Frequently Asked Questions About Deviated Septum

What is a deviated septum?

deviated septum

A deviated septum is a condition that impacts the nasal septum and affects our breathing. Our nasal septum is the dividing wall between the left and right sides of our nose and is made of bone and cartilage.

In someone with a deviated septum, the septum is crooked or off-center (usually significantly so).  It can be deviated to the left, right or S-shaped. This usually results in a host of complications that can range from annoying to life-altering.  Some imbalance in the size of our breathing passages is completely normal, but severe imbalances (especially those that cause breathing problems) are cause for concern.

Can a septum piercing cause a deviated septum?

Not really. A proper septum piercing pierces the fleshy membranous piece between your nostrils, not the actual cartilage in your nose.

Is a deviated septum painful?

It can be! More than anything, deviated septums are uncomfortable– they can make it difficult to live your daily life.

What causes a deviated septum?

A deviated septum can have several causes.  In some cases one is born with a deviated septum as it forms during fetal development, but in many other cases a deviated septum can develop during an injury such as a fall, sports injury, car accident or a hit as a child, adolescent or adult.

Anyone at any age may experience an injury that causes a deviated septum. Infants, for example, can be injured during childbirth with their injuries resulting in deviated septum. Adults are a risk of a wide array of traumatic accidents (like falls, violent assaults, and car accidents) that may cause a deviated septum.

  • A deviated septum can get worse with time as someone ages; normal aging processes impacts the nose, including the septum and nostrils.

How to tell if you have a deviated septum?

You may notice certain signs or symptoms that indicate you have a deviated septum. Below, we’ve addressed some of the most common symptoms that a deviated septum can cause. You can check there to find out more about the signs of deviated septum.

You may also experience increased facial pain and awareness of the nasal cycle. Our noses regularly alternate being obstructed on one side or the other– but with a deviated septum, this process (called the nasal cycle) can become hyper-obvious.

Here’s the rub: many septal deformities do not create symptoms. According to Mayo Clinic, most of them do not. This may make it difficult to recognize a deviated septum when it occurs.

Can a deviated septum get worse?

For some people, a deviated septum changes over time. Natural aging that happens in our faces and noses does have the potential to make a deviated septum worse. Even if someone’s literal deviated septum doesn’t worsen, they may experience changing or escalating symptoms.

Does insurance cover deviated septum repair?

Yes most insurances do cover a deviated septum repair if it’s to change the inside of the nose for solely breathing or functional reasons without changing the outside or cosmetic appearance of the nose.  However the best way to find out the answer to this question is to contact your insurance provider. Septoplasty is one of the most commonly-covered procedures by many insurances though. It is often deemed medical necessary due to its ability to cause issues with sleeping and breathing, sinus infections and sinus headaches.  For insurance to cover the procedure patients usually have to have failed use of intranasal steroid sprays (i.e. Flonase, Nasacort, etc.), antihistamines (i.e. Claritin, Zyrtec, etc.), sinus rinses and decongestants (i.e. Sudafed etc.).

How can you fix a deviated septum? Can a deviated septum heal on its own?

It’s impossible for a deviated septum to heal on its own.  However, treatment for a deviated septum varies depending on the circumstances and severity of it.  Depending on the severity of ones deviated septum, they can be a candidate for an in-office minor procedure to fix it often termed partial septoplasty, which can be performed under local anesthesia.  For more common and severe cases a small outpatient surgery is the best way to repair it under general anesthesia.

Other steps that most doctors recommend to patients before undergoing surgery include:

  • Medications to reduce swelling:
    • Intranasal steroids (i.e. Flonase, Nasacort, etc.)
    • Antihistamines (i.e. Claritin, Zyrtec, etc.)
    • Decongestants (i.e. Sudafed or Phenylephrine based pills)
  • Nasal dilators or breathe-rite strips to open the nasal passages
  • Sinus rinses

Do nