Been on a TexAgs hiatus for a bit, probably going to take another. However:
People conflate various and sundry nasal procedures with "septoplasty", and the indications for, and recovery from, these procedures vary widely.
A septoplasty is usually done along with an inferior turbinate procedure, most commonly a "submucous resection", for various reasons. In and of itself, it is really only done to improve nasal airflow. This MAY improve sense of smell, although I would NEVER try to tell a patient that they should do this strictly for this reason. It MAY reduce the frequency and severity of sinusitis, but again that is far from a given. Often, a septoplasty is done in order to improve access for sinus surgery, polypectomy, etc. Without doing a septoplasty, it can be difficult if not impossible to access the sinuses.
Every single human has a degree of septal deviation, it is just a matter of how severe yours is, how much that deviation is affecting you in terms of breathing, and weighing the pros and cons of having the procedure. I am assuming you have tried conservative treatment, including nasal saline, nasal steroids, plus or minus nasal antihistamine sprays.
Again assuming that you have tried, and have failed these, and that nasal obstruction is bothering you either during normal activities, exercise, or sleep, a nasal septoplasty plus or minus submucous resection of the inferior turbinates is a fairly straightforward procedure that any competent ENT should be able to do. It can be "monkey simple" or very difficult, depending upon the degree of bend, prior surgery, location of the deviation, etc. If you have a severe bend that comes all the way to the front of the nose, or a "high" bend, it is definitely trickier. The cartilaginous and bony septum forms a "tent pole" support for the nose, so over-resection can be troublesome (think Michael Jackson). When I see a patient with one of these, using a baseball analogy, I tell them that I am going to go for a "double" and not a home run, because often going for a home run ends - poorly. Also, the cartilaginous septum has a lot of "memory" to it. Put your finger on the tip of your nose, and push it sideways. It always snaps right back into place. When there is a cartilaginous bend in the septum, "up front", you have to be careful to resect or reshape enough to break that "memory" without over-resecting. Sometimes managing expectations is as important as doing the surgery in and of itself. I'd rather have a patient breathing only minimally better after surgery than having a loss of support for their nose.
I put splints or packing in the nose after a septoplasty probably less than 1% of the time that I do one. I put absorbable packing in the nose after sinus surgery nearly 100% of the time. If your septum doesn't hold up on its own at the end of the case, no amount of splinting or packing is likely to make it any more successful. Anyone who has had splints in their nose will tell you just how miserable of an experience it is. Without packing or splints, recovery is usually pretty simple. I recommend no strenuous activities for a week (anything that makes your heart rate go up or your breathing to be heavy) in order to reduce the risk of postoperative bleeding, and I usually tell people to avoid flying for two weeks so the patient and I can both avoid becoming internet celebrities because a plane had to be diverted, grounded, etc., because of a bleed in-flight.
Hope this helps.
