Septoplasty Recovery: Complete Guide to Deviated Septum Surgery Recovery

The recovery after septoplasty may vary in different individuals. Complete recovery from septoplasty may take 6 weeks or more. Patients are recommended to take rest for minimum of 1 week.¹Baumann I. Quality of life before and after septoplasty and rhinoplasty. GMS current topics in otorhinolaryngology, head and neck surgery. 2010;9.

Re-deviation of septum, although rare, can occur after the surgery. This can be due to inadequate or improper correction of the nasal septum, resulting in persistent or recurrent nasal obstruction after septoplasty. Research suggests that the incidence of re-deviation in adolescents is higher than in adult patients. This could be due to immaturity of septal cartilage and their ability to regrow in adolescents.³Derin S, Sahan M, Deveer M, Erdogan S, Tetiker H, Koseoglu S. The Causes of Persistent and Recurrent Nasal Obstruction After Primary Septoplasty. J Craniofac Surg. 2016 Jun;27(4):828-30⁴Lee, E., Lee, S. J., Kim, H. J., Shin, J. M., Choi, J. H., & Lee, J. Y. (2018). Incidence of re-deviated nasal septum after septoplasty in adolescent and adult patients. Acta Oto-Laryngologica, 1–4

A significant improvement in nasal breathing is observed by individuals within 3-6 months of septoplasty surgery. However, placement of nasal packing and swelling after the surgery can make individual feel uneasy and stuffy for about a week post-surgery.⁵Sundh C, Sunnergren O. Long-term symptom relief after septoplasty. Eur Arch Otorhinolaryngol. 2015 Oct;272(10):2871-5.

The initial symptoms such as pain, swelling, and bruising will reduce in 7-10 days after the surgery. Overall healing is slow. It may take ~3-6 months for the septum to heal completely. However, it may also take about a year for patients to appreciate the changes after the surgery.⁶Ishii LE, O’Connor SS, Strike DJ, Walsh SA. Plain Language Summary: Improving Nasal Form and Function after Rhinoplasty. Otolaryngology–Head and Neck Surgery. 2017 Feb;156(2):220-7.⁷Septoplasty Results - American Society of Plastic Surgeons

The nasal septum is a midline structure that positions the nose centrally. Any deformity in the septum gives a crooked appearance to the nose. During septoplasty, deviated septum is repositioned centrally. This improves the appearance of the nose and makes it look more symmetrical.⁸Saharia PS, Deepti Sinha. Septoplasty can Change the Shape of the Nose. Indian J Otolaryngol Head Neck Surg. 2013;65(Suppl 2):220-225. doi:10.1007/s12070-011-0330-7.

Usually, septoplasty done right makes the nose look symmetrical and improves the function of the nose. In some cases, overcorrection of the nose can make your nose look different. In such cases, rhinoplasty may be required to improve the appearance of the nose.⁹Ketcham, A. S., & Han, J. K. (2010). Complications and Management of Septoplasty. Otolaryngologic Clinics of North America, 43(4), 897–904.

The uneven appearance of nostril in the initial days after surgery is normally seen due to presence of swelling. If the uneven appearance of the nose persists for a longer time (more than 6 weeks) then consult your doctor.¹⁰Ketcham, A. S., & Han, J. K. (2010). Complications and Management of Septoplasty. Otolaryngologic Clinics of North America, 43(4), 897–904.

Saddle nose appearance is a most common cosmetic defect observed after septoplasty.   The over resection (cutting) of the cartilage during septoplasty leads to loss of height of the nose, giving a saddle nose appearance. This affects both appearance and function of the nose.¹¹Ketcham, A. S., & Han, J. K. (2010). Complications and Management of Septoplasty. Otolaryngologic Clinics of North America, 43(4), 897–904.

1–2 days: Individual may feel mild to moderate amount of pain and swelling. The nose may feel stuffy or congested due to the presence of dressing. Individual will need to breathe through the mouth for a week even after removal of the dressing. Blood-stained mucus discharge from the nose is common. Blowing of the nose is completely restricted

3-7 days: Nose may still feel stuffy and sore. Gentle blowing of the nose can be performed. Individual can sneeze with mouth open. Dryness of nose and crusting (accumulation of mucus) are common. Drainage of blood-stained mucus is normal. Performing of vigorous exercises should be avoided. Nasal splints are removed during this period.

