuses, septoplasty may be considered at the same time in appropriate candidates. Evaluating the nose and sinuses together helps ensure the whole airway is addressed rather than only part of it, which can give medications a better chance to reach the sinus lining afterward. Enlarged turbinates or nasal valve narrowing are sometimes addressed in the same setting as well, depending on what the examination reveals. Combining procedures is decided individually, weighing your symptoms, anatomy, and overall health. When procedures are combined, recovery and insurance authorization are planned around the full set of work being performed.

When endoscopic sinus surgery is medically necessary for chronic sinusitis, recurrent infections, nasal polyps, or obstruction documented by examination and imaging, insurance may cover part or all of the procedure. Coverage depends on your specific plan, your diagnosis, demonstrated medical necessity, and any prior authorization requirements your insurer applies. Documentation of your symptoms, prior treatments tried, nasal endoscopy, and CT findings typically supports that review. Because surgery may involve separate charges from the surgeon, the facility, anesthesia, and imaging, your out-of-pocket responsibility can vary. The office can help review your benefits and the authorization process after your consultation so you have a clearer picture before scheduling.