Septoplasty: What to Expect on the Day of Surgery

A septoplasty is typically done as an outpatient procedure to repair a damaged or deviated septum in the nose. Find out what to expect the day you arrive for surgery and when you can go home.

Before the Surgery

As with most surgeries, there are a number of tests and examinations your healthcare provider will likely perform before your surgery. These include:

• Lab work to rule out pre-existing conditions or prevent complications like bleeding
• A physical examination
• Imaging studies like X-rays and/or a CT scan

Your healthcare provider may also recommend the following steps be taken before and on the day of surgery:

• Avoid consuming alcohol at least one or two days before surgery (although abstaining a week beforehand is ideal).
• If you are undergoing general anesthesia, refrain from eating starting at midnight the day before; you can have clear liquids up to six hours before the operation.
• Avoid certain medications such as aspirin and NSAIDs, and certain vitamins, as these can cause an increased risk of bleeding
• You may be prescribed an antibiotic to take prior to your surgery in order to prevent infection

During the Surgery

A septoplasty is usually performed as an outpatient procedure. This means that you will go home on the day of surgery, Your surgery may take place either in a hospital's outpatient surgery center, or in a standalone surgery center. Whatever the case, the procedure is similar. The entire surgery should take between one and three hours. 

• Get changed: First, you will be asked to change into a hospital gown upon your arrival on the day of surgery. Plan to have someone accompany you and drive you home, and you may be asked to leave your belongings or valuables with that person during your surgery.
• Clean up: Once you have changed your skin will be prepared and cleaned for surgery to prevent infection.
• Time out: Your medical team, including the surgeon, should review the procedure with you, and verify the purpose and plan for the day.
• Anesthesia: After the procedure is verified, you will receive anesthesia, either general or local anesthesia or conscious sedation. Your healthcare provider will recommend the best choice for you, but conscious sedation is more common for septoplasty. This means that you will be asleep during the surgery, and remain in a recovery area for some time after while you wake up.
• Making the incision: Septoplasty can typically be performed in a minimally invasive method. Typically, the septum is accessed through incisions within the nasal cavity. In some cases, or when a septoplasty is performed alongside a rhinoplasty, a small incision is made on the outer part of the nose in the narrow strip of tissue that separates the nostrils. 
• Accessing the septum: Once the initial incision is made, the membrane that covers the septum is pulled away at one side. This membrane is delicate and must be lifted carefully to avoid tearing a hole in the lining as it is lifted away. This is done on both sides of the septum.
• Making repairs: Once the membrane lining the septum is lifted, your surgeon will remove, repair, or reshape the deviated or crooked parts of your septum. If sections of the septum are removed, your surgeon will leave enough healthy bone and cartilage behind to maintain the shape of your nose.
• Closing up: Once the repair is complete, your surgeon will replace the mucosal lining that was lifted away from the septum, and stitch the incisions closed.
• Get ready to heal: To promote healing and reduce the chance of scarring, your surgeon may place soft plastic sheets or splints inside your nose to support the septum as it heals. Packing is not usually used.

After the Surgery

Once your surgery is completed, you will be brought out of the operating room and into a recovery area. Medical staff will monitor you as the effects of the anesthesia wear off and you begin to wake up.

Once you are awake and your anesthesia wears off, you will likely be discharged. Most patients go home from a septoplasty on the same day. You should have someone to drive you home.

Your healthcare provider will review any follow-up care with you, including when and how your splints or other dressing will be changed or removed. The splints typically do not remain in place long, and dissolving sutures are usually used in septoplasty, so there is no need to have your stitches removed.

A Word From Verywell

All surgeries carry risks and can cause anxiety. A septoplasty is a relatively simple procedure, without large external incisions or inpatient hospital stays. You should be able to go home the day of your surgery, and are unlikely to have visible scars.