7–10 days: Improvement in breathing is observed. Pain and swelling are reduced. Some amount of dryness of the nose and crusting is still evident. One can resume work that doesn’t require any physical strain.

10–14 days: Improvement in breathing evident but individual may still feel restricted.

6 weeks: Individuals can resume back physical activities such as sports and exercises as the septum heals.

Nose remains delicate and fragile after the surgery until healing completes. Patients are recommended to avoid excessive physical, strenuous activities and sports for a period of 6 weeks until the nose regains its previous strength.

For initial few weeks patients are unable to breathe through the nose due to presence of nasal packing and swelling of the nose post-surgery. However, significant improvement in nasal breathing is reported 3-6 months after the surgery.

Patient may feel uneasy or have a blocked nose for some time (more than a week) after the surgery due to presence of swelling and nasal packing. This feeling of congestion improves with healing. However, sometimes patient continues to have blocked nose even after months of septoplasty, indicative of need for revision surgery.²²Simpson JC. Postoperative Care of The Patient After Nasal Surgery

Patient may feel uneasy or have a blocked nose for some time (more than a week) after the surgery due to presence of swelling and nasal packing. This feeling of congestion improves with healing. However, sometimes patient continues to have blocked nose even after months of septoplasty, indicative of need for revision surgery.²³Simpson JC. Postoperative Care of The Patient After Nasal Surgery[/mfn]

Nose can be kept moist by using saline spray or rinsing with saline irrigation after removal of packing post-surgery. The use of humidifier also keeps the nose moist and fastens the healing.²³Simpson JC. Postoperative Care of The Patient After Nasal Surgery[/mfn]

It is recommended to irrigate the nose twice daily after removal of packing post-surgery.²⁴Simpson JC. Postoperative Care of The Patient After Nasal Surgery[/mfn]

Commercially available nasal irrigation includes multiple forms of saline solutions, herbal solutions, nasal corticosteroids, and nasal antihistamines. Homemade saline solutions or saline solutions, e.g., Ayr, Ocean, Simple Saline without preservatives are best to use.²⁵Berry, Y. J. (2003). Negative Side of Nasal Saline Sprays: They Can Be Harmful. Archives of Otolaryngology–Head & Neck Surgery, 129(12), 1352.

How to use:

Sinus rinse after septoplasty is a method to keep nose clear and moist and prevent the formation of scabs (crusty mucus) post-surgery. It also reduces the swelling (edema) and fastens the healing and recovery after septoplasty.

It is recommended to rinse the nose twice daily using a saline solution. The nasal solution can be delivered using positive pressure squeeze bottles, negative pressure (sniffing solution into nose), or Neti pots. Saline solution can be freshly prepared at home by adding two teaspoons of salt in ~1000ml (1 quart) of warm water. Addition of ½- 1 teaspoon of baking soda is performed to buffer the solution. ²⁶Süslü, N., Bajin, M.D., Süslü, A.E. et al. Effects of buffered 2.3%, buffered 0.9%, and non-buffered 0.9% irrigation solutions on nasal mucosa after septoplasty. Eur Arch Otorhinolaryngol 266, 685–689 (2009).²⁷Brown, C. L., & Graham, S. M. (2004). Nasal irrigations: good or bad? Current Opinion in Otolaryngology & Head and Neck Surgery, 12(1), 9–13.

How to use:

The upper lateral (side) cartilage on the nose and the wall of the nasal septum form a space known as nasal valve. This nasal valve regulates the entry of air into the nasal cavity. The collapse of nasal valve can cause narrowing of the space resulting in nasal obstruction.

