What is a Septoplasty?

A septoplasty is a surgical procedure used to treat a deviated septum. The septum is the wall of cartilage and bone in your nose, separating your two nostrils. This septum may be crooked or off-center from birth, or it can become that way from a nose injury. A septoplasty is the only method of treating a deviated septum.

Deviated Septum

The condition is common though many people don’t even realize they have a deviated septum. In fact, the American Academy of Otolaryngology-Head and Neck Surgery report that as many as 80% of people have an off-center nasal septum. Depending on just how off-center your septum is, your symptoms may range from giving you no grief at all to being responsible for:

• Difficulty breathing through one side of your nose
• Frequent nosebleeds
• Frequent sinus infections
• A dry mouth in the morning from mouth-breathing overnight

If your crooked septum isn’t causing you any problems, you may continue on your merry way. However, if a deviated septum is impacting on your quality of life in some way – hello, septoplasty.

The Septoplasty Procedure

Many septoplasties are performed under general anesthetic, meaning you’re asleep for the procedure. However, depending on the preferences of you and your ENT (ear, nose, throat) surgeon, you may be considered to undergo the surgery with a local anesthetic to your nose instead.

If you are scheduled for a general anesthetic, your surgeon will advise you to cease blood thinning medications such as ibuprofen or aspirin a couple of weeks before your operation. You’ll also need to avoid eating or drinking by midnight before the day of your procedure.

A septoplasty is typically performed through the nostrils, without disturbing the skin on the outside of your nose. Through small incisions in the mucous membrane covering the septum, the surgeon can then readjust the position of the bone and cartilage, trimming and removing any excess tissue.

The incisions are closed with self-dissolving stitches and you may have soft splints inserted into each nostril. These silicon splints help to support the septum while it heals. There may also be some surgical packing material applied to your nostrils to help manage post-operative bleeding.

The whole operation usually takes an hour to an hour and a half. Septoplasties are generally an outpatient procedure, meaning you go home on the same day of your operation. You’ll need someone to drive you home as you will be under the influence (of general anesthesia).

Though a septoplasty in isolation isn’t designed to change the shape of your nose, it may be combined with a rhinoplasty for this purpose. If you have sinus issues, your ENT surgeon can also perform a sinus operation at the same time as the septoplasty.

Septoplasty Recovery

Pain after a septoplasty is not usually significant. The incisions heal reasonably quickly, and any discomfort and swelling should be short-lived. However, it will take three to six months for the nose to stabilize, and up to a year for complete healing.

Immediately after your operation, a few tips can help make your recovery as smooth as possible:

• Sleep with your head slightly elevated to minimize swelling to your nose
• Avoid blowing your nose for a few weeks
• Take a break from strenuous activities, which will help lower your risk of a nosebleed
• Wear alternative clothes to those that need to be pulled over your head, such as ones with a button-down front (or ones that you can squeeze into from bottom up)
• Avoid swimming for six weeks after your operation
• Gently clean your nose with a saline nasal spray or sinus irrigation
• Avoid steroid nasal sprays for at least two weeks

You can consider using over-the-counter pain medication, such as acetaminophen, but continue to avoid aspirin, ibuprofen, or naproxen as they can increase your risk of a post-operative bleed. An ice pack to your nose can also help with pain and swelling.

Within one to two days after your septoplasty, you’ll be scheduled for a review with your surgeon. Any packing material, dressings, or splints will be removed at this appointment.

You can expect any swelling to resolve in about a week. By this time, breathing through your nose should become easier.

Though recovery from a septoplasty is generally uneventful, even the best laid plans can sometimes go astray. See a doctor if you experience:

• Uncontrollable nosebleeds
• Increasing pain, swelling, or redness around your nose
• High fever with chills
• Pus-like discharge from your nose
• Nausea with or without vomiting
• Breathing difficulties, coughing, or chest pain

Potential Risks and Complications

Septoplasties have a high success rate, typically quoted around 80%. However, as established above, things don’t always go according to plan.

The general risks of any surgical procedure are excessive bleeding, infection of the surgery site, and allergy or a reaction to the anesthetic. Specific to the septoplasty procedure, other complications include:

• Failing to fully correct the deviated septum, resulting in persisting symptoms
• Unintentionally altering the outward shape of the nose, such as a saddle nose deformity
• A perforation (hole) in the septum
• Decreased sense of smell
• Numbness of the upper gums, teeth, or nose

The most common complication post-septoplasty is excessive bleeding; infections tend to be rare. Fortunately, alterations to sense of smell are most often temporary, as is the loss of sensation to the teeth. If the initial surgery fails to fully fix the deviated septum, your surgeon can perform a touch-up procedure.

In the majority of situations, a deviated septum is not a problem. But if you are unimpressed by the unequal size of your nasal passages and a crooked nasal septum is causing you grief, discuss your options with your family doctor or contact one of our ENT Doctors at Berger Henry ENT Specialty Group.