March 1, 2023

Septoplasty Surgery

What is Septoplasty Surgery?

A septoplasty is a surgical procedure to correct deficits in the nasal septum. It is considered a low-risk nasal airway surgery typically done in adolescents and adults.

The nasal septum is composed of bone and cartilage between the nostrils. Usually located in the central area of the nose, it divides the nasal cavities to support airflow when breathing. When the septum is deviated, or not centrally located, it can impede or disrupt nasal airflow for breathing. There may also be other growths or features of the septum (e.g., polyps, swell bodies, crooked tissue) that can impact the airway.

A septoplasty may be recommended to correct deviations or irregularities by removing, realigning, or reconstructing portions of the nasal septum.

Key Points About Septoplasty Surgery

• Corrects a deviated nasal septum to improve airflow and reduce nasal obstruction
• Typically performed as an outpatient procedure—most patients go home the same day
• Can help relieve symptoms like breathing difficulty, chronic sinusitis, epistaxis, or sleep apnea
• Usually low‑risk; anesthesia options include local with sedation or general
• Common recovery involves nasal splints or grafts removed within about a week

What Happens During Septoplasty?

Septoplasties require the shaving, removal, or reinsertion of pieces of bone and/or cartilage to achieve the correct alignment of the nasal septum. Septoplasty surgeries may vary slightly depending on the severity of the condition and the surgeon’s preferences.

Typically, surgeons operate through an incision within the nose. However, depending on the surgical approach and specific patient needs, a small external incision between the nostrils may be required. After your surgeon corrects the cartilage and bone tissues, they will replace the other soft tissue and membranes over your septum for healing.

Structures, such as grafts or nasal splints, may be put into place to support the opening of your airway during recovery. These are often secured with a stitch and remain in place for approximately one week. Both stitches and splinting may be removed at your follow-up appointment or may self-dissolve. Ask your surgeon about these options and what to expect.

Patients receive anesthesia for pain management and numbing during their septum surgery. Again, the type of anesthesia administered depends on the severity of the condition and the surgeon’s preferences, as well as your medical history. Your surgeon will discuss recommendations and options with you before your septoplasty.

Anesthesia is generally classified as local or general:

• Local anesthesia and septoplasty: This type of anesthesia is limited (or localized) to your nose and does not require full sedation. The surgeon will inject or apply the medication directly to the nasal tissue. Sometimes this is paired with a mild sedation medication that can be administered orally or via IV. Though you remain conscious during the procedure, this mild sedative plus local anesthesia will ensure that you are both pain-free and relaxed, with some lethargy and grogginess.
• General anesthesia and septoplasty: This pain-numbing approach is typically received by inhaling a medicated gas or IV medication. Patients are fully sedated (or temporarily unconscious) when under the influence of general anesthesia.

Most septoplasty surgeries last under two hours, with additional time spent in a post-surgical recovery area for monitoring and time for your anesthesia or sedation to subside.

Septoplasties are usually done as outpatient procedures, and you can expect to go home the same day. Depending on your specific surgeon and the area you live in, your septal correction surgery may be done in a physician’s office, an outpatient surgical center, or a hospital surgical center.

Wherever your procedure occurs, you will most likely be required to have a ride home from a family member or friend, as anesthesia will be used. Plan accordingly with your surgeon and loved ones.

How Do I Know If I Need a Septoplasty Procedure?

If you think you need septoplasty surgery, consult with your doctor. The most commonly reported symptoms in septoplasty candidates are difficulty breathing, chronic nose bleeds (epistaxis), or chronic sinus infection/inflammation (sinusitis/rhinitis).

In general, your doctor may recommend a septoplasty surgery to:

• Correct a deviated septum
• Address sleep apnea
• Remove nasal tissue thickening the septum
• Address recurrent nose bleeds
• Address other conditions that restrict or block the nasal airway

These conditions may occur due to congenital conditions or as a result of a nasal injury. Candidacy for septoplasty surgery is typically determined by the severity of your condition, your prior medical history, and your other personal risk factors. Talk to your doctor if you feel these symptoms are impacting your quality of life or if you think a septoplasty might be right for you.

If a deviated septum is making breathing through your nose feel like a losing battle, chat with us to find an ENT near you who can evaluate whether septoplasty is the right fix.

What is a Deviated Septum?

A deviated septum is characterized by your nasal septum being crooked or off-center within your nose. Therefore, the septum is “deviated” from the midline or leaning toward one side of the nasal cavity. This condition is common, with healthcare professionals estimating that up to 80% of people have some amount of deviated septum findings on examination.

