Septoplasty

Published by Bupa’s Health Information Team, March 2011.

This factsheet is for people who are having septoplasty, or who would like information about it.

Septoplasty is an operation to correct a bent (deviated) septum in the nose. The septum is the piece of cartilage and bone that separates the two sides of the nose.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About septoplasty

Septoplasty is an operation to straighten the septum in your nose. Your septum is the bone and cartilage that runs down the middle of your nose and separates your nostrils. In around eight out of 10 people the septum is bent to one side. For most people this doesn’t cause any problems and they may not even be aware of it.

If your septum is severely bent to one or both sides (deviated), it can block your nose. A deviated septum can develop because your bone cartilage grows that way or it can become bent after an injury to your nose.

You may be offered septoplasty to treat a blocked nose or if you get frequent sinus infections. Septoplasty is also sometimes done to help your surgeon reach your sinuses if you need sinus surgery.

Septoplasty won't usually change the way your nose looks. However, if your nose isn’t straight, it may be possible to have surgery to reshape it at the same time. Speak to your surgeon about your options.

What are the alternatives?

If your septum is bent, it won’t cause you any harm, so you may decide to leave it as it is.

However, if your septum is causing you problems and affecting your day-to-day life, you may want to have it straightened. The only way to straighten it is to have a septoplasty. Nasal sprays and drops might help unblock your nose if it’s swollen or inflamed.

Preparing for septoplasty

Your surgeon will explain how to prepare for your operation. For example, if you smoke, you will be asked to stop as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.

Septoplasty can be done as a day case, which means that you have the operation and go home the same day. However, many people need to stay in hospital overnight after the operation.

The operation is usually done under general anaesthesia, which means you will be asleep during the procedure. You can also have septoplasty done under local anaesthesia, which means that you will be awake but your nose will be numb. If you’re having the operation under local anaesthesia, you may be offered a sedative to help you relax.

If you're having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice.

At the hospital your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during septoplasty

Septoplasty usually takes 30 to 45 minutes, though it can take longer if the operation is complex.

Your surgeon will make a cut inside your nose and remove any bone or cartilage that is blocking it. He or she will then straighten your septum by moving it back into the middle of your nose. When everything is properly in place your surgeon will use stitches to hold it together.

Your surgeon may put dressings into your nostrils to help reduce any bleeding. You may also have small pieces of plastic called splints put inside your nose to prevent scar tissue from developing.

What to expect afterwards

You may need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

If you have septoplasty done under local anaesthesia, you will usually be able to go home when you feel ready but you may need to arrange for someone to drive you. You should have a friend or relative stay with you for the first 24 hours.

If you have dressings in your nose, you will usually need to keep them in overnight and your nurse or surgeon will take them out before you go home. If you have plastic splints in your nose, these will usually need to stay in place for about a week after your operation. You will probably need to return to the hospital to have these taken out.

You may not be able to breathe through your nose if you have dressing packs in, or if your nose is swollen. You will have to breathe through your mouth for a few days until these are taken out and any swelling goes down.

Your nurse will give you some advice about caring for your healing wounds before you go home. You will usually be given a date for a follow-up appointment.

Recovering from septoplasty

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you’re in any doubt about driving, please contact your motor insurer so that you’re aware of their recommendations, and always follow your surgeon’s advice.

You may have some watery, blood-stained fluid coming from your nose for the first two weeks after your operation. Don’t blow your nose for a week after septoplasty as it may cause bleeding. If you sneeze, try to do it with your mouth open to protect your nose.

You will need to breathe through your mouth for the first few days. This can cause your lips to dry out so use petroleum jelly or lip balm on your lips to stop them cracking.

Keep your head up as much as possible in the first 24 to 48 hours after your operation and sleep or rest in an upright position with several pillows.

Your nose may feel blocked or congested, as if you have a heavy cold, for a couple of weeks after your operation. Your surgeon may give you a nasal spray or nose drops to help with this.

It can take up to three months for your nose to get completely back to normal after septoplasty. While your nose is healing, stay away from dusty or smoky places.

Follow your surgeon’s advice about returning to work and leisure activities. Most people are able to return to work one or two weeks after the operation. Don’t play any contact sports, such as rugby or football, for at least a month after your operation.

See your GP straight away if you develop:

• heavy bleeding that doesn’t stop within 10 to 15 minutes
• a blocked nose that gets worse
• raised temperature or fever
• increasing pain

What are the risks?

As with every procedure, there are some risks associated with septoplasty. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

These are the unwanted but mostly temporary effects you may get after having the procedure. The side-effects of septoplasty include:

• pain and discomfort in your nose, particularly at the front
  
• a blocked nose
  
• blood-stained, watery fluid that comes from your nose

Complications

Complications are when problems occur during or after the operation. Most people aren’t affected. The main complications of septoplasty are listed below.

• Bleeding. You may have heavy bleeding after your operation. If this happens, it’s usually in the first few hours after the procedure or between five and 10 days afterwards. If you have heavy bleeding, your surgeon may need to put packing into your nose. You may also need another operation to stop the bleeding.
• Infection in your nose. This is rare but can be serious. If you have pain and an increasingly blocked nose, see your GP as soon as possible.
• A hole in your septum. This usually doesn’t cause any problems, but you may hear a whistling noise when you breathe in and out. You may need another operation to correct this.
• A change in the shape of your nose. This is rare, but if it does happen, you may need another operation to correct it.
   

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.