Septoplasty Recovery Guide

What should I expect?

Septoplasty straightens the wall between your nostrils (the septum). It takes about 30 to 45 minutes, is done in our office or at a surgery center, and you go home the same day. We do not pack the nose with gauze. All of these are normal:

• Some bleeding from the nose for the first few days, usually mild, and pink or blood-tinged drainage that tapers off over the first week or two.
• Soft plastic splints inside your nose, held in place by a stitch, if your surgeon used them. In some cases they are used to keep swelling down and prevent blood from collecting in the septum. They are removed 3 to 7 days after surgery.
• A very blocked nose at first, from swelling and crusting, and from splints if your surgeon used them. This does not mean the surgery failed.
• Numb upper front teeth or gums, which about 1 in 10 people notice. It comes from irritation of small nerves and almost always goes away, usually within a few weeks and sometimes over a few months.
• Some people notice a weaker sense of smell while the nose is swollen. If you do, it usually comes back over weeks to months.
• Mild facial pressure, headache and tiredness in the first week.

Your nose stays fragile for at least 6 weeks, so avoid anything that could bump or injure it.

How do I keep my nose clean?

• Use saline nasal spray every few hours while you are awake until your first post-op visit. It keeps the lining moist and loosens crusts. After septoplasty, a spray is used instead of a rinse unless your surgeon tells you otherwise. If you also had balloon sinuplasty, rinse instead, as the Balloon Sinuplasty Recovery Guide describes.
• Do not blow your nose for the first week. Gently dab or wipe the outside instead. If you need to sneeze, sneeze with your mouth open.
• Do not put anything inside your nose, such as cotton swabs. If you have splints, do not pull on them or the stitch.

What about bleeding?

Light oozing and pink drainage for the first few days are normal, and it is usually mild.

• Tape a piece of gauze under your nose if there is mild bleeding, and change it as needed.
• You may use Afrin nasal spray as needed for bleeding and congestion for 3 to 5 days after surgery. Stop after 3 to 5 days, because longer use causes rebound stuffiness.
• If it bleeds, sit up and lean slightly forward (do not tip your head back), use a spray or two of Afrin, then pinch the soft lower part of the nose firmly for 15 minutes without letting go.
• Call us for bleeding that does not stop, or any bleeding that worries you. Call 911 or go to the ER for severe bleeding you cannot control, or bleeding with lightheadedness or fainting.

How should I manage pain?

Most people have mild to moderate pain that over-the-counter medicine controls well. Acetaminophen and ibuprofen together work better than either one alone.

• Acetaminophen (Tylenol): 1,000 mg every 6 hours, no more than 4,000 mg in 24 hours (or 3,000 mg if your package says so, or if you have liver problems or drink alcohol regularly).
• Ibuprofen (Advil, Motrin): 400 mg every 8 hours with food, or naproxen (Aleve): 220 to 440 mg every 8 to 12 hours with food. Research has not shown that these increase bleeding after nasal surgery. Skip them if you have a stomach ulcer or kidney disease, or were told not to take them.
• If we prescribed medicine, take it exactly as directed.
• If you take aspirin or a blood thinner, follow your surgeon’s instructions on when to restart it.

What else helps?

• Sleep with your head raised on an extra pillow or two for the first several nights.
• Walking is fine, starting right away.
• Avoid smoking and dusty or smoky places, which slow healing.
• If you use CPAP, keep using it while you heal, starting the night of surgery.

When can I get back to normal?

• No heavy lifting, straining, bending over, strenuous exercise or anything tiring for 1 week. After that, ease back into your normal activities.
• Do not blow your nose for the first week.
• Some people go back to work in a couple of days, and some take up to a week. Physically demanding jobs may need longer.
• Do not fly or travel for at least 1 week.
• Glasses are usually fine to wear.
• Protect your nose from bumps for at least 6 weeks, and wait for your surgeon’s OK before contact sports.

When will I breathe better?

• The first week is the most blocked, from swelling and crusting, and from splints if your surgeon used them. Breathing usually opens up as the swelling goes down.
• Expect steady improvement week by week. Most of the improvement in breathing comes within the first month (Law et al., 2021).
• Healing takes about 1 to 2 weeks after septoplasty alone, and about 3 to 6 weeks when the turbinates were also reduced. With turbinate reduction, crusting, dryness and stuffiness can last up to about 6 weeks.
• The lasting result is judged at about 6 months. For most people, the improvement is permanent.

What happens at my first visit?

• If splints were placed, they are removed 3 to 7 days after surgery. Removal is quick; you may feel brief pressure. Do not try to remove them yourself.
• Your surgeon checks how you are healing and clears out crusts. Some people have another visit a few weeks later.
• Mention at a visit if you notice a whistling sound when you breathe, lasting crusting or repeated nosebleeds.

When should I call?