Patient Guide
Nasal septoplasty, from start to finish.
A guide for patients preparing for septoplasty: why the operation is done, what it involves, how to prepare, what to expect afterward, the risks, and how the hospital day and follow-up are arranged.
Written and reviewed by Dr. Justin Khetani, MD, FRCSC, Otolaryngology–Head and Neck Surgery · Last reviewed
General guidance only. Your written instructions, and anything Dr. Khetani's office tells you directly, take precedence over this page.
What happens, in order
- Before Why the septum is blocking your breathing
- At least 3 weeks before Stop smoking
- At least 10 days before Stop aspirin and anti-inflammatories
- Under general anesthesia The operation itself
- 45 minutes, then 2 to 3 hours In recovery, then home
- First 3 to 4 days Light bloody discharge
- About one week The splints come out
- 1 to 2 weeks Time away from work
Each stage links to the section that explains it in full.
01 / 06
The Problem
Why might I need a septoplasty?
The nasal septum is the wall of cartilage and bone, covered with a mucous membrane, that divides the nose into two separate chambers, left and right. Normally the septum is relatively straight, with nasal cavities of similar size on each side.
Occasionally, however, the septum is severely bent, or deviated: enough to encroach on the nasal airway. A deviated septum may develop as the nose grows, or can result from an injury to the nose.
The common symptoms are restricted nasal breathing and a predisposition to sinus infections. When those symptoms interfere with normal life, correcting the septum becomes worth considering.
Deviated · Corrected
Fig. The septum, straightened in place.
02 / 06
The Operation
What is a septoplasty?
A septoplasty corrects a deviated nasal septum that interferes with the proper function of the nose. The surgery takes place under general anesthesia.
It can be done either endoscopically, using a nasal telescope, or in the traditional manner; in both cases the work happens through an incision inside the nose, so there is no external cut. The surgeon lifts the mucous-membrane lining of the septum, then removes and/or straightens the deviated portions of the septal bone and cartilage before laying the lining back down.
Because the correction is internal, the operation is about how the nose works, not how it looks. If you are also weighing a change to the nose's appearance, that is a different conversation: rhinoplasty, and it is assessed separately.
03 / 06
Getting Ready
How do I prepare for surgery?
Two rules protect you from bleeding and poor healing. Both start well before the operation day.
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Stop before surgery
Do not take aspirin or salicylate-containing medications for at least 10 days before surgery. They can significantly increase bleeding. The same applies to anti-inflammatory medications (NSAIDs) such as ibuprofen. If a physician has prescribed one of these, don't stop it on your own; the office will coordinate with the prescribing physician.
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Smoking
Do not smoke for at least 3 weeks before your surgery. Smoking worsens nasal and lung symptoms and impairs healing. If you can use the operation as a reason to stop entirely, so much the better.
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Your written instructions
You will receive written pre-operative instructions covering fasting, medications and arrival time. They are specific to your operation and take precedence over this page.
04 / 06
Recovery
What should I expect afterward?
In the early period after surgery there is usually some tenderness and swelling inside the nose. The outside of the nose will not usually show any effects of the surgery, though the tip of the nose may remain tender for a week or two.
Expect three to four days of light, blood-tinged nasal discharge. This is part of normal healing, not a sign that something is wrong.
Plan for one to two weeks away from work, depending on what your work involves. Breathing typically improves progressively as the internal swelling settles; the early congestion is not the final result.
05 / 06
The Honest Part
What are the risks of septal surgery?
Septoplasty is a common operation and complications are rare, but rare is not never. These are the ones this guide covers: return of the blockage, bleeding, changes around the nose and teeth, a hole in the septum, and anesthesia.
You may experience recurrence or persistence of your symptoms. Over time, because nasal cartilage has a degree of "memory", there can be a tendency for the septum to reshape itself back toward its deviated position.
Other complications from the surgery are rare, but they can include bleeding, a change in the shape of the nose, or numbness of the front teeth. These are often temporary.
A septal perforation, a small hole in the nasal septum, can occasionally result after surgery. Perforations are often symptom-free, but the symptoms they can cause include whistling, crusting, or bleeding from the nose. Rarely, a perforation can result in loss of support for the bridge of the nose (a saddle-nose deformity).
With newer medications and techniques, serious complications of general anesthesia are uncommon. They remain possible, however, and you are welcome to discuss them with the anesthesiologist before your operation.
06 / 06
The Day Itself
Hospital, home and follow-up.
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An outpatient operation
A septoplasty is booked as an outpatient procedure unless you have medical conditions that would require monitoring overnight. The procedure itself takes about 45 minutes.
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Recovery & going home
You will remain in the recovery area for two to three hours after the procedure, and then leave the hospital with a friend or family member. Don't plan to drive yourself.
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Splints & follow-up
The nose is not packed after septoplasty. Soft splints (Doyle splints) are usually placed inside the nose to support the healing septum. How long they stay in depends on how severe the deviation was and how much surgery was needed: often you will follow up with Dr. Khetani about one week after surgery to have them removed, and in rare cases they stay two to three weeks.
Concerns or emergencies after surgery
Contact the office at (905) 639-2244 with questions or concerns; post-operative calls are prioritised. For heavy bleeding, difficulty breathing, high fever, severe pain, vision changes or any emergency, do not wait for a call back; go to your nearest emergency department or call 911.
Related Patient Information
Keep reading.
This guide is general patient education, based on the practice's patient information material. It is not medical advice about your case, and the instructions provided directly by Dr. Khetani and his care team for your individual treatment take priority.
Dr. Justin Khetani · Otolaryngology, Head & Neck Surgery · 1435 Plains Rd E, Unit 5, Burlington, ON L7R 3P9 · ENT office (905) 639-2244