Septoplasty straightens the septum, the wall of cartilage and bone that divides the nose in two. It is done through the nostrils, leaves no cuts on the outside, and most people go home the same day. Recovery is simpler than after a rhinoplasty, but the nose usually feels more blocked before it feels better. What follows is what most people go through; your own instructions come from your surgeon, who knows the details of your operation.
The first days
As the anaesthetic wears off you may feel sick for a short while; it usually passes quickly, and medicine can be given if needed. Once it has passed you can eat and drink, and when you feel well enough, often the same day, you go home.
For the first days your nose feels blocked, as if you had a heavy cold. This comes from swelling inside the nose and, if they were used, packing or splints. Packing is not used in every operation: stitching the septum in place from the inside can make it unnecessary. If packing was placed, it usually comes out after a few hours or the next day. If soft plastic splints were placed inside the nose, they are usually removed at a check-up seven to ten days later. The stitches inside the nose dissolve on their own.
Because you will mostly breathe through your mouth, it will feel dry; drinking water often helps. The nose will be a little sore, but simple painkillers are usually enough. Take what you were given as prescribed, and do not add other medicines without asking your doctor.
Some bleeding after septoplasty is normal. Most of it is old blood from the operation, and you may need to change the gauze under your nose a few times in the first days. Take these days quietly at home and avoid anything strenuous that could start the bleeding again. Stay away from dust and smoky places, because smoke irritates the lining of the nose and slows healing. If you smoke, you are advised not to before or after surgery.
Rinsing, and not blowing your nose
Do not blow your nose at all for at least two days after you get home, and then start very gently. The pressure of blowing can restart bleeding. If you need to sneeze, keep your mouth open. Do not pick at crusts or put cotton buds or fingers into the nostrils; the crusts will come away by themselves.
If your surgeon has advised saline rinses, they will also tell you when to start. Lean forward over the sink, breathe through your mouth and let the solution into each nostril gently, without forcing it. If you make the solution at home, use tap water that has been boiled and cooled to room temperature, never while it is still hot. If you were given a nasal spray or cream, use it after rinsing, and clean the rinse bottle after each use. Regular rinsing softens the crusts and helps them clear on their own.
You can shower and wash your hair, but use lukewarm rather than hot water for the first 48 hours, as heat raises the risk of a nosebleed.
When breathing starts to improve
A blocked nose in the first week is expected and does not mean the operation has failed. Breathing usually starts to open up once any splints are out and the swelling inside begins to go down. It can take up to three months, though, for the nose to settle completely and for breathing to become clearly easier, with better and worse days along the way.
In a randomised trial of adults with a blocked nose caused by a deviated septum, people who had septoplasty were doing better at one year than those treated without surgery, and the difference held for two years of follow-up. Still, every nose is different, and a blocked nose can have causes other than the septum, which is why your breathing is followed at your check-ups. If you need a nasal spray for something like an allergy, a straighter septum can also help the spray reach the inside of the nose.
Sometimes the septum cannot be straightened completely, bends again as it heals, or bands of scar tissue form inside the nose. If your nose is still clearly blocked after three months, mention it at your check-up so that further treatment can be considered. Numbness of the upper teeth, upper lip or nose tip is also common and usually fades with time.
For a few months after surgery the nose is vulnerable to knocks. A blow during this time can push the septum out of place again.
Work, sport and everyday life
Plan for about two weeks off work, especially if you work somewhere dusty or your job involves physical effort such as heavy lifting. Some people with desk jobs return sooner; decide this with your surgeon.
Avoid strenuous exercise such as weight training, running and fitness classes for the first two weeks. Short, gentle walks are usually fine. Because the nose stays vulnerable to knocks for a couple of months, take a break from contact sports such as football, basketball or martial arts during that time. Your surgeon will tell you when you can start again.
You can do light everyday tasks from the first days, as long as you do not tire yourself. Avoiding sudden strain in the first days lowers the risk of bleeding.
When to call
Call the practice the same day if any of the following happens in the first two weeks: a fever of 38°C or more that does not settle; feeling unwell and not wanting to eat or drink; pain that your painkillers do not control or that keeps increasing; or bleeding that does not stop, or gets heavier, despite the advice you were given.
A nose that first opens up and then becomes more and more blocked, red and painful also needs to be seen without delay. It can be a sign of blood collecting under the lining of the septum (a haematoma) or of an abscess, and these need early treatment: an infection is treated with antibiotics, and a collection of blood or pus may need to be drained.
Heavy bleeding that will not stop, or difficulty breathing, is an emergency: call 112.
Without these signs, some blood-stained discharge, crusting and stuffiness are an ordinary part of healing. Be patient, protect your nose and keep your check-ups.