Five things you need to know about a deviated septum

As a facial plastic surgeon, I see patients for all kinds of trouble with their noses. Many have breathing trouble related to a deviated septum. Here are five things that you need to know about a deviated septum.

What is the nasal septum?

The red arrow points at a severely deviated septum. This patient also had sinus problems related to the deviated septum.


Your nasal septum is the wall that divides the two sides of your nose. It is made of a large piece of cartilage that sits in a v-shaped piece of bone. The cartilage can be felt as a firm structure on the inside of your nostrils. It should be straight but can become bent or deviated from nasal trauma or the growth process.

How can you tell if you have a deviated septum?

In some cases, it’s quite obvious because the outside of your nose will be significantly crooked as in the patient above. However, it’s not always so clear. A significantly deviated septum will cause nasal obstruction. The nasal obstruction will always be worse on the affected side. Allergies and colds can make the obstruction worse, but the affected side will always be worse than the other.

Should you have a deviated septum fixed?

A deviated septum is generally not a serious problem. If your breathing is affected to a point where it bothers you, or your septum is so deviated that it’s contributing to sinus problems (as in the x-ray above), you should consider having it fixed. The procedure is called a septoplasty. It’s generally done to improve your quality of life.

Will a septoplasty change my nasal appearance?

If your external nose is very crooked like in the picture above, straightening your septum will make your nose straighter. If the deviated portions are more on the inside, then usually nothing will change. The incisions are placed on the inside of your nostril so they are invisible. If you want your nose to look different, you can choose to have a cosmetic rhinoplasty at the same time as the septoplasty.

What is the recovery like?

In the interest of full disclosure, I have not had surgery on my septum, but I have done the surgery on hundreds of patients including three people that worked with me. In general the pain is minimal and people experience relief with Tylenol or Ibuprofen. Generally the breathing is better immediately after surgery. My co-workers were able to return to the office after a long weekend to recuperate.

Of course, not every deviated septum needs to be fixed! I look in plenty of noses and see a deviated septum, but if the patient doesn’t have a breathing complaint, we leave it alone! However, if you have a deviated septum that makes it hard to breathe, septoplasty is a great option for permanent breathing improvement with very little pain.

To see before and after photos of patients who had their deviated septums straightened as a part of a rhinoplasty, click here.

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