Many people are born with or develop a deviated septum and experience no signs or symptoms at all. Some people may observe a crooked aspect to their nose. Deviated septums may also occur after a nasal injury.

What Are the Signs that I Need Deviated Septum Surgery?

When signs and symptoms are experienced, commonly reported effects of a deviated septum include:

• Difficult breathing
• Noisy breathing or snoring while sleeping
• Preferring to sleep on one side to improve breathing
• Sleep apnea
• Recurrent headaches
• Recurrent nose bleeds (epistaxis)
• Recurrent sinus infections (sinusitis) or inflammation (rhinitis)
• Chronic runny nose
• Possible, one-sided facial pain

If you believe you are experiencing one or more of these symptoms or conditions, talk with your doctor. They may conduct a visual examination (looking inside and outside of your nose) and ask additional questions about your symptom severity. Both processes will allow your doctor to determine a diagnosis and discuss your deviated septum management options.

Septoplasty Side Effects and Risks

While relatively commonplace and low-risk, septoplasty is still a surgical intervention. All surgical interventions carry some risks. Therefore, it is important to be aware of potential side effects and complications associated with septoplasty procedures.

Some potential risks include:

• Infection
• Unintended reactions to anesthesia
• Excessive or uncontrolled bleeding
• A perforation, or hole, in your septum
• Decreased sense of smell
• Developing scar tissue
• Unintended changes in nose shape

Some patients also report noticing limited intended results or even persistent symptoms after surgery. With that said, approximately 85% of people do report positive outcomes after their septoplasty.

It is important to discuss your specific case and its potential risks, as well as potential benefits, with your surgeon while considering a septoplasty surgery.

Recovering from Septoplasty

Most patients recover from the septoplasty procedure in one to two weeks. You will likely be scheduled for a follow-up appointment with your surgeon about one week after your surgery date. Before you are discharged home, you will typically be given strict precautions to protect your new nasal airway in those early days of recovery.

While each patient’s experience is unique, below are some common precautions and recommendations to expect:

• Pain management - During that week, you will likely experience some amount of pain or discomfort due to the surgical procedure. Your doctor will prescribe pain medications and/or discuss over-the-counter medication and other pain management options. If you are having uncontrolled or excessive pain, contact your care team.
• Activity limitations - Rest is highly encouraged, particularly during the first week or two of recovery. Light walking and out-of-bed activity are typically recommended immediately after surgery, as inactivity can increase your risk of blood clots or pneumonia. You can normally resume light, usual daily activities after one week.

Other common activity recommendations include avoiding blowing your nose, sneezing with your mouth open, sleeping with your head elevated, and avoiding strenuous activities (i.e., going to the gym, playing sports, and heavy lifting) for one month.

You may consider wearing button-down or large loose shirts to avoid pushing your nose when pulling clothing overhead during recovery. You may also want to discuss a plan for help with strenuous housework, work accommodations, or other physical activities with others in preparation for this recovery period.

Ask your doctor about clearing you for specific activities.

• Caring for your surgical dressing and nasal splints - Your surgeon and care team will educate you on your specific care instructions for your bandages and nasal splints. Often, your surgeon will ask you to wait at least 48 hours before changing the bandaging.

Sometimes, you will need to avoid getting bandages and splinting wet, meaning you need to shower with caution or opt for a sponge bath until cleared by your doctor. Patients are typically taught how to use a saline wash to keep their nasal area clean during recovery.

These care recommendations are usually dependent on what materials were used for splinting, stitching, and bandaging. Ask your doctor for more information about your specific care instructions.

When to contact your doctor right away - Some side effects are common and expected during your recovery.

However, there are times when you should contact your doctor to avoid more serious complications, including:

• Trouble breathing
• Heavy, uncontrolled bleeding
• Disorientation or altered mental status
• Chills, fever, or headache
• Stiffness in your neck
• Severe, uncontrollable pain

Call your doctor immediately if you are experiencing any of these symptoms. If it is after hours, consider seeking care at your nearest emergency department.

Consult Your Doctor to See If Septoplasty Is Right for You

While you will likely feel back to normal with all precautions lifted in a short amount of time, it is important to remember it may take months for the tissues in your septum and nasal cavities to fully heal. This is largely due to the nature of and natural process of tissue healing.

Many people have benefited greatly from septoplasty surgery and corrective deviated septum surgery. If you feel that one or more of the conditions, signs, and symptoms discussed above are impacting your life, ask your doctor about the potential of a septoplasty surgery.

While it is a common and low-risk procedure, septoplasty may not be the right choice for everyone. Discuss all your surgical and nonsurgical options for symptom management with your provider to make a plan that best fits your wants and needs.