How is Septoplasty Performed?

I have been diagnosed with a deviated septum. Instead of being centrally aligned, the central part of my septum is skewed into my left nostril and according there is a larger space in my right. If I were to get septoplasty performed, how exactly would this work? Would the septum be restored or adjusted to a central location so that both the blockage in my left and the space in my right would be eliminated? Or would the surgery just eliminate the blockage on the left side and leave the right essentially unchanged?

Doctor Answers 9

Septoplasty Technique Summarized

A septoplasty is usually performed thru the nostrils without any external incisions or cuts. In your case, the deviated portions of the cartilage that are impinging on your left airway should likely be trimmed down. In doing so, the left side should be made larger and will approximate the opening on the right side. The end result should be that you feel like you are getting the same amount of air through both nostrils

San Diego Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

How is caudal septoplasty performed

As with most surgical procedures, there are multiple ways to perform septoplasty and to get good results.  I agree that you likely have a caudal deviation of the septum.  This is a common problem, and trickier to correct than a more posteriorly deviated septum.  Without additional information from you, and without having examined you, briefly, the nose skin on either side of the cartilaginous and bony septum is lifted through incisions inside your nose, and the deviated portion of the posterior septum is removed and the skin flaps are replaced, bringing your septum into the midline.  In the front of your nose, a sufficient amount of cartilaginous septum is preserved to support the nasal tip.  ThenThe cartilage can then be detached  from the bone below, and re-fixed in the midline with a stitch.  This is all done through the nostrils with no cuts on the outside of the nose.  

I would suggest a face-to-face consultation with a qualified surgeon who can review the procedure with you and do an examination of the nose.  Take a look at their before and after photos for caudal septal deviation correction prior to scheduling surgery.


Dara Liotta, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 31 reviews

Septoplasty surgery

You have what we would describe as a "Caudal End Deviation" meaning the very front portion of your septum is deviated into your nasal airway and nostril.  This particular brand of septal deviation is a little bit more tricky than the average internal-only deviation.  I would strongly recommend that you visit with a Double Board certified surgeon in both facial plastic surgery and ENT as I would expect that you will need an open approach to replace and repair this issue.  Commonly, the deviation at the level of the nostril is bad enough that merely repositioning the cartilage does not adequately take care of the 3 dimensional strain on the septum and months later you will notice a return of obstruction and be disappointed that it "didn't take."  An open approach in this particular situation will allow complete access and repair.  Sometimes, caudal end deviations even go so far as needing to have the entire septum removed, the bent portions excised, the septum turned 180 degrees and then completely replaced to correct these challenging twists and deformities.  Make sure your surgeon's plan addresses these issues!

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

What you gain on one side, you lose on the other.

Great question. The total space inside your nose remains the same with Septoplasty. So when the center wall is shifted into the center, one nasal channel;s cross section area is increased, while the other's is reduced. Not infrequently after successful surgery the patient is aware the formerly better side feels restrictive, as the blocked side is now open. Often this is ameliorated by removing some of the fleshy swelling of the turbinate on the 'better side.

Oakley Smith, MD, FRCSC
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 93 reviews

Septoplasty surgery

the type of septoplasty performed depends on the nature of the problem.  Ideally the septum is straightened without removing large segments of cartilage - but rather reshaping the cartilage and supporting the nasal valve region.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Technical details of correcting the nasal septum

A septoplasty is designed to improve and balance the nasal airway and remove obstructions to airflow.  The most common way is to remove the offending cartilage and bone while other techniques involve repositioning alone.  Often the turbinates need to be addressed at the same time.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Septoplasty Surgery for Deviated Nasal Septum

Septoplasty corrects a deviated nasal septum. If performed on its own, this nasal surgery is usually performed entirely through the nostrils, without external incisions. During the surgical procedure, deviated and crooked portions of bone and cartilage may be removed entirely or they may be readjusted and repositioned. The septoplasty procedure has different exact techniques and approaches, largely dependent on the anatomy of the nasal septum for each particular person, and if a rhinoplasty is performed at the same time. For most noses, the central part of the septum is deviated, and the septoplasty surgery removes this central area. Best of luck.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

How is a septoplasty performed?

A septoplasty is performed by making an incision on the inside of the nose, the lining of the nose is elevated and the cartilage and bone that make up your septum are realigned as best as possible into the midline. The object of a septoplasty is to restore a normal airway on both sides of the nose. From your description of your situation I would assume that the obstruction would be relieved on the left side and the septum moved to the midline so this would change the space on the right.

Andres Gantous, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 25 reviews

Septoplasty for Deviated Seputm

A septoplasty is a surgery performed to correct a deviated (or crooked) septum. A true "septoplasty" does not involve changing the shape of the nose. The septum is the piece of cartilage that separates one side of the nose from the other. Normally, the septum is straight. When it is crooked, it is termed a deviated septum. A deviated septum can block the nasal passage and contribute to symptoms of nasal obstruction.

Correction of a deviated septum with a septoplasty involves making an incision on the inside of the nose. The skin covering the septum is lifted off the cartilage and the deviated setpum (intranasal part only) is either removed or reshaped to make the breathing passages more open. It is infrequent that a septoplasty alone will correct external crookedness.

For a nose that is crooked on the inside and the outside, a septorhinoplasty (in which both the septum and the nasal framework are corrected) may be required. This involves reconstructing the nasal framework, correcting a deviated septum, and often surgically-breaking the nasal bones (osteotomies).

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
4.7 out of 5 stars 147 reviews

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.