What is septoplasty?
The septum is the wall of cartilage and bone that divides the nose into two passages. When it is bent — deviated — one side is narrower than the other and airflow is restricted. Septoplasty is the operation that straightens it.
It is a functional operation. The incisions are inside the nose, nothing is done to the external framework, and the shape of the nose is not intended to change. Where both breathing and appearance are being treated, the combined operation is called septorhinoplasty and is planned differently.
What symptoms does a deviated septum cause?
| Symptom | Why it happens |
|---|---|
| Blockage on one side | The deviation narrows one passage |
| Mouth breathing, especially at night | The nose cannot carry enough airflow |
| Disturbed sleep, snoring | Nasal resistance increases during sleep |
| Recurrent sinus infections | Impaired drainage and ventilation |
| Nosebleeds | The exposed, deviated area dries and crusts |
| Dry mouth or throat on waking | The result of breathing through the mouth |
Not every blocked nose comes from the septum. Allergic rhinitis, enlarged turbinates, nasal polyps and, in children, enlarged adenoids all cause similar symptoms. Examination is what separates them, and treating the wrong cause is why some patients feel no better after surgery.
Who is a candidate for septoplasty?
Surgery is generally considered when:
- blockage is persistent rather than intermittent;
- it interferes with sleep, exercise or daily comfort;
- examination confirms a deviation that matches the reported symptoms;
- medical treatment — nasal steroid sprays, allergy treatment where relevant — has been tried and has not been sufficient.
Surgery is normally deferred in children until nasal growth is well advanced, unless obstruction is severe.
What does the evidence show?
For many years septoplasty was performed on clinical judgement rather than trial evidence. That changed in 2019, when a pragmatic randomised controlled trial published in The Lancet compared septoplasty, with or without concurrent turbinate surgery, against non-surgical management in adults with a deviated septum and nasal obstruction. Outcomes favoured the surgical group.
A subsequent systematic review and meta-analysis of randomised controlled trials, published in the European Archives of Oto-Rhino-Laryngology in 2025, pooled the available trials and reached a broadly consistent conclusion.
What this evidence supports is that septoplasty helps appropriately selected adults whose obstruction is caused by the deviation. It does not support operating on every deviated septum found on examination, which is why selection matters as much as technique.
How is the operation performed?
- Anaesthesia. General anaesthesia in most cases.
- Internal incision. A single incision is made inside one nostril; there is no external incision.
- Elevation. The mucosal lining is lifted from both sides of the septal cartilage and bone.
- Correction. Deviated portions of cartilage and bone are straightened, repositioned or removed. Enough cartilage is always left in place to support the nose — over-resection is what causes a collapsed dorsum years later.
- Turbinates. If the turbinates are enlarged and contributing to the blockage, they are reduced during the same operation.
- Closure and support. The lining is repositioned and secured, usually with absorbable sutures. Thin internal splints are commonly placed for the first week.
What does recovery look like?
| Period | What is usual |
|---|---|
| Days 1–3 | Blockage from internal swelling, mild discomfort, some blood-stained discharge |
| Day 5–7 | Internal splints removed; nose still swollen inside |
| Weeks 1–2 | Crusting settles; saline rinses usually recommended |
| Weeks 2–4 | Breathing steadily improves; most people back to normal activity |
| Weeks 4–8 | Full benefit generally apparent |
Advice during recovery usually includes saline rinses, avoiding nose blowing in the first days, avoiding heavy lifting and strenuous exercise for a few weeks, and avoiding swimming until you are told it is safe. Specific instructions are given to you after your operation.
What are the risks?
- Bleeding, usually minor and in the first days.
- Infection, uncommon.
- Persistent or recurrent obstruction — either because the cartilage shifts during healing or because another cause, such as allergy, contributes to the symptoms.
- Septal perforation — a hole between the two sides, uncommon, occasionally causing whistling or crusting.
- Change in the shape of the nose — rare, and associated with removing too much support; avoided by conservative resection.
- Reduced sense of smell, usually temporary.
- Numbness of the upper front teeth, usually temporary.
This list is not exhaustive; the risks that apply to you are discussed at consultation and again during informed consent. Individual results vary.
Septoplasty or rhinoplasty — which do you actually need?
| Septoplasty | Rhinoplasty | Septorhinoplasty | |
|---|---|---|---|
| Goal | Breathing | Appearance | Both |
| Works on | Internal septum | External framework | Both |
| External shape changes | No | Yes | Yes |
| Typical operating time | 45–90 minutes | 2–3 hours | 2.5–3.5 hours |
| Splint on the outside | Usually not | Yes | Yes |
| Recovery to daily life | About 5–7 days | About 7–10 days | About 7–10 days |
If your complaint is purely that you cannot breathe, septoplasty may be all you need. If you want the shape changed as well, the two are combined — see the main rhinoplasty page.
What affects the price?
Cost depends on the extent of the correction, whether turbinate surgery is included, the length of the operation and the hospital. No prices are published on this site and no figure can be given before an examination. See the Medical Disclaimer.
What is the process for patients travelling to Izmir?
Septoplasty has a shorter recovery than rhinoplasty, and there is no external splint to remove. Even so, a stay of several days is advised so that the internal splints can be taken out and the early healing checked before you fly home. Your own timetable is confirmed at consultation.