Septoplasty
Straightening the wall inside the nose so air can move freely.
What it is
Septoplasty is a surgical procedure that corrects a deviated septum. The septum is the internal wall, made of cartilage in front and bone in back, that divides the inside of the nose into a left passage and a right passage. When that wall is bent, twisted, or shifted off-center (which is true for an estimated 70 to 80 percent of adults to some degree), one or both nasal passages are narrowed. Air has to squeeze through a smaller opening, and breathing through the nose becomes difficult or impossible.
Why we do it
The nose is not just an accessory to the airway, it IS the front door of the airway. Air that travels through the nose is filtered, warmed, humidified, and mixed with nitric oxide (a molecule the body produces in the sinuses that helps the lungs absorb oxygen). When the septum blocks normal nasal airflow, people compensate by breathing through the mouth. Chronic mouth breathing is associated with sleep-disordered breathing, snoring, dry mouth, dental decay, gum disease, and a measurable drop in oxygen during sleep. Septoplasty restores the nasal route the body was designed to use.
What happens during the procedure
The procedure is performed under general anesthesia. Working entirely through the nostrils (no external incisions, no visible scarring), the surgeon lifts the lining of the septum, removes or repositions the deviated cartilage and bone, and replaces the lining over a now-straight midline. Soft internal splints are sometimes placed to support healing for the first week. Septoplasty is frequently combined with turbinate reduction. The turbinates are the spongy ridges on the side walls of the nose. When the septum bends one direction, the turbinate on the opposite side often grows larger to fill the space, and both need to be addressed in the same operation for a durable result.
Who it’s for
Adults and adolescents who cannot breathe well through one or both sides of the nose, particularly when the difficulty has been present for years and worsens with allergies, exercise, or sleep. Common signs include snoring, mouth breathing during sleep, recurring sinus infections, and the inability to use a CPAP machine comfortably because air cannot pass through the nose. Septoplasty is usually deferred until facial growth is complete (around age 16 in girls, 17 to 18 in boys).
Recovery and what to expect
Most patients go home the same day. Expect nasal congestion, mild bruising, and a sense of pressure for the first three to five days. Strenuous activity is restricted for two weeks. The full benefit of the surgery is felt at six to eight weeks once internal swelling resolves, though most people notice dramatically easier breathing within the first month.