Septoplasty is a surgical procedure performed to correct a deviated septum. Since a displaced septum can block airflow and interfere with breathing, septoplasty is usually performed to restore the ability to breath freely.

Septoplasty may be done alone, or it may be done in conjunction with another surgical procedure such as rhinoplasty. “In a large percentage of rhinoplasties, we’re also doing septoplasty just to get material to strengthen the nose,” says Nick Slenkovich, MD, a plastic surgeon at Colorado Plastic Surgery Center in Denver, Colo. “And rhinoplasty always takes into account the septum and anything we may need to do to ensure function.”

Why Patients Choose Septoplasty

The septum is the vertical wall in the nose separating the two nasal passages. Made up of thin bone and cartilage, the septum is lined with a thin mucous membrane layer that offers protection and keeps the nose moist.

Ideally, the septum is located in the center of the inner nose and is flanked by the two airways. Few people have a perfectly straight septum, but more significant deviations can lead to problems. When the septum is crooked or displaced, it can block airflow in one or both of the nasal airways making breathing difficult. Obstructed breathing can also interfere with sleep.

Patients elect septoplasty surgery in order to straighten the nasal septum and improve airflow.

How Common Is Septoplasty?

A deviated septum is one of the main reasons to have functional nasal surgery. In fact, it’s listed as the third most common head and neck procedure performed in this country.

What Happens During Septoplasty?

During the septoplasty procedure, an incision is made inside the nose, so there are no visible signs of surgery outside the nose. The mucous membrane layer is lifted away from the cartilage to allow the septum to be repositioned. Depending on condition of the septum, it may be necessary to flatten or remove some of the cartilage to open the nasal passages. Once repositioning is complete, the mucous lining is put back in place.

Local or general anesthesia may be used during septoplasty. If the surgery is performed under local anesthetic, IV sedation will be given to induce drowsiness. Following the procedure, you will be monitored in a recovery room and may be kept in the hospital overnight.

Recovering From Septoplasty

Nasal packing or splints may be placed during surgery to support the septum and reduce the risk of bleeding. Packing usually remains in place from one to three days. Your surgeon will go over a list of instructions for you to follow after your septoplasty. These may include:

  • Avoid heavy lifting or bending for one week
  • No vigorous exercise
  • Don’t blow your nose
  • Keep the head of the bed elevated or use additional pillows
  • Avoid bumping the nose
  • Do not pull tight sweaters or shirts across the nose when dressing

You may notice a small amount of swelling and mild nasal drainage during the recovery period. Stuffiness is also common.

Recovery time varies from person to person, but basic septoplasty recovery usually occurs within a few days. Many patients continue to see gradual improvement over a period of three to four weeks.

Possible Risks and Complications of Septoplasty

The success rate of septoplasty is very high. Although the procedure is considered safe and has few complications, as with any surgery, there are some risks to be aware of.

“There are really two main risks to be concerned about with septoplasty,” says Dr. Slenkovich. “The first is getting a hole in the septum, and the second is that the breathing function will not have been improved.”

Septal perforation, or a hole in the septum, is a complication Slenkovich describes as “very rare,” but it can occur during septoplasty.

Some patients also find that nasal congestion or stuffiness persists following surgery or returns after a short time. This could indicate additional surgery is needed to address other issues such as inflammation of the nasal turbinates or flimsy nostrils.