Septoplasty: Do I Need Surgery to Repair My Deviated Septum?

Medically Reviewed by Shruthi N, MD on September 09, 2024
6 min read

Septoplasty is a nose surgery that straightens the wall of cartilage and bone between your two nostrils. That wall is called your septum, and when it's crooked, you have a deviated septum.

A deviated septum can make it hard to breathe.

Most people have a septum that is at least slightly off-center. But if your wall is way off, you have a deviated septum. Some people were born that way. For others, a nose injury caused the issue.

If your deviated septum doesn’t affect your breathing or lead to frequent sinus infections, also known as sinusitis, you probably can leave it alone. You may want to talk to your doctor about treatments other than surgery.

But if your deviated septum blocks one or both nostrils so that it’s hard or impossible to breathe through your nose, you may want to consider surgery.

That stuffy nose can be a breeding ground for bacteria to grow. This causes painful inflammation and infection, which may keep you from getting better. If this is the case, an operation might help.

Septoplasty vs. rhinoplasty

Rhinoplasty is a different kind of nose surgery. When you have rhinoplasty, a surgeon changes the shape of your nose. You might have it after an injury or to fix a problem you were born with. You also might have it for cosmetic reasons because you want to change how your nose looks or how it fits into your face. You might have rhinoplasty and septoplasty at the same time.

You'll probably meet with your surgeon before your procedure. They'll talk to you about the surgery and examine you. That visit might include: 

  • Taking your medical history, including medicines you take and any other conditions you might have
  • Doing a physical exam to check the inside and outside of your nose
  • Other tests, such as blood work done before surgery
  • Photographing your nose
  • Discussing your goals so that you're clear on what the septoplasty can and can't do

Before your surgery, you should avoid over-the-counter medicines that contain ibuprofen or aspirin, because they can make bleeding worse. Follow your surgeon's directions about other medications. If you smoke, you should quit before your surgery.

This surgery is usually done by an ear, nose, and throat specialist. 

On the day of the operation, you’ll get some type of anesthesia. You and your doctor will decide whether local anesthesia (you'll be awake) or general anesthesia (you'll be asleep) is the best option. Septoplasty usually takes about 1.5 hours.

Usually, your surgeon won’t have to cut the skin on your face, where someone might see it. They can use instruments that they put into the nostrils. This means you probably won't have bruises or visible stitches on your face afterward.

To fix your deviated septum, your surgeon might remove damaged parts of your septum altogether, or they might make adjustments and reinsert them. Your surgeon will trim your septum and make it straighter. Sometimes, they may need to cut the bone to place it in the right position. You may also get silicone splints to support your septum.

Your doctor may decide you need nasal packing. This is when gauze-like material is placed in the nasal cavity to absorb blood or other fluids. They will remove it at your first follow-up appointment.

After your surgery, you'll move to what's called a recovery room. Health care professionals will monitor you there. Septoplasty is often an outpatient procedure, which means you can go home once the staff decides you're stable. You'll need someone to drive you home.

Once you've healed after your deviated septum surgery, you'll probably find that air flows through your nose more easily. Among the benefits of septoplasty are: 

  • Improved breathing
  • Less snoring, which helps you get better rest
  • Your sinuses drain more easily, which reduces the risk of infections

You should ask your surgeon ahead of time about the risks involved with deviated septum surgery. There’s a chance you could have complications, such as:

  • Bleeding
  • Infection
  • Bad reactions to anesthesia
  • Slight tear or hole in the septum
  • Scarring (though it probably will be inside your nose and not visible to others)
  • Toxic shock syndrome (this is rare)
  • Leak of spinal fluid (this also is rare)

Sometimes after surgery, you might continue to have symptoms of sinusitis until the infection clears up completely. Or, if there were other blockages in your sinuses, such as polyps, there may still be some lingering breathing or drainage issues.

These risks are slight.

Septoplasty side effects

Your nose or teeth might be numb or especially sensitive after the procedure, although that's usually temporary. For most people, this goes away within a few months.

You also might notice that your sense of smell is affected. This is called hyposmia, and it usually clears up within 6 months.

The most common complaint people have after septoplasty is that it didn't improve their breathing as much as they''d hoped.

Once you're home, there are some things that you’ll need to remember in the days and weeks following surgery:

  • Avoid heavy lifting and other hard activities.
  • Keep your head raised when you sleep. You might need to use an extra pillow.
  • Avoid blowing your nose.

Before you head home, make sure to get all your instructions in writing — for care of your nose and for medications. It’s very important to follow your doctor’s advice to avoid complications.

How much you'll pay for septoplasty depends on several factors, such as where you live, what type of insurance (if any) you have, and how complicated your procedure is.

Many insurance companies cover septoplasty when it's done to correct a medical issue. How much you'll spend depends on your copay, deductible, and other factors.

If you have Medicare, your costs will range between $400 and $750, though your costs will go up if more than one doctor is involved. If you have a supplemental plan, you may pay less.

If you don't have insurance, the cash price for a deviated septum surgery ranges from $5,000 to $10,000.

When you have a deviated septum, the wall separating your nostrils is crooked. This can interfere with your breathing and lead to frequent sinus infections, among other problems. In a surgery called septoplasty, a doctor can trim, reshape, and fix your septum. It's usually an outpatient procedure. The risks are fairly low, though some people have trouble with their sense of smell for up to 6 months afterward. The biggest complaint most people have after the procedure is that they didn't get as much relief as they'd hoped.

Can a deviated septum be fixed without surgery?

No. But if your deviated septum causes only mild symptoms, you may be able to manage them by using decongestants, antihistamines, or nasal sprays.

Is it worth fixing a deviated septum?

Your doctor may use a method called the Nasal Obstruction Symptom Evaluation (NOSE) scale to measure how severe your condition is. The score will help you and your doctor figure out whether surgery will have much benefit for you. You'll probably want to consider less invasive approaches to your problem before you agree to surgery.

What happens if you don't get a deviated septum fixed?

In some cases, a deviated septum doesn't affect your quality of life at all. Some people have only mild symptoms. Severe cases can affect your ability to breathe through your nose and cause chronic nosebleeds.

As much as 80% of the population may have deviated septums, and many of those people probably don't know it.

Is deviated septum surgery safe?

Septoplasty is a minor surgery with very low risks. Most people need about a week to recover. Septoplasty is one of the most common surgeries done by ear, nose, and throat specialists. About 85% of people who have the surgery find it improves their symptoms significantly.