Could my septum be deviated? (photo)

Thank you for your question. I recommend you see a rhinoplasty expert for a consultation. Make sure the rhinoplasty surgeon also performs septoplasties routinely as part of the rhinoplasty (not all surgeons do!). He or she also needs to perform a nasal endoscopy during your initial consultation. Most patients have a deviated septum to some extent but nasal obstruction is not necessarily related to the deviated septum; or at least the deviated septum is often not the primary cause of nasal obstruction. In other words, just because there is a deviated septum does not mean that the deviated septum is the primary cause of nasal obstruction. Oftentimes, there is external or/and internal nasal valve collapse, which may be the primary cause of nasal blockage and hence needs to be addressed through appropriate cartilage grafts. Based on your description I suspect that you have at least some nasal valve collapse given your improvement of nasal breathing when flaring your nostrils (called the "Cottle maneuver"). If breathe right strips or pulling your cheeks sideways improve your nasal breathing meaningfully, chances are you need more than just a septoplasty. I advise that you seek a consultation with a board-certified facial plastic surgeon (or general plastic surgeon who performs septoplasties - not everyone does), who sepcializes in rhinoplasty and who not only performs primary rhinoplasty but also a significant number of revision surgeries. Regarding insurance coverage, most insurances cover the septoplasty portion of the procedure, and some also cover nasal valve repair. Good luck!

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their
results.   The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

From the photos you have provided it seems like you have a deviated septum; however, you need to be examined in person, specially if you are having problem breathing.  You should seek consultation with a board certified plastic surgeon and in choosing one you should review the before/after photos to see if you like the results (make sure they show you three views from each patient - front, quarter turn and profile.