Deviated nasal septum surgery—commonly called septoplasty—is a surgical procedure that straightens the nasal septum so air can pass more freely through both nasal passages. When medicines are not enough, septoplasty can improve breathing, reduce mouth-breathing, and help you return to comfortable breathing through your nose.
Below is a patient-friendly, evidence-based guide written for people comparing septoplasty with rhinoplasty or other nasal surgeries. It explains candidacy, steps of the operation, anesthesia choices, risks, recovery, and costs.
What is a Deviated Septum?
The septum is the midline wall of cartilage and bone that divides the nose into two nasal passages. Trauma, genetics, or growth patterns can bend this wall, create spurs, or twist the nasal bones. The result is nasal obstruction, dryness, headaches, snoring, and poor exercise tolerance. Medicines like saline rinses and steroid sprays help inflammation, but they cannot correct a deviated septum when the problem is structural.
Septoplasty vs. Rhinoplasty (and When to Combine Them)
- Septoplasty focuses on the inside: straightening bone and cartilage to restore airflow. From outside, the nose usually looks unchanged.
- Rhinoplasty reshapes the external framework (tip, bridge, width) and may include valve support; it is a form of facial plastic surgery.
- Septorhinoplasty combines both—chosen when internal deviation coexists with tip/bridge crookedness or valve collapse. Many plastic surgeons and ear nose and throat specialists (ENTs) offer both options.
If your primary complaint is nose surgery for looks, rhinoplasty is discussed. If your goal is to breathe through the nose, septoplasty (sometimes with turbinate reduction or valve repair) is the starting point.
Who Is a Good Candidate?
You’re likely a candidate if you have:
- Persistent nasal obstruction on one or both sides for >6–12 weeks
- Failure of medical therapy (saline irrigation, steroid sprays, allergy management)
- Objective deviation/spurs seen on exam or nasal endoscopy
- Sleep disruption, exercise intolerance, or recurrent sinus trouble linked to airflow blockage
- Realistic expectations and stable health after reviewing your medical history
Contraindications include active infection, uncontrolled allergies, and bleeding disorders; these are individualized with your surgeon.
How the Operation Works (Step-by-Step)
- Anesthesia. Most septoplasties use general anesthesia; straightforward cases can be performed with local anesthesia plus light sedation.
- Incision and exposure. A small internal incision allows the lining to be lifted while protecting the cartilage and bone.
- Straightening. Deviated sections are removed, reshaped, or repositioned; spurs are trimmed; the bony portion may be gently fractured and realigned. The emphasis today is preservation—reusing your own cartilage to maintain support.
- Stabilization. Quilting sutures and, if needed, soft silicone splints prevent hematoma and adhesion.
- Adjuncts. If inferior turbinates are enlarged, a conservative reduction is added. When the internal valve is narrow, spreader or batten grafts can be placed (often when septoplasty is combined with rhinoplasty).
Time in the operating room: ~30–60 minutes for isolated septoplasty; longer when combined with structural rhinoplasty.
Benefits and Realistic Limits
Benefits
- Marked improvement in airflow and comfort while breathing through your nose
- Better sleep quality, reduced mouth-breathing and dryness
- Improved exercise tolerance; some patients smell better once airflow is restored
- Easier CPAP use for people with obstructive sleep apnea
Limits
- Allergies and viral colds still need medical management; surgery doesn’t “cure” inflammation
- Snoring or apnea may persist if other sites of blockage exist
- Rare external shape change with isolated septoplasty; cosmetic goals require rhinoplasty
Risks & Safety
When performed by experienced plastic surgeons or ear nose and throat specialists, septoplasty is safe. Still, every surgical procedure carries risks:
- Bleeding or septal hematoma
- Infection (rare)
- Adhesions (synechiae)
- Septal perforation (hole) with crusting/whistling
- Temporary smell reduction or upper-lip/teeth numbness
- Persistent obstruction if turbinates or valves aren’t addressed (occasionally needs revision)
- Anesthesia-related risks
Your surgeon will tailor risk minimization to your medical history and anatomy.
Recovery Timeline & Aftercare
Day 0–1: Stuffiness and low-grade oozing are common. Keep your head elevated, use cold compresses, and start saline sprays as advised. Do not blow your nose. You’ll need a responsible adult to drive you home after anesthesia.
Days 2–3: Congestion peaks. Light walking is fine; avoid bending and heavy lifting.
Day 5–7: Clinic visit for splint removal (if used). Many patients already improve breathing once swelling eases.
Week 2: Return to desk work. Continue irrigations; avoid contact sports.
Weeks 3–4: Noticeable airflow gains; gentle nose-blowing may be allowed.
Months 2–3: Lining heals fully; airflow stabilizes. If combined with rhinoplasty, outer swelling refines for months.
Anesthesia Choices: General vs Local
- General anesthesia offers full comfort and stillness, ideal for crooked septums with spurs or when combining with rhinoplasty or valve grafts.
- Local anesthesia with sedation can be suitable for limited internal corrections. Your surgeon weighs airway safety, duration, and your anxiety level when recommending the approach.
What Results Can You Expect?
With proper selection and technique, most patients experience substantial relief of nasal obstruction and can comfortably breathe through the nose within weeks. Objective airflow improves, and patient-reported scores (e.g., NOSE scale) drop significantly. Final stability is judged at 2–3 months for isolated septoplasty and by 6–12 months if external work is added.
Costs & Insurance Basics
Pricing varies by region and scope but usually includes:
- Surgeon’s fee, facility fee, and anesthesia
- Added procedures (turbinate reduction, valve repair)
- Pre-op tests, post-op meds, supplies, and follow-ups
When documentation shows functional blockage and failed medical therapy, insurers may cover the functional part of nose surgery. Cosmetic components fall outside coverage.
Preparing for Surgery: Practical Checklist
- Optimize allergies and sinus health before the date
- Stop smoking/vaping and hold blood-thinning meds as instructed
- Arrange a friend/family member to drive you home and stay the first night
- Stock saline rinses, acetaminophen, soft foods, and extra pillows
- Protect the nose from bumps; postpone intense workouts and contact sports until cleared
FAQs
Is septoplasty painful?
Most people report pressure and congestion more than sharp pain; standard pain medicines are usually enough.
Will my nose look different?
With isolated septoplasty the outer shape rarely changes. External symmetry or tip/bridge concerns require rhinoplasty or combined surgery.
When can I fly?
Often after 1–2 weeks for straightforward cases, provided there’s no active bleeding or infection. Confirm with your surgeon.
Can it fix snoring or apnea?
It reduces nasal resistance and can help CPAP tolerance, but it is not a stand-alone cure for sleep apnea.
How long do results last?
Results are typically long-lasting. Rarely, trauma or cartilage “memory” can shift alignment later.
Key Takeaways
- Septoplasty is a targeted surgical procedure that straightens bone and cartilage inside the nose to improve breathing.
- It differs from rhinoplasty, which reshapes the outside; the two are often combined when structure and airflow both need help.
- Done by qualified plastic surgeons or ear nose and throat specialists, it is one of the most effective nasal surgeries for people who can’t comfortably breathe through the nose due to a deviated septum. Contact with Emre İlhan.