Individuals undergoing septoplasty to improve symptoms of nasal obstruction may often have persistent symptoms due to nasal valve collapse. In such cases revision surgery may be recommended by the doctor.²⁸Dağli E, Ocak E, Mirici E, Kaya M, Acar A. Effects of early postoperative nasal decongestant on symptom relief after septoplasty. Int Forum Allergy Rhinol. 2018 Dec;8(12):1476-1480

Nasal irrigation is a method to keep the nose moist and clean using saline solution post-surgery. It is also an effective method to soften and remove nasal crusting (nasal scabs) associated with the surgery.²⁹Simpson JC. Postoperative Care of The Patient After Nasal Surgery

Nasal irrigation can be performed after removal of nasal packing (~2-3 days after the surgery). It is performed using positive pressure squeeze bottles, negative pressure (sniffing solution into nose), or neti pots.

How to use:

It is recommended to rinse nose twice daily up to 3 weeks after septoplasty.³⁰Brown, C. L., & Graham, S. M. (2004). Nasal irrigations: good or bad? Current Opinion in Otolaryngology & Head and Neck Surgery, 12(1), 9–13.

The use of nasal decongestants after septoplasty is effective in the early postoperative period. It helps to reduce nasal crusting (nasal scabs), nose bleeding, and nasal congestion (blockage). However, prolonged use of decongestant can reverse the effect and cause nasal congestion.³¹Dağli E, Ocak E, Mirici E, Kaya M, Acar A. Effects of early postoperative nasal decongestant on symptom relief after septoplasty. Int Forum Allergy Rhinol. 2018 Dec;8(12):1476-1480

Afrin is a nasal decongestant which is used in the form of nasal spray during the initial post-operative care. It is mainly used to arrest bleeding and provides relief from nasal blockage. However, Afrin is not recommended beyond 3-5 days after septoplasty as its action may reverse, resulting in nasal congestion.

Individuals can eat light soft and bland meals for initial few days. Diet rich in fibers help prevent constipation post-surgery. Diet rich in vitamins and minerals fasten the healing and recovery post-surgery. Avoid eating spicy, greasy, and acidic food and drink at least 8 cups of water everyday to stay hydrated.

Keep the head elevated while sleeping by using 2-3 pillows underneath the head for 2-3 days post-surgery. This helps to reduce the swelling, congestion, and increase patient’s comfort.

Sleeping on sides doesn’t impact the outcomes of the septoplasty. However, it is recommended on sleep on back with elevated head position instead of sleeping on sides to avoid unnecessary pressure on the nose.

No, its better to avoid smoking for at least 2 weeks after the surgery.

Research suggests that smoking cigarettes delays the wound healing, prolongs the mucociliary clearance (clearing of mucus filled with bacteria and allergens). This promotes infection and increases the risk of developing septal perforation (perforation on the septum), affecting the surgical success.³⁶Cetiner, H., Cavusoglu, I., & Duzer, S. (2017). The Effect of Smoking on Perforation Development and Healing after Septoplasty. American Journal of Rhinology & Allergy, 31(1), 63–65.

Drinking alcohol should be avoided for at least 1-2 week after septoplasty as it may delay the healing at the operated site.

The nasal passage and breathing without difficulty may take ~2-3 weeks after the surgery.

Yes, one can shower but precautions should be taken to avoid the entry of water in the nose as it may loosen the dressing and irritate the mucosa (inner skin). It is better to take tub bath until the nasal dressing is removed.

Nose picking should be avoided after septoplasty as may injure the operated site. The accumulated mucus can be cleaned using cotton swabs or Q-tips with antibiotic ointment or petroleum jelly after the removal of nasal packing or splints.

Individuals often complain of headache post-surgery. This could be due to presence of nasal packing or several other causes. But a significant improvement in the severity of headaches may be observed within 3 months of the surgery. Headache after septoplasty can be managed with the help of painkiller medications. In case of severe headaches consult your doctor.⁴²Lakshmanan, S., Singh, U., Zaffrullah, N. S., & Manimaran, V. (2020). Clinical Outcome Following Endoscopic Septoturbinal Surgeries for Rhinogenic Contact Point Headache: A Retrospective Analysis. Indian Journal of Otolaryngology and Head & Neck Surgery.

Mild to moderate pain may be experienced by the patient for 2-3 days post-surgery. Mild pain may also be experienced during retrieval of splints. However, intake of pain killers, application of cold pack over the operated site, and sleeping with the head elevated using pillows can help overcome the pain early.⁴³Bloom, J. D., Kaplan, S. E., Bleier, B. S., & Goldstein, S. A. (2009). Septoplasty Complications: Avoidance and Management. Otolaryngologic Clinics of North America, 42(3), 463–481.

Sneezing should be avoided with mouth closed after the surgery. Instead, mouth should be kept open while sneezing for at least 2 weeks after the surgery.⁴⁴Simpson JC. Postoperative Care of The Patient After Nasal Surgery

Mild to moderate swelling will occur for 3-4 days after the surgery and subside gradually. It may be accompanied by bruising or discoloration of the skin. However, the use of medications and placement of a cold pack or ice intermittently for 20 minutes for the first 48 hours after the surgery can fasten the recovery.⁴⁵Simpson JC. Postoperative Care of The Patient After Nasal Surgery

Individual may feel pressure built up in the sinus area for few days post-surgery. This may be due to swelling of the tissues and accumulation of mucus plugs in the nose, resulting in stuffy feeling and increased sinus pressure. This can be overcome by sleeping with elevated position (using 2-3 pillows) and also with the use of saline irrigation and regular cleaning of nose after removal of nasal packing.⁴⁸Simpson JC. Postoperative Care of The Patient After Nasal Surgery

Individual may feel sinus infection-like symptoms for few days after the surgery. This could be due to swelling of the tissues or due to accumulation of mucus in the nose. However, use of saline irrigation and regular cleaning of nose with Q-tips or cotton swabs using antibiotic ointment may help overcome this feeling. In case of persistence of the condition, consult your doctor.⁴⁹Simpson JC. Postoperative Care of The Patient After Nasal Surgery

Upper teeth share a common nerve supply with the nose. So, any damage or stretching of nerve during septoplasty may instill a feeling of pain, tingling, or numbness in the upper tooth region. Pain is temporary and remains only for few weeks after the surgery.⁵²Yariktaş M, Döner F, Doğru H, Tüz M. Septoplastinin horlama üzerindeki olumlu etkisi [The beneficial effect of septoplasty on snoring]. Kulak Burun Bogaz Ihtis Derg. 2003 Feb;10(2):58-60.

Individuals may develop dry nose after septoplasty due to trauma to the nasal mucosa (inner skin) and altered blood flow during the procedure. This condition improves over time as the healing completes. Hence, it is important to keep the nasal mucosa moist with the help of nasal sprays (for initial few days), humidifiers, and nasal irrigation to fasten the recovery. However, some individuals may experience complications such as septal perforation or empty nose syndrome after septoplasty which also causes dryness of the nose.⁵³Kuduban O, Bingol F, Budak A, Kucur C. The Reason of Dissatisfaction of Patient after Septoplasty. Eurasian J Med. 2015;47(3):190-193. doi:10.5152/eurasianjmed.2015.18

Nasal crusting or excessive accumulation of mucus is common as the nose heals after septoplasty. This accumulated mucus doesn’t drain normally but instead thickens and dries, resulting in stuffy and congested nose. Crusting is softened and removed with the help of saline irrigation and use of humidifiers.⁵⁴Simpson JC. Postoperative Care of The Patient After Nasal Surgery

Septoplasty is an effective method to relieve snoring in individuals with nasal obstruction. Research suggests that individuals reported improvement in the quality of sleep along with improvement in the duration of sleep after septoplasty.⁵⁵Yariktaş M, Döner F, Doğru H, Tüz M. Septoplastinin horlama üzerindeki olumlu etkisi [The beneficial effect of septoplasty on snoring]. Kulak Burun Bogaz Ihtis Derg. 2003 Feb;10(2):58-60.[/mfn]Alharethy S (2016) Septoplasty is Promising for Improving Snoring. J Otol Rhinol 5:3.[/mfn]

Inability to breathe or presence of nasal obstruction may indicate the need for revision surgery. The necessary of revision surgery could be due to inadequate surgery performed by the surgeon (unaddressed nasal deformities during the primary surgery) or presence of complex deformities needing multiple interventions for correction.⁵⁶Derin S, Sahan M, Deveer M, Erdogan S, Tetiker H, Koseoglu S. The Causes of Persistent and Recurrent Nasal Obstruction After Primary Septoplasty. J Craniofac Surg. 2016 Jun;27(4):828-30

Infection after septoplasty is rare (~0.48-2.5%) but may occur immediately after surgery. Most of the times infection after septoplasty remains localized to the septum and nasal cavity but they can rarely occur in the form of dangerous threats involving other systems (e.g., brain abscess, meningitis, cerebritis, endocarditis, shock).

Several signs of infection after septoplasty include fever, nausea, vomiting, bleeding from nose, pus discharge, and swelling. Most of the doctors consider use of nasal packing for prolonged time as a causative for severe infection.⁵⁷Bloom, J. D., Kaplan, S. E., Bleier, B. S., & Goldstein, S. A. (2009). Septoplasty Complications: Avoidance and Management. Otolaryngologic Clinics of North America, 42(3), 463–481.

Postoperative infection is a possible complication because of the growth of Staphylococcus aureus bacteria at the operated site. The presence of Staphylococcus bacteria is common but it doesn’t always cause infection. However, if there is any break (cut, injury due to nose picking or excessive blowing of nose) in the mucosal lining of the nose, bacteria may enter the site and cause infection.

The infection is characterized by presence of pain, swelling, redness, bleeding, and fever. This can be prevented by the use of antibiotic ointment (Muciprocin) or saline irrigation twice daily to keep the operated site clean and minimize crusting and growth of bacteria.⁵⁸Bloom, J. D., Kaplan, S. E., Bleier, B. S., & Goldstein, S. A. (2009). Septoplasty Complications: Avoidance and Management. Otolaryngologic Clinics of North America, 42(3), 463–481.

Bruising (discoloration of skin) of nasal region, eyes, and cheeks may occur after septoplasty due to damage to the underlying blood vessels during the procedure. Swelling and bruising remain for 5-6 days after surgery and subside gradually. Application of ice or cold pack at operated site for 20 minutes intermittently for 2-3 days can help reduce swelling and bruising.⁵⁹Bernardo MT, Alves S, Lima NB, Helena D, Condé A. Septoplasty with or without postoperative nasal packing? Prospective study. Braz J Otorhinolaryngol. 2013 Aug;79(4):471-4. English, Portuguese

Septal perforation or hole in the nasal septum is a post-surgery complication reported in 1%-6.7% of individuals. Research suggests the perforation can be due to mucosal trauma (trauma to the inner skin) caused by excessive use of nasal saline sprays, intranasal steroids, or placement of tight sutures to stabilize splints.

Septal perforation is characterized by symptoms such as nasal obstruction, crusting, dryness of mucosa (inner skin), bleeding of nose, discharge from the nose, abnormal airflow and whistling during nasal breathing, headache, and pain. Most of the perforations are small and manageable. In cases where perforation continues to enlarge can compromise the structural support of the nose. Meanwhile, small perforations can be managed with the use of antibiotic gels and saline irrigation. Large perforations may require surgical intervention.⁶⁰Ketcham, A. S., & Han, J. K. (2010). Complications and Management of Septoplasty. Otolaryngologic Clinics of North America, 43(4), 897–904.⁶¹Bloom, J. D., Kaplan, S. E., Bleier, B. S., & Goldstein, S. A. (2009). Septoplasty Complications: Avoidance and Management. Otolaryngologic Clinics of North America, 42(3), 463–481.

Runny nose is common in the initial post-operative symptom after surgery. It is observed for initial few days and subsides over time. This drainage after the surgery will be bloody at first, but will turn clear and reduce as the site heals.  

Loss of taste sensation is commonly reported in individuals after septoplasty. It is often accompanied with the loss of smell sensation. These symptoms are temporarily experienced by the individual for 1-2 weeks after surgery due to the presence of edema. Consult your doctor in case of persistence of symptoms even after complete recovery.

Developing cold post-surgery in the first post-operative week is common. It subsides easily over time as the nose heals. In case of persistence of the symptom, consult your doctor.