Septoplasty: unblocking your nose with surgery

Written by: Professor Hesham Saleh
Edited by: Nicholas Howley

If you have a blocked nose due to a structural problem, your doctor might recommend surgery. A septoplasty is performed when your septum is causing the blockage. We spoke to leading rhinologist Mr Hesham Saleh about what patients can expect from the procedure, what risks are involved, and whether the appearance of your nose can be affected.


What is the septum?

The nasal septum is what we call the part of your nose which divides the two nostrils. It is made of a thin piece of cartilage and bone.

Most people have a nasal septum that is straight and does not cause any breathing problems. However, some people may have a septum that is bent into one or both of the sides of the nose. This may be a problem you have had since birth or the result of an injury. A bent or deviated septum can block the airways in your nose and interfere with your breathing.

A deviated septum is treated with a surgical procedure known as a septoplasty.

What does a septoplasty involve?

A septoplasty is usually carried out under general anaesthetic and takes around 30-45 minutes.

The surgeon will go through the inside of the nose and make a small cut inside to realign the cartilage and bone that make up the septum. A septoplasty does not usually involve cuts to the skin on the exterior of the nose.

In some cases, a septoplasty is combined with other procedures. For example, some patients may require sinus surgery where the sinuses are blocked, or a septorhinoplasty to straighten the nose itself. A septorhinoplasty is a more invasive procedure and you may require a splint afterwards.

Are there any risks involved in the procedure?

Septoplasty is safe procedure, but there is a small chance of complications, such as:

  • bleeding – you may need a pack inserted into the nose to prevent this, or in rare cases, further surgery
  • infection – this is a very rare occurrence but needs prompt medical attention
  • a hole in the septum – this may produce a “whistling” sound when you breathe or nose bleeds. Most of the time you will not need surgery for this.
  • numbness in the teeth – this occurs very rarely but tends to improve after a few months

Will my nose look different after the procedure?

Septoplasty does not usually involve any change to the outward appearance of your nose. In rare cases you may have a small dip in the bridge of your nose. A septorhinoplasty, on the other hand, involves more extensive changes, and you should have a consultation before your operation about what to expect.

By Professor Hesham Saleh
Otolaryngology / ENT

Professor Hesham Saleh is a highly accomplished, leading London-based consultant rhinologist and facial plastic surgeon who specialises in rhinoplasty, endoscopic sinus surgery, rhinology, anterior skull-base surgery, orbital decompression, as well as lacrimal surgery. He currently practises at the Charing Cross Hospital and the Harley ENT Practice

The esteemed Professor Saleh successfully completed his FRCS (ENT) in 1995, before going on to obtain a FRCS (ORL-HNS) four years later, in 1999. He notably featured in The Times'  top 140 doctors list and was elected in their top 50 surgeons list. He is regularly invited as an international expert in rhinoplasty and rhinology at conferences worldwide and serves as Professor of Practice in Rhinology at Imperial College. He forms an integral part of a myriad of professional bodies including the Royal Society of Medicine, for which he is the past president of the section of Laryngology and Rhinology.

His main research interests include rhinitis, chronic rhinosinusitis, anterior skull-base pathology, as well as nasal deformities. Currently, Professor Saleh is the leading investigator in a large number of prestigious and well-established multicentre trials, where he is responsible for the investigation of olfactory damage and eradication of multidrug resistant bacteria that affect the sinuses. 

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