Could I have a deviated septum even though there is no visual deformity? (photo)

I almost always breathe with my mouth, especially at night. I've tried Claritin and nasal sprays but to no avail. Could it be possible that I have a deviated septum? I have never broken or damaged my nose before but my nostrils are asymmetrical. My septum don't really look deviated so perhaps there is another cause? This also seems like a hereditary thing because my father has heavy breathing and usually always breathe with his mouth. I will be seeing a doctor soon. Photos are attached.

Doctor Answers 12

Deviated septum and other causes of nasal airway obstruction

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With regard to nasal deviation, three possibilities generally exist:
1. Visible external nasal deviation with internal septal deviation
2. No visible external nasal deviation (nose appears straight) with internal septal deviation
3. No visible external nasal deviation (nose appears straight) without internal septal deviation.

In your case, it is possible that your external nose appears generally straight but that you do have a deviated septum internally. Additionally, there are other areas of the nose that can be the cause of structural obstruction including the external valves, the internal valves and the turbinates. Physiologic problems can also cause nasal airway obstruction in the absence of a structural deformity - these include problems such as allergic rhinitis.

You should see seek the opinion of a board certified otolaryngologist (ear, nose and throat surgeon) to have an evaluation of your nose and nasal airway.

Deviated Septum

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Absolutely.  It is possible to have a deviated septum without an outward deformity.  An in-person consultation is recommended to evaluate the inside and outside of the nose.  Please consult with a board certified specialist (such as a facial plastic surgeon with training in head and neck surgery) who can assist you with achieving the results you seek. 

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Deviated Septum?

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An internal evaluation of your airway with a speculum and direct visualization is necessary to diagnose a deviated septum. Sometimes it is obvious and sometimes it is not so obvious. A straight nose does not mean that the septum is not deviated and a crooked nose does not mean the septum is the cause. Consult a board certified plastic surgeon who has expertise in rhinoplasty.

Best wishes

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 25 reviews

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Deviated septum

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Only an internal inspection of your nose can determine if you have significant septal deviation and if is contributing to your breathing problem.  You should consult with a plastic surgeon or ENT doctor to determine if such is the case in your situation.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Deviated septum findings

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It is possible to have a deviated septum further inside your nose that is leading to your nasal blockage symptoms. This wouldn't necessarily translate into a visible deformity outside your nose.

Your doctor will need to check inside your nose to see if there are any other explanations for your nasal obstruction. Enlarged turbinates, generalized skin lining swelling and nasal polyps are other things that need to be ruled out.

You can read more about deviated septum repair at my web reference link below.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Diagnosing a deviated septum

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The only way to know if you have clinically significant deviated septum is to have a physical examination by an experienecd rhinoplasty surgeon or otolaryngologist- who can also rule out other causes of nasal obstruction. Good Luck.

Roy A. David, MD
San Diego Facial Plastic Surgeon

Deviated Septum Without Visual Deformity

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It is possible to have a deviated septum without any external visual deformity. You need to have an examination by an experienced rhinoplasty specialist because there are many possible causes of nasal obstruction such as enlarged turbinates and valve narrowing.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Nasal obstruction symptoms

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Nasal obstruction can come from a variety of issues such as a deviated nasal septum, turbinate hypertrophy, valve collapse,  and vestibular stenosis. Each one of these issues are treated differently with surgery, after patients have failed medical therapy. To diagnose  a deviated septum an ENT/ facial plastic surgeon will need to examine the posterior portion of the nose. Repairing the deviated septum will not  change the outside appearance of the nose, only improve the airflow for medical necessity.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Nasal blockage without external deviation

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Hi Derek,
There are many reasons to have nasal blockage without external deviation of the nose. You can also have a deviated septum which is purely internal, but that usually affects 1 side more than the other. Turbinate enlargement, nasal valve collapse, and nasal swelling or congestion are also common causes of this problem.

Nasal congestion can occur from allergies, non-allergic irritation, hormonal imbalance, and as a side effect of medication. Chronic sinusitis can also be a common cause of nasal congestion.

I think you'll find some answers when you go for an examination. Probably the best place to start is with a nose spray, like Nasonex or Flonase.

Best of luck

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

Possible Deviated Septum

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If you have problems breathing through your nose it is very possible you have a deviated septum  As far as not ever fracturing your nose or damaging your nose it is still possible to have deviation since birth. Not all deviated septum's are visible without an internal examination. Upon a consultation and direct examination your surgeon will be able to give a proper diagnosis. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 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.