Do I have a deviated septum? (Photo)

Question

There's a bit of difficulty when breathing from my left nostril but it alternates. I prefer to sleep on my right side if that means anything.

Semih Yildiz, MD, FEBOPRAS · Answer

The five patient photos show the external nose from front and profile, but they cannot show the internal septum or confirm its deviation. Alternating blockage can occur with the normal nasal cycle, turbinate swelling, allergies, or a septal deviation; sleeping on one side does not establish the cause. Please see an ENT or board-certified rhinoplasty surgeon for an internal examination and, if needed, nasal endoscopy. A septoplasty is considered when obstruction is persistent and the internal findings match your symptoms—not from photographs alone. Saline and allergy treatment may help mucosal swelling if appropriate for you, but they will not straighten a structurally deviated septum. Seek prompt care for sudden severe obstruction, recurrent heavy bleeding, fever, or significant pain.

Gary M. Horndeski, MD · Answer

The photographs you have provided do not show whether or not you have a deviated septum. However, it is not uncommon for people to have trouble breathing from alternate sides. You would benefit from a rhinoplasty as you have a dorsal hump, the nose is over projecting and the nasal columella angle is less than 90 degrees.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Lucian Ion, FRCS · Answer

Thank you for your question and for submitting your photographs.

The front view image suggests that the nasal bridge deviates slightly in one direction and then shifts to the other, with the tip appearing relatively aligned with the facial midline. Since the image might be mirrored, it is unclear which side corresponds to the right or left in your case.

To better understand the characteristics of the nasal bridge, you could take a photograph:
	•	Slightly from below: This angle shows the alignment and curvature of the bridge more clearly.
	•	Slightly from above: This perspective can further demonstrate the direction of the nasal bridge.

To address these features, a septorhinoplasty is generally required. This procedure corrects both:
	•	Breathing issues related to the nasal airway.
	•	Cosmetic concerns by reshaping and aligning the nasal bridge and tip.

Caner Kacmaz, MD · Answer

Yes you have deviated septum. Septoplasty surgery is aimed at correcting a deviated septum to improve breathing. It does not significantly alter the external appearance of the nose. If you are looking to improve your breathrather than the look, septoplasty is a great option for you. Good luck

Ronald J. Edelson, MD · Answer

Alternating nasal obstruction is usually caused by enlarged turbinates but a deviated septum could also be involved. In internal nasal evaluation will determine what is causing the obstruction

Eric M. Joseph, MD · Answer

Somebody's nasal breathing fluctuates from side to side, it's usually from alterations of the size of the nasal turbinates. Turbinates are organs in the nose that filter and humidify the air. In that regard, a trial of over the counter Flonase or Astepro maybe indicated. Since you sleep on your right side, you may indeed have a septal deviation to the right. An examination would be necessary to determine this. I hope this helps! Sincerely, Dr Joseph

William Portuese, MD · Answer

The only way to make a diagnosis of a deviated septum is to have an internal examination of the nose. A septoplasty is performed when there's a deviated septum present which is blocking airflow. Sometimes inferior turbinates are also reduced when they're enlarged. This is functional nasal surgery is billed to the patient's medical insurance, once medical necessity has been documented. A rhinoplasty is performed for cosmetic purposes, and both can be done simultaneously. Expect to pay for the rhinoplasty component yourself.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can see from your photos , you may have deviation, for this, it will be correct to perform an internal examination of the nose first.
It would be better face to face consultation.
Best Regards!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. The best way to determine if you have a deviated septum is with an intranasal speculum exam. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Do I have a deviated septum? (Photo)

Answers (9)

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