Deviated Septum

Medically Reviewed by Nayana Ambardekar, MD on December 17, 2022
3 min read

A deviated septum is a condition in which the nasal septum -- the bone and cartilage that divide the nasal cavity of the nose in half -- is significantly off center, or crooked, making breathing difficult. Most people have some sort of imbalance in the size of their breathing passages. In fact, estimates indicate that 80% of people, most unknowingly, have some sort of misalignment to their nasal septum. Only the more severe imbalances cause significant breathing problems and require treatment.

Some people are born with a deviated septum. Other people develop a deviated septum after injury or trauma to the nose.

The most common symptom of a deviated septum is nasal congestion, with one side of the nose being more congested than the other, along with difficulty breathing. Recurrent or repeated sinus infections can also be a sign of a deviated septum. Other symptoms include frequent:

Many sleep apnea patients have a deviated nasal septum. 

Sometimes symptoms of a deviated septum can be relieved with medications. If medicine alone doesn't offer adequate relief, a surgical procedure called septoplasty may be needed to repair a crooked septum and improve breathing.

During septoplasty, a surgeon, working through the inside of the nose, makes a small incision in the septum and then removes the excess bone or cartilage required to even out the breathing space of the nostrils.

Sometimes, a rhinoplasty, or "nose job," is combined with septoplasty to improve the appearance of the nose. This procedure is called septorhinoplasty. Septoplasty may also be combined with sinus surgery.

Surgery to repair a deviated septum is usually performed in an outpatient setting under local or general anesthesia and takes about one to one and a half hours, depending on the amount of work being done. You should be able to go home three to four hours after surgery.

Internal splints or soft packing material may be put in the nose to stabilize the septum as it heals. If a septoplasty is the only procedure performed, there should be little to no swelling or bruising after surgery. However, if a septorhinoplasty is performed, a week or two of swelling and bruising is normal following the procedure.

If possible, it is best to wait until after the nose has stopped growing, around age 15, to have surgery.

Newer procedures are becoming available that use balloon septoplasty techniques that avoid actual surgery and are done in the office setting. These are being done for milder cases.

No surgery is completely risk-free, and the benefits of undergoing surgery -- in this case, being able to breathe better -- must outweigh the risks. Septoplasty and septorhinoplasty are common and safe procedures; side effects are rare. Still, talk with your doctor about the possible risks of surgery before you make a treatment decision.

Although rare, risks of septoplasty and/or rhinoplasty may include:

  • Infection
  • Bleeding
  • Hole (perforation) of the septum
  • Loss of the ability to smell

If you are having nasal symptoms and think you may have a deviated septum, make an appointment to see an ear, nose, and throat doctor, or ENT. There are a number of reasons why you may be experiencing these symptoms, including chronic sinusitis or nasal allergies. Make sure you get the right diagnosis so that you can get the treatment you need.

Show Sources


American Academy of Otolaryngology-Head and Neck Surgery: "Fact Sheet: Deviated Septum" and "Nose Surgery."

Cedars-Sinai Medical Center: "Deviated Septum."

American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgery: "Surgery of the Nose."

American Rhinologic Society: "Septoplasty and Turbinate Reduction."

American Sleep Apnea Association: "Sleep Apnea Information."

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