SEPTUM DEVIATION

The septum is the wall that divides the nose into two halves, made of cartilage at the front and bone at the back. Any curvature in this wall is referred to as septum deviation. It is also commonly known as a crooked nose or nasal septum deviation.

This deviation can make breathing more difficult. While airflow is reduced on the curved side, the open side often compensates, and the patient may not immediately notice the issue. Over time, however, the turbinates (nasal tissues) on the normal side can enlarge, and nasal blockage becomes more apparent. The deviation may involve only cartilage, only bone, or both. The surgical approach is planned accordingly.

SEPTUM DEVIATION SURGERY

Septum deviation surgery involves correcting the curved wall inside the nose commonly referred to as the “nasal pillar” composed of cartilage at the front and bone at the back. The procedure can be performed under general or local anesthesia and typically lasts between 30 and 45 minutes. This surgery does not alter the external shape of the nose.

A minimal 2mm internal incision is made inside the nose. Since no external incision is created, there are no visible scars. The stitches placed inside the nose are dissolvable, so there is no need to have them removed later.

Septal deviations may be congenital or caused by trauma. Before surgery, the relationship between the internal deviation and the outer shape of the nose should be carefully evaluated. If the outer structure is also crooked, internal correction alone may not resolve the problem this is especially true in trauma-related cases. In such scenarios, both functional and cosmetic surgery should be performed together. In most cases of septum deviation, turbinates (nasal tissues) also become enlarged. These are typically reduced using radiofrequency ablation during the same session. Radiofrequency is a minimally invasive method and not a full surgical procedure.

POSTOPERATIVE PERIOD AFTER SEPTUM DEVIATION SURGERY

The recovery process is not usually painful or difficult. Most patients can be discharged on the same day. The silicone splints and nasal tapes used during surgery are typically removed after 2–3 days. Once removed, the patient feels significantly more comfortable and can return to normal daily activities.

After splint removal, we recommend saline nasal irrigation, which can be purchased or made at home. Antibiotics are usually prescribed for about one week. Some crusting inside the nose is normal and may continue for a while, especially if radiofrequency was applied to the turbinates. Full recovery and optimal breathing can take 1 to 2 months.

Since the surgery targets the internal part of the nose and not the nasal bridge, there is typically no bruising or swelling around the eyes. This kind of swelling is more common with cosmetic rhinoplasty. However, even in cosmetic procedures, we now use Piezo technology, which significantly reduces bruising and swelling.

RISKS AND COMPLICATIONS OF SEPTUM DEVIATION SURGERY

As with all surgical procedures, there are potential complications. Thanks to modern techniques, however, the risks have been greatly minimized. The most common intraoperative or postoperative risk is bleeding, but with current surgical methods, this is rare. Infection is another general surgical risk, but it’s not higher for nasal surgeries like deviation correction.

A rare long-term complication is septal perforation, especially if the septum is excessively manipulated. However, the use of advanced techniques and special silicone splints has greatly reduced this risk as well.