Septoplasty is a type of nose surgery that’s done to correct a deviated septum, when the cartilage and bone in the middle of the nostrils make breathing harder.
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.
It involves straightening and repositioning the septum by cutting, removing, and/or reinserting pieces of it the correct way.
A septoplasty can be performed on its own, or as part of a rhinoplasty (a surgery to reshape the nose, also called a nose job) or a turbinate reduction (where a surgeon reduces the size of the turbinates, which are small, bony structures in the nose).
Septoplasty is typically done to address a deviated septum, a common issue with the nose.
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.
Septoplasties are also performed to remove nasal polyps (soft, noncancerous growths inside the nose that can make breathing difficult), treat chronic sinus infections, or stop frequent nosebleeds.
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.
Septoplasty is most commonly done as an outpatient procedure, meaning you’ll go home afterward rather than staying overnight in the hospital. It’s common for otolaryngologists (also called ENTs, which stands for ear, nose and throat) to do septoplasties, but some plastic surgeons perform them too, Hull says.
Some people have what’s called an endoscopic septoplasty, meaning the surgeon uses a camera to get better visibility inside the nose, Hull says. Other times, surgeons forego the camera and use their eyes and a headlamp to illuminate the area.
Either way, your surgeon will use various tools, including a scalpel and scissors, to cut and reposition your septum, Hull says.
You’ll likely be placed under general anesthesia, so you won’t feel anything during the procedure, Hull says. Sometimes, local anesthesia — where only part of your body is numbed — is an option. The decision comes down to your surgeon’s preferences, your own preferences, and what’s safest for you, Matarasso says. There’s a higher risk of complications from general anesthesia if you smoke, have allergies to medications, or have kidney, heart, or lung problems.
During the procedure, the surgeon starts by making an incision (cut) on the side of your nose. They lift the mucosal lining, which covers the septum, away from the cartilage on both sides. Then they remove and/or reposition the cartilage and bone of the septum. Finally, they reconnect the mucosal lining on both sides of your septum.
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.
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.
A straightforward version of the procedure can take less than an hour or even as little as 30 minutes, Matarasso says. A septoplasty that’s part of a rhinoplasty is likely to take longer — about two to three hours, Hull says.
You won’t need much anesthesia during a septoplasty, so any sedative should leave your system within 24 hours, Hull says.
Any surgery comes with risks, namely “bleeding, pain, infection, and damage to surrounding structures,” Hull says. That said, these are all rare with septoplasty.
Call your healthcare provider if you experience difficulty breathing, pain that worsens or doesn’t improve with medication, high fever, headache, chills, disorientation, neck stiffness, or a heavy, uncontrollable nosebleed.
Although it’s rare, it’s also possible to experience side effects from anesthesia, such as changes to your heartbeat or breathing, an allergic reaction, or confusion. Talk to your doctor if you have difficulty breathing, numbness, difficulty swallowing, severe itchiness, or slurred speech after having anesthesia.
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 24 Hours You shouldn’t have any bruising, but you may feel a little out of it or fatigued after the anesthesia, Hull says. You may also feel mild to moderate pain or pressure around your eyes, cheeks, and forehead, but it should fade in the first few days after surgery.
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.
You don’t need to make any changes to your diet, unless the anesthesia leaves you feeling queasy. If that’s the case, you may want to stick to bland foods until you feel back to normal, Hull says.
In the First Two Weeks Your surgeon will also likely instruct you to use a saline rinse and a topical decongestant in your nose to help limit bleeding during the first two weeks after your procedure.
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.
You don’t have to confine yourself to your bed, but you do need to limit strenuous activity for at least two weeks while you’re healing.
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.
Hull says a perforation that doesn’t cause symptoms doesn’t need to be fixed. But if you have perforation symptoms, you may need surgery to repair it. “Not all ENTs do those, so you want to talk to somebody who has some experience doing them,” Hull says.
The initial recovery from a septoplasty takes about one week, though your bone and cartilage will continue healing for up to a year. You’ll likely see your surgeon a week after the procedure to make sure that you are healing properly, Hull says.
While septoplasty is largely effective — up to 85 percent of people breathe more easily afterward — some people still experience breathing problems after the procedure. These folks may opt for a second septoplasty.
Following your surgeon’s instructions for preparation and recovery can help deliver an optimal outcome.
Septoplasty is a surgery that corrects a deviated septum in people who experience breathing issues. The procedure involves removing or repositioning parts of the septum (the cartilage and bone that separate the two nostrils). It’s generally considered a safe and effective surgery, and most people notice improvements in breathing and airflow afterward. An experienced surgeon can help you prepare for and recover from a septoplasty.
