Septoplasty (septum surgery) is the medical name for the procedure that corrects and straightens the nasal septum. The nasal septum is the name for the bone and cartilage partition between the two nasal cavities. The septum should be located in the center of the nose. If it is not straight, it deviates into one of the nasal cavities and that impedes airflow. Deviations of the septum cause nasal obstruction. Nasal obstruction can cause a number of problems from sinusitis to sleep apnea. 

Most septum surgery doesn’t take more than an hour and the initial recovery time is only a few weeks.

What happens during septum surgery

During septum surgery bits of bone and cartilage are removed to realign the septum in the nasal cavity.

The procedure is performed under anesthesia. It may be done under local, but more commonly it is performed under general anesthesia.

The ear, nose and throat (ENT) specialist works through the nostrils. There is no external incision or scarring. During the procedure the ENT makes an incision in the lining of the septum, releases the membranes, and begins the process of removing and reforming the tissue and bone necessary to produce a straight septum.  At the end of the procedure, splints, tubes or packing may be inserted.  All sutures will be internal. Unlike a rhinoplasty that is concerned with the exterior appearance of the nose, septum surgery will not leave bruising under the eyes or in the cheek area.  Exterior swelling, if any, will be minimal.

Preparing for septum surgery

The ENT will recommend septum surgery after a thorough examination, which may include visual examination with an endoscope or a CT scan.

If septum surgery is recommended, it will usually be performed under a general anesthesia. This means you will need to avoid eating and drinking after midnight on the night before surgery.  The ENT will instruct you to stop taking NSAIDs (like aspirin, ibuprofen, etc.) and certain other medications for 2 weeks prior to the surgery. This reduces your risk of excessing bleeding during surgery and during recovery.

Your surgery will be performed on an outpatient basis. No overnight stay is required for routine septoplasty. Be sure to follow instructions for preregistering (if necessary) with the surgical center and obtaining approval from your medical insurance carrier (if required). 

On the day of the surgery, wear loose fitting clothes and a shirt that buttons down the front. The day of surgery and during the recovery period you don’t want to wear clothing that pulls over your head.

You will stay at the surgical center until the anesthesia wears off and your condition is stable.  Once released, you will need a friend or family member to drive you home.

Septum surgery recovery

The entire recovery process can take months. The tissue where the incision is made and the membranes are lifted will heal very quickly. Cartilage and bone take much longer to heal, this is the reason for the extended recovery period.

Swelling and pain will be present in the first few days but will subside. Sleeping with your head elevated will make it easier to breathe and the ENT may insert breathing tubes if you have nasal packing. You will want to avoid NSAIDs as they can increase your risk of bleeding. The ENT will prescribe oral pain medication that will not increase risk of bleeding.

If splints or packing is inserted after surgery, you will return to the ENTs office for removal.  However, with advanced surgical techniques, these may not always be necessary.

Septum surgery has helped many people improve their breathing and their quality of life. The recovery period is brief in comparison to the years of breathing freely it can bring.