A deviated septum occurs when the bone and cartilage dividing your nasal cavity are off-center or crooked. This variation can restrict airflow through one or both nostrils, leading to breathing difficulties, congestion, or other symptoms. Septoplasty is the surgical procedure designed to correct this misalignment to improve nasal airflow and breathing. This article outlines what to expect before, during, and after the procedure.
Preparing for Your Procedure
Preparation for septoplasty involves several steps. Consultations include discussing your medical history and symptoms with your surgeon. They will perform a physical examination and may order imaging tests to assess the deviation. You will receive instructions to stop certain medications, especially blood thinners like aspirin or ibuprofen, and some herbal supplements, typically a week before surgery to reduce bleeding risk.
Avoid alcohol and smoking before the procedure, as these can negatively affect healing. Fasting is required for 6 to 8 hours before surgery. Arrange for someone to drive you home on the day of surgery, as anesthesia effects prevent driving. Following pre-operative instructions helps prepare for surgery and minimizes complications.
During the Surgery
Septoplasty is typically an outpatient procedure, allowing most individuals to return home the same day. The procedure usually takes 30 to 90 minutes, depending on the deviation’s complexity. Anesthesia options include general anesthesia (you are completely asleep) or local anesthesia with sedation (numbs the area while keeping you relaxed).
The surgeon makes an incision inside the nose, avoiding external cuts and preserving its outer appearance. The mucosal lining covering the septum is lifted, allowing access to the underlying bone and cartilage. Deviated portions of the septum are reshaped, removed, or repositioned to straighten the structure and improve airflow. Other procedures, like turbinate reduction, may be performed concurrently if needed. Once straightened, the mucosal lining is repositioned, and internal incisions are closed, often with dissolvable sutures.
Immediately After Surgery
After surgery, you will be monitored in a recovery room as anesthesia wears off. Expect grogginess, mild pain, and a headache upon awakening. You may also notice a stuffy nose, ear fullness, and swelling, with discomfort similar to a sinus infection.
Nasal packing or splints may be present to support the straightened septum and control bleeding. Packing may be removed within hours or days, while splints typically remain for 5 to 10 days and are removed at a follow-up visit. Pain management will be provided, and you will typically be discharged home the same day once stable and alert.
Navigating Home Recovery
Home recovery requires managing symptoms and promoting healing. Expect mild to moderate pain, manageable with prescribed medication or acetaminophen. Avoid NSAIDs like ibuprofen during initial recovery, as they increase bleeding risk. Swelling and bruising around the nose and eyes are common and will gradually subside, though some residual swelling may persist for several months.
Mild bloody discharge is expected for 24 to 72 hours; a drip pad can manage this. Contact your surgeon if bleeding becomes heavy or persistent. Nasal congestion is common due to internal swelling and splints, making initial nasal breathing difficult. Temporary nausea (especially with general anesthesia) or a sore throat from the breathing tube may occur. Numbness in the nose tip or upper teeth is also possible.
Post-operative care instructions are crucial for optimal recovery. Keeping your head elevated, especially while sleeping, for several days or weeks can help reduce swelling and discomfort. Your surgeon will likely recommend starting nasal saline rinses a day or two after surgery to keep the nasal passages moist and clean, aiding in the removal of crusting and dried blood. It is important to avoid blowing your nose forcefully for at least one to two weeks to prevent dislodging sutures or causing bleeding. If you need to sneeze, do so with your mouth open to minimize pressure on the nasal passages.
Activity restrictions are in place to protect the healing tissues. Rest is important during the first few days. Avoid strenuous exercise, heavy lifting, or activities that involve bending over or straining for at least two weeks, often up to one month or six weeks, as these actions can increase blood pressure in the head and potentially lead to bleeding.
Light activities, such as walking, can typically be resumed within a week. Most people can return to non-strenuous work or school within a week, while those with more physically demanding jobs may need two weeks off. Contact sports should be avoided for a longer period, generally two to four weeks or more, and swimming or flying may be restricted for about two weeks. If you wear glasses, avoid letting them rest on your nose for about a month if possible, to prevent pressure on the healing septum.
Follow-up appointments with your surgeon are scheduled, often within a week after surgery, to remove any splints and monitor your healing progress. It is important to contact your surgeon if you experience signs of complications, such as increased pain, excessive or persistent bleeding, signs of infection like fever above 101°F, increased redness, swelling, or unusual discharge. While initial recovery and significant improvement are often seen within one to four weeks, the complete healing and stabilization of the nasal structure can take several months, typically three to six months. Though rare, potential long-term considerations can include continued nasal dryness, a decreased sense of smell, or the formation of a septal perforation, which is a small hole in the septum.