Getting Ready for Septoplasty and Turbinate Reduction

What is the surgery?

• The septum is the wall of cartilage and bone that divides your nose into two sides. Septoplasty straightens it by reshaping the cartilage and removing some cartilage and bone.
• The inferior turbinates are structures of thin bone covered by nasal lining. They warm and moisten the air you breathe and control airflow. They are reduced by shrinking the tissue inside them and moving them out to the side.
• The goal is more space inside your nose, so it is easier to breathe.
• All incisions are inside the nose, so there are no scars on your face.
• The surgery takes about 30 to 45 minutes and is done in our office or at a surgery center, under IV sedation or general anesthesia. Most people go home the same day.
• We do not pack the nose with gauze. Some surgeons place soft plastic splints inside the nose to keep swelling down and keep blood from collecting in the septum. If you have them, they come out 3 to 7 days after surgery.

Our septoplasty page and turbinate reduction page explain who the surgery helps.

What are the risks?

Every surgery has risks. Your surgeon will go over them with you before surgery, and you can ask about any of them.

• Anesthesia is safe, but it has some risks. The anesthesia team can go over them with you. Tell us if anyone in your family has had a problem with anesthesia.
• Pain, bleeding and infection are risks of any surgery.
• Numb upper front teeth. This is usually temporary.
• Some blockage may remain. Up to about 1 in 5 people still have some blockage after surgery, and another procedure may be needed.
• Turbinates can grow back over several years, and the blockage can return.
• Empty nose syndrome. Reducing the turbinates can make it harder to feel air moving through the nose.
• Loss of smell is rare.
• A hole in the septum (septal perforation) is rare. It often causes no symptoms, but it can cause crusting, bleeding or a whistling sound when you breathe, and may need to be repaired.
• A blood clot in the septum (septal hematoma) can damage the cartilage and make the top of the nose sink if it is not treated. Call us right away for new, worsening pain or pressure in the nose, or a nose that is completely blocked on both sides.
• Toxic shock syndrome is very rare, but it can be life-threatening.

When you come in for surgery, we will ask you to sign a printed copy of this guide to show that you have read it and that your questions have been answered. Bring your questions with you.

How do I get ready?

1. As soon as your surgery is scheduled

   • Give us a list of every medicine, vitamin and supplement you take. We will tell you which to stop and when.
   • If you smoke or vape, stop now. Stopping helps your body heal and makes anesthesia safer, and the earlier you stop, the better: aim for at least 4 weeks before surgery, though even 2 weeks helps. Stay off until your surgeon says you have healed.
   • Plan time off. Some people go back to work or school in a couple of days, and some take up to a week. Physically demanding jobs may need longer.
   • Plan your travel. For at least 1 week after surgery, stay within about an hour of our office or an emergency room, and do not fly.
   • Arrange for an adult to drive you home and stay with you the first night.

2. 1 to 2 weeks before

   • Aspirin is usually stopped 1 to 2 weeks before surgery. If you take aspirin or a blood thinner for your heart, a stent or stroke prevention, do not stop it on your own: your surgeon will check with the doctor who prescribes it.
   • Ask us whether to pause ibuprofen (Advil, Motrin) or naproxen (Aleve).
   • Ask about herbal remedies and supplements, such as fish oil, vitamin E, ginkgo or garlic pills, which can raise the chance of bleeding.
   • If you take insulin or other diabetes medicines, ask how to take them before surgery.
   • Get the supplies in the next section.

3. The night before

   • Follow the eating and drinking instructions from our office or the surgery center exactly. Many ask for nothing to eat after midnight, and some allow clear liquids until a few hours before. If you eat or drink when you should not, your surgery may need to be postponed for your safety.
   • Take only the medicines we told you to take that morning, with a small sip of water.
   • Get a good night’s sleep.

4. The day of surgery

   • Wear comfortable clothes and a top that buttons or zips in the front, so you do not pull it over your nose afterward.
   • Wear glasses instead of contact lenses, and leave jewelry and valuables at home.
   • Bring your photo ID, insurance card and list of medicines.
   • Plan to be there about 3 to 4 hours in all, for check-in, surgery and waking up.

What happens after surgery?

• Most people go home the same day.
• Some bleeding from the nose for the first few days is expected. It is usually mild. If you are worried about how much you are bleeding, call us.
• Your nose will feel blocked at first from swelling. This does not mean the surgery failed.
• Do not blow your nose for 1 week. No heavy lifting, straining or strenuous exercise for 1 week, then ease back into your usual activities.
• Your first visit is usually 3 to 7 days after surgery. If you have splints, they come out then.
• If you use CPAP, keep using it, starting the night of surgery, unless your surgeon tells you otherwise.

The Septoplasty Recovery Guide has everything you need after surgery: rinsing, bleeding, pain medicine and when to call.

When should I call before surgery?