At a glance
Septoplasty is a surgical procedure that straightens the nasal septum, the wall of cartilage and bone that divides the inside of the nose into a left and right airway. When this wall is significantly off-centre or irregular, it is called a deviated septum, and it can make breathing through the nose noticeably harder.
During the operation, a surgeon works entirely inside the nose, trimming, repositioning, or reshaping the septum so that both airways are as open as possible. No cuts are made on the outside of the nose, and the outer shape of the nose is not changed unless a separate cosmetic procedure is combined at the same time.
Medical Condition
Septoplasty is recommended when a deviated septum causes symptoms that significantly affect daily life and do not improve with medication alone. The decision to operate is based on how much the deviation is affecting breathing, sleep, and quality of life, not on the anatomy alone.
- Chronic nasal obstruction (persistent blocked nose on one or both sides) that does not respond to nasal sprays or allergy treatment
- Recurrent nosebleeds caused by turbulent airflow over an irregular septum
- Chronic sinusitis (repeated sinus infections) where the deviated septum is blocking normal sinus drainage
- Obstructive sleep apnoea (interrupted breathing during sleep) that is partly caused by nasal blockage
- Snoring linked to nasal airway narrowing
- Headaches or facial pressure attributed to abnormal airflow or blocked sinuses
- Preparation before other nasal surgeries, such as endoscopic sinus surgery, where the septum must be straightened first to allow access
Septoplasty is not suitable for everyone. Surgeons will usually advise waiting or exploring alternatives in certain situations.
- Children and young teenagers, because the septum is still growing and surgery may affect development
- Patients whose symptoms are mild and well-controlled by medication
- People with active nasal infections or significant nasal inflammation that has not been treated first
- Patients with certain bleeding disorders or conditions that make general or local anaesthesia high-risk, unless carefully managed by a specialist
Risks & Complications
Septoplasty is generally well-tolerated, but like any surgical procedure it carries recognised risks that a patient should discuss with their surgeon beforehand.
- Post-operative bleeding, which is the most common complication and usually settles on its own or with packing
- Temporary swelling and nasal congestion in the weeks after surgery, making the nose feel blocked even though the septum has been corrected
- Infection inside the nose or, rarely, in the sinus cavities
- Septal perforation (a small hole in the septum) that may cause crusting, whistling sounds, or, in rare cases, require a further procedure to repair
- Changes in the sense of smell, usually temporary but occasionally persistent
- Numbness or altered sensation in the upper front teeth or tip of the nose, typically short-lived
- Persistence or partial recurrence of symptoms if the septum shifts back slightly during healing
- Adverse reaction to anaesthesia, a general risk of any operation performed under sedation or general anaesthetic
- Damage to surrounding structures such as the turbinates (small bony ridges inside the nose) or, very rarely, the base of the skull, though this is uncommon with experienced surgeons
Preparation & Procedure
Preparation begins at least one to two weeks before the operation. Blood thinners, anti-inflammatory pain relievers such as aspirin or ibuprofen, and certain herbal supplements are usually stopped well in advance because they increase the risk of bleeding. Your surgeon will give you a specific list to review with your prescribing doctor.
Smoking slows healing of the nasal lining and raises the risk of infection, so most surgeons ask patients to stop smoking for at least two weeks before and after the procedure. Alcohol is typically avoided in the final day or two before surgery. If a general anaesthetic is planned, you will be asked to stop eating solid food around six hours before and stop drinking water usually two hours before, though your hospital will confirm the exact times.
Standard pre-operative tests help the team confirm you are fit for surgery. These typically include:
- Blood tests to check for anaemia (low red blood cells), clotting function, and general health
- Nasal endoscopy (a thin camera passed gently into the nose) so the surgeon can see the full extent of the deviation
- CT scan of the sinuses in some cases, particularly if chronic sinusitis or additional sinus surgery is also planned
- An assessment of any allergies or previous reactions to anaesthetic drugs
On the day of surgery, the procedure itself usually follows a sequence similar to this, though your hospital's approach may differ slightly:
- 1. You change into a hospital gown and an intravenous (IV) line is placed in your arm for fluids and medication.
- 2. Anaesthesia is given. Septoplasty can be done under general anaesthesia (you are fully asleep) or, in some centres, under local anaesthesia with sedation (you are relaxed and the nose is numbed).
- 3. The surgeon makes a small incision inside one nostril to access the septum. No external cuts are made.
- 4. The mucosa (the delicate lining of the nose) is carefully lifted away from the underlying cartilage and bone.
- 5. The deviated sections of cartilage and bone are trimmed, reshaped, or repositioned.
- 6. The mucosa is laid back in place and held with dissolvable stitches.
- 7. Soft splints or light packing may be placed inside the nostrils to support the septum while it heals. Not all surgeons use these.
- 8. You are moved to a recovery area where nursing staff monitor you as the anaesthesia wears off.
Aftercare
Most patients go home the same day or after one night in hospital, but the nose continues to heal over several weeks and certain precautions during that time make a real difference to the outcome.
- Nasal packing or splints, if used, are usually removed by the surgeon within a few days at a clinic visit. This is momentarily uncomfortable but quick.
- Expect noticeable swelling and congestion for two to four weeks. Breathing improvement is often not fully felt until the swelling settles, which can take up to three months.
- Sleeping with your head slightly elevated in the first one to two weeks reduces swelling.
- Blowing your nose forcefully is avoided for at least two to three weeks to protect the healing septum.
- Strenuous exercise, heavy lifting, and contact sports are typically restricted for two to four weeks, depending on how healing is progressing.
- Saline (saltwater) nasal rinses are usually recommended several times a day to keep the inside of the nose moist and clear of crusts.
- Avoid swimming pools, dusty environments, and anything that might push bacteria into the nose for the first few weeks.
- Pain in the first few days is managed with mild pain relief as advised by your doctor. Significant pain or a sudden increase in swelling after the first few days should be reported promptly.
- Follow-up appointments are usually scheduled at one to two weeks, then again at around six to eight weeks, so the surgeon can check that healing is on track.
- If a septal splint was placed, care instructions for keeping it clean will be given before discharge.
Cost & What Determines It
The total cost of septoplasty varies widely depending on where the procedure is done, the complexity of the individual case, and what is included in the hospital's package. Two patients with a similar diagnosis can face very different bills.
- Complexity of the deviation: a simple unilateral (one-sided) deviation costs less to correct than a deviation that runs through multiple sections of bone and cartilage or is combined with turbinate reduction (shrinking of the bony ridges inside the nose)
- Hospital class and country: private tertiary hospitals in major cities charge significantly more than regional hospitals or facilities in countries where medical costs are lower
- Type of anaesthesia: general anaesthesia adds the cost of an anaesthesiologist and more monitoring compared to local anaesthesia with sedation
- Length of stay: same-day discharge costs less than an overnight or multi-night admission
- Additional procedures performed at the same time, such as turbinoplasty (reshaping the turbinates) or endoscopic sinus surgery, which add to both operating time and material costs
- Implants or internal splints: absorbable or silicone nasal splints used to support the septum add a device cost that varies by brand and type
- Post-operative medications: antibiotics, nasal saline rinses, and pain relief for the recovery period
- Pre-operative tests: blood work, nasal endoscopy, and CT scans are sometimes bundled and sometimes billed separately
Hospital packages for septoplasty often include the surgeon's fee, the operating theatre, anaesthesia, one or two nights of inpatient care, and a first follow-up visit. Items that tend to be billed separately include the pre-operative specialist consultation, imaging studies such as a CT scan, medications to take home, and any subsequent follow-up visits after the first.
BPJS Kesehatan and most Indonesian private insurance policies do not cover elective surgical procedures carried out abroad, which means patients travelling for this procedure typically pay the full cost themselves or rely on an international health insurance plan that explicitly covers overseas treatment. Before travelling, ask the hospital for a written cost estimate that itemises what is and is not included. This protects you from unexpected charges and makes it straightforward to compare options across hospitals.
Frequently Asked Questions
How long does septoplasty surgery take?
Septoplasty usually takes between 60 and 90 minutes, though more complex cases can run longer. The surgeon works entirely inside the nose to straighten the septum, which is the wall of cartilage and bone that divides your two nostrils. Because no cuts are made on the outside of the nose, there are no visible scars.
Will I be asleep during septoplasty, and how bad is the pain after?
Most patients receive general anaesthesia, meaning they are fully asleep for the whole procedure, though some surgeons use local anaesthesia with sedation for simpler cases. After the operation, the inside of the nose feels sore and blocked, similar to a bad head cold. Doctors typically manage this with oral pain relief, and most people find the discomfort settles noticeably within the first week.
How long is the recovery after septoplasty, and when can I go back to work?
Most people feel well enough to return to a desk job within one to two weeks after septoplasty. The nose continues to heal internally for several weeks after that, so strenuous exercise, heavy lifting, and contact sports are usually avoided for four to six weeks. Swelling inside the nose can make breathing feel restricted at first, but this gradually improves as healing progresses.
How much does septoplasty cost?
The cost of septoplasty varies depending on several factors specific to your case. These include whether the procedure is done alone or combined with other nasal work such as turbinate reduction (shrinking the bony structures inside the nose to improve airflow), the class of hospital you choose, the surgical team's fees, and the length of your stay. Requesting a written cost estimate directly from the hospital is the most reliable way to get an accurate figure for your situation.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
