Septoplasty

What is septoplasty?

Septoplasty is surgery inside your nose to straighten a deviated septum. Your septum, about 7 centimeters long (2.5 to 3 inches) in adults, consists of cartilage and bone. It separates the inside of your nose into two chambers, or nostrils.

If your septum is deviated (crooked or bent), it can block one or both nostrils and interfere with airflow. A crooked septum can happen because of an injury, or you can be born with it. When this happens, you may need a septoplasty. Healthcare providers may also recommend septoplasty to:

• Remove nasal polyps
• Treat chronic sinusitis or obstructive sleep apnea
• Stop recurrent nosebleeds (less common)
• Address other conditions that block your nasal airway

Septoplasty is one of the most common procedures performed by otolaryngologists (ear, nose and throat doctors, or ENTs). It’s a minor, outpatient surgery. This means you’ll likely get to go home the day of your procedure.

How should I prepare for septoplasty?

Before surgery, your healthcare provider will review your medical history. This includes asking about any medications or supplements you’re taking.

They’ll let you know what medicines to stop taking before surgery. Some, like aspirin, ibuprofen and naproxen, may increase your bleeding risk. They’ll also let you know when to stop eating or drinking before surgery.

What happens during septoplasty?

Typically, a healthcare provider called an anesthesiologist will place you under general anesthesia. This means you’ll be asleep during surgery. Local anesthesia, which numbs your nose, may be an option.

Your surgeon will create an incision (cut) on one side of your nose. They’ll lift the thin membrane (mucosa) that covers and protects your septum. Then, they’ll reshape your septum’s bone and cartilage.

Sometimes, surgeons perform another procedure called a turbinate reduction alongside septoplasty. If this is the case, they’ll remove parts of the bone and cartilage that are slowing airflow through your nasal passages.

Afterward, they’ll reposition the mucosa over your septum. They’ll insert splints or soft packing inside your nose. This material holds nasal tissue in place, prevents nosebleeds and reduces the risk of scar tissue. Or your surgeon may sew tissue back together using dissolving stitches. They’ll disappear on their own in time.

How long does this procedure take?

Septoplasty surgery takes between 30 and 90 minutes. It’s usually done on an outpatient basis, so most people go home the day of their surgery.

How painful is a septoplasty?

You’ll likely be asleep during septoplasty, so you won’t feel any pain at all.

After your operation, you can expect mild to moderate discomfort. Many people compare the feeling to a sinus infection. You may feel pain and pressure around your eyes and across your forehead, cheeks and upper teeth. These sensations are normal and generally fade within a few days.

What are the potential benefits and risks of septoplasty?

Septoplasty surgery can improve airflow through your nasal passages, so you can breathe better. Breathing easier can improve your quality of life.

Although septoplasty complications are rare, any surgical procedure comes with risks. These include:

• Infection
• Excessive bleeding
• Decreased sense of smell (hyposmia)
• Scarring (not usually visible since it’s inside your nose)
• A perforation (hole) in your septum
• Septal hematoma (pooled blood in your septum)
• Numbness of your nose and teeth (usually temporary)
• Toxic shock syndrome (rare)
• Spinal fluid leak (rare)

What happens after septoplasty?

After septoplasty, your medical team will keep a close eye on you while the anesthesia wears off. Once you’re awake and doing well, you’ll be able to go home.

Afterward, it’s common to temporarily experience:

• Bloody drainage (the packing will help absorb it)
• A mild headache
• Stuffy nose
• Ear fullness
• Swelling

You’ll see your provider within about a week for a follow-up visit. They’ll remove any splints or packing that hasn’t dissolved during this appointment.

What is the recovery time?

Initial septoplasty recovery usually takes about a week or two. But overall healing of the bone and cartilage will continue for several months.

How can I take care of myself during recovery?

Your surgeon will give you a list of instructions to help you heal. They may include guidance about:

• Caring for your nose. During the first week or two after surgery, avoid blowing your nose. Sneeze with your mouth open and sleep on your back with your head elevated.
• Caring for your dressing. Leave gauze in your nose until the drainage stops (usually after two days). If the bleeding requires changing the gauze hourly, contact your surgeon.
• Cleaning your nose. Your provider will teach you how to clean your nose by rinsing it with saline. If you develop crusting around your nostrils, cleanse the outside with a cotton swab dipped in equal parts hydrogen peroxide and water. Never stick the swab inside your nose.
• Eating. It’s a good idea to avoid spicy foods that can make your nose run during the first week or two. Otherwise, you should be able to eat like you normally do.
• Medications. You can take over-the-counter pain relievers. If you have a low-grade fever (101 degrees Fahrenheit or less), your provider may recommend a fever reducer (like acetaminophen).
• Activity levels. Rest at home for several days. Most people can resume light activities (like walking and light chores) in about a week. It may take a month before you can do strenuous activity (like working out).

When should I call my healthcare provider?

Call your provider immediately if you experience any of the following during recovery:

• A heavy, uncontrollable nosebleed
• Confusion or disorientation
• High fever (more than 102 degrees Fahrenheit) or a fever that lasts two days
• Neck stiffness
• Pain that worsens and doesn’t improve with medications
• Severe headaches
• Trouble breathing

Is a septoplasty the same as rhinoplasty?

No. Rhinoplasty focuses on changing the external appearance of your nose. But septoplasty targets the structures inside your nose so you can breathe better. Rhinoplasty is generally a cosmetic surgery procedure, while septoplasty restores function.

Does septoplasty change nose shape?

No. Septoplasty itself doesn’t change the shape of your nose. But, if you want to change the shape of your nose, your surgeon may be able to combine septoplasty with rhinoplasty.

Ask your healthcare provider about your treatment options.

Is septoplasty a major surgery?

No. Septoplasty is a minor, low-risk procedure. Recovery usually takes a few days and requires an average of a week of downtime. But, as with any surgery, septoplasty carries some risks, including bleeding, infection and numbness.