Septoplasty and Turbinate Reduction

my nose gets congested on 1 side then switches later. believe this is a turbinate obstruction. during a septoplasty would they remove this entirely? if not, why not?


Doctor Answers 9

Physiology of the turbinates

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You are experiencing the normal nasal cycle, but you are experiencing it a bit too much!  If you go ahead with a septoplasty and turbinate procedure of some kind, you should improve.  Its always a question of how much.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 51 reviews

Turbinate reduction to relieve nasal obstruction

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The nasal turbinates function to humidify the air that we breath. The side that is humidifying tends to feel congested during that time period and the opposite side of the nose feels open. This switches every few hours and is called the nasal cycle.

Sometimes the nasal turbinates are excessively swollen and fail to respond to medications. Turbinate reduction surgery is an alternative. Removing them completely is not advisable as this can leave you with a nose that is non functional and too dry with hard dry crusts. The medical term for this is atrophic rhinitis.

Good luck

Ran Rubinstein, MD

Ran Y. Rubinstein, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 157 reviews


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Septoplasty and tubinate reduction are two different procedures.

Turibinates are bony outcroppings within the nose. They increase the surface area within the nose and serve to humidify, filter and warm air before they enter our lungs. There are 3 turbinate on each side of the nose: inferior, middle and superior. It is normal of the turbinates on the left side of the nose to swell while the ones on the right side of the nose shrink throughout the day. This is why you can breath better on one side vs the other during different times of the day. The turbinates can also swell as a result of allergies and other pathologies. The middle turbinate is the most common turbinate that is surgically altered for medical reasons. Typically the middle turbinate is altered to allow better air flow through the nose. However, the turniates serve a very important role in breathing and should only be surgically altered when absolutely necessary otherwise this can cause many breathing problems including increased nasal obstruction.

The septum is the cartilage and bone that separates the right and left side of your nose. In a septoplasty, a crooked septum is straightened to improve the nasal airway.

So a septoplasty and turbinate reduction are 2 different procedures and should be performed judiciously.

Hope this helps

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 283 reviews

Turbinate and septal treatment for nasal congestion or allergies or obastruction or deviation

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You are experiencing what we call the autonomic nasal cycle. The nasal congestion normally alternates from one side to the other. Agressive treatment of the turbinates has two potential complications: one is the possibility of hitting a blood vessel at the back edge of the turbinate and the other is the risk of creating an excessively dry nasal condition called rhinitis sicca.

The turbinates act to warm, moisten and filter the incoming air. Therefore we seek to reduce the size but not necessarily eliminate them.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Normal nasal cycles

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Your nose goes through nasal cycles related to blood flow. Resulting in an alternating sensation of nasal congestion.  This can be more pronounced during a common cold or if you have structural issues inside the nose (deviated septum or inferior turbinate hypertrophy). If it is related to a structural issue surgery may help. Best to consult with your ENT or rhinoplasty surgeon. 

Edward S. Kwak, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 28 reviews

Alternating congestion and septoplasty

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Great question.  It is common for congestion to switch sides. Certainly trying some allergy treatments would be worthwhile to see if this helps.   If it does not then a good exam of the inside of the nose would be warranted by an ENT specialist.  There are many possible areas of blockage in the nose and the septum and turbinates are not the only areas that can cause blockage.  After having performed around 1,000 nasal surgeries ranging from rib grafts to septoplasties and major cancer reconstruction, it is important to accurately diagnose the source of the blockage .


Good luck,


Robert F. Gray, MD,FACS 

Robert F. Gray, MD, FACS
Bay Area Facial Plastic Surgeon

The nasal cycle

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The nasal cycle is the sequential congestion and decongestion of the nose. This is a normal physiologic response.  If you are breathing well otherwise, you may have a normal nose.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon

Nasal cycle vs nasal obstruction

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What you are describing sounds potentially like the normal nasal cycle of side to side temporary obstruction.  A true septal deviation and turbinate hypertrophy generally doesn't clear on the obstructed side.  Go to see a qualified ENT or plastic surgeon for an evaluation. 

Septoplasty and turbinate reduction

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Our noses NORMALLY alternate the engorgement of their turbinates, but the symptoms you describe occasionally it MAY be a sign of allergies or Vasomotor Rhinitis.

The inferior Turbinates have an important function in the nose and are NOT removed needlessly. There are several forms of dealing with enlarged turbinates from pushing them outward - away from the septum (outfracuting), to coagulating them electrically to get them to shrink, to removing them partially. Non one does complete turbinectomies these days because of the associated complications.

A septoplasty would be done for septal obstruction or deviation. It MAY be combined with a turbinate procedure if the airway needs to be opened further.

Good Luck.

Peter A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.