Septoplasty is an operation to relieve nasal obstruction by straightening a bend in the central wall (septum) that divides the nasal cavity in two. It does not change the outside appearance of the nose; if the shape is also to be addressed, septorhinoplasty is planned.

Can a deviated septum be fixed with medication, and when is surgery needed?

No, medication does not straighten a deviated septum. Nasal sprays or allergy medicines can ease symptoms only by reducing swelling of the nasal lining; they do not change the bent cartilage or bone. Surgery is the only permanent solution.

The decision to operate depends on how much the deviation affects your comfort in daily life. Beyond that, there are a few clear situations that make surgery necessary: if you use a CPAP device for sleep apnoea, the nose needs to be open for the device to work effectively, and a deviation can stand in the way of this treatment. And if the deviation blocks drainage of the sinuses on one side and causes recurrent one-sided sinusitis, that too is a clear reason for surgery.

Does septoplasty change the outside shape of the nose?

No, under normal circumstances septoplasty does not change the outside of the nose; it corrects only the internal structure (the airway). There is one rare exception: removing septal tissue incorrectly or excessively can cause the nasal bridge to lose its support and collapse (saddle nose deformity). This is a rare complication that can be prevented in experienced hands by preserving enough cartilage to support the bridge.

If you also want a change in the shape of your nose, that is outside the scope of septoplasty; in that case septorhinoplasty is planned.

Is packing used, and for how many days?

Whether packing is used depends on the extent of the surgery. When it is used, it can stay in for 4 to 10 days. The packs I use are thin silicone with a breathing channel inside, so they do not stop you from breathing through your nose while they are in place.

When does breathing improve after surgery?

For the first 2 to 3 days the inside of the nose may feel swollen and blocked; this is a normal part of the process. Around days 4 to 5, especially once any packing has been removed, a clear improvement usually starts to be felt.