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After septal perforation surgery

Surgery does not end when you leave theatre. The first weeks are disorienting: the nose is blocked, the crusts smell, and nothing yet looks like the result. Here is what to expect, week by week: splints, crusting, bleeding, getting back to normal, what should worry you, and when the result is judged.

Written by the Septal Perforation team, patients, from the sources cited · Reviewed by doctors · Updated 2 November 2026 · Method and sources

On this page Week by week What is normal Warning signs Getting back If it re-opened
  1. Day 0 – 2

    Hospital

    One night in most teams. The nose is completely blocked by silicone splints: you breathe through your mouth, your throat dries out, sleep is poor. Pain stays moderate and responds to paracetamol.

  2. Week 1 – 2

    Crusting and rest

    Brownish discharge, unpleasant smell, small bleeds: that is the normal picture. Gentle rinses following your team's protocol, and never blow your nose. Back to a desk job within one to two weeks.

  3. 2 wks – 2 months

    Splints come out

    Between 2 weeks and 2 months depending on the team, and longer if you tend to pick your nose. The removal is brief, more impressive than painful. Breathing does not come back at once: the mucosa is still swollen and takes weeks to settle. Judge nothing that day.

  4. 3 – 6 months

    The mucosa rebuilds

    Crusts become less frequent, smell gradually returns. This is also when you start to learn whether the closure holds. But re-opening can happen late: in one series, 98% of holes were closed when the splints came out, 93.8% at 18 months. Hence follow-up of at least one year (Alobid (ed.), Springer 2026, ch. 25).

  5. 12 months

    The result

    A result is judged at one year, not before: that is the follow-up used by published series, and therefore the only comparable one. Ask for a check endoscopy and a written report.

Normal, however unpleasant
A completely blocked nose for as long as the splints are in
Brown crusts and a bad smell for several weeks
Small bleeds, especially after a rinse
Numbness of the nasal tip, upper teeth and upper lip, which fades over a few months
Reduced smell, nasal voice, fatigue
Call or seek care without waiting
Fever above 38.5 °C, shivering
Heavy bleeding that does not stop after fifteen minutes of pressure
Pain that increases instead of easing
Purulent, foul-smelling discharge, especially with fever
A splint that comes loose or falls out
Facial swelling, visual problems, severe headache

Getting back to normal

Blowing your nose

Not before your team says so, often three weeks. Until then, sniff gently, wipe, never blow.

Exercise

Walking from discharge. Moderate effort and weights at around three to four weeks. Contact sports and swimming after the splints come out.

Flying

One to two weeks minimum, as cabin air is very dry. Moisturise the mucosa before, during and after the flight.

Glasses

If the approach was open, avoid pressure on the bridge for four to six weeks: a supporting tape or a light frame.

If the perforation has re-opened

This is not the end of the road, but it is not the moment to rush back to theatre either. The mucosa needs to recover: allow six to twelve months of local care before another attempt. Above all, a revision closes less well than a first attempt: it belongs in a high-volume centre, not with the operator who has just failed. Check the directory and ask for annual volume before committing.

Protocols vary between teams, sometimes widely, especially splint duration. Your surgeon's written instructions always take precedence over this page.

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