What Is Septoplasty?

Septoplasty is a surgical procedure that corrects something about the septum (the wall of bone and cartilage that separates the nostrils), either functionally or cosmetically, explains Alan Matarasso, MD, an American Society of Plastic Surgeons member in New York City and a clinical professor of plastic surgery at Hofstra University/Northwell School of Medicine.

Having a deviated septum means the septum isn’t centered in the nose but is closer to one nostril, Dr. Matarasso says. That can block airflow on one side of the nose, causing difficulty breathing (although not always).

However, you don’t need a septoplasty for a deviated septum unless it’s causing breathing issues, says Benjamin Hull, MD, a board-certified otolaryngologist and fellowship-trained rhinologist at Associates of ENT Surgery in Texas.

Typically, septoplasty candidates have already tried inhaling nasal steroid sprays daily for a month but still experience trouble breathing. “The medicines aren’t going to move cartilage and bone,” Dr. Hull says.

Your doctor will also rule out other underlying causes of the breathing problems first, including sinus problems and allergies, before recommending a septoplasty, Matarasso says.

Cosmetically, a deviated septum can make the nose appear crooked or asymmetrical, so some people elect to have a septoplasty to change the appearance of their nose, Matarasso says.

Either way, your surgeon will use various tools, including a scalpel and scissors, to cut and reposition your septum, Hull says.

Before a septoplasty, you must be medically cleared for surgery. This means you don’t have any underlying health issues that could affect the operation or your recovery, such as high blood pressure (hypertension) or diabetes, Matarasso says.

Your surgeon will provide guidelines once you’ve been given the green light. Many of these guidelines apply not just to septoplasties but to surgery in general, Matarasso says.

The guidelines include:

• Stop taking certain medications before surgery, especially those that can cause excessive bleeding, such as blood thinners, Matarasso says. You must stop taking specific vitamins and supplements too, he adds. Talk to your doctor about when to stop taking your medications and supplements.
• If you’re having a septoplasty under general anesthesia, stop eating and drinking by midnight the night before your surgery, Hull says.
• Quit smoking, which can increase your risk of complications after surgery and slow your healing.

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• Check whether your insurance plan covers septoplasty. Coverage varies based on insurance providers, surgeons, and the reason for the surgery, Matarasso says.
• Plan to take a week off of work or school, Hull says. You’ll also need a trusted friend who can pick you up after the procedure and stay with you for the first 24 hours to monitor you in case any complications arise.

As already mentioned, you’ll likely be fully sedated for a septoplasty. Still, you may be able to use local anesthesia, depending on your preference, your surgeon’s preference, and how extensive your surgery is, Matarasso says.

You won’t need much anesthesia during a septoplasty, so any sedative should leave your system within 24 hours, Hull says.

Have a trusted friend pick you up after the procedure and stay with you for the first 24 hours. Your friend is there to keep an eye on you in the rare event that any complications arise, Hull explains. After that, you should be able to handle your recovery on your own.

In the First Week You may wear a rubber splint in your nose to stabilize the structure for about a week after surgery, Hull says. You’ll also use what’s called a mustache dressing, where you tape gauze under your nose to catch blood. You’ll change the gauze as needed — you’ll likely notice you need to change it less frequently as the days go on, Hull notes.

To reduce bleeding, prop yourself up on extra pillows or sleep in a recliner so your head stays higher than your heart for the first week or so after surgery, Hull says.

Your surgeon may prescribe narcotic pain medications after the procedure, but many people manage with over-the-counter pain relievers like acetaminophen and ibuprofen, Hull says.

In the First Month After two weeks, Hull usually tells patients that they can return to any physical activity they enjoy, except for swimming. You shouldn’t fully submerge your face in water until three weeks after your procedure, though washing your face and showering are generally fine, he says.

While rare, a septoplasty’s major potential complication is septal perforation, a hole in the septum that goes from one nostril to the other. “It can create crusting in the nose and a whistling sound when you breathe,” Matarasso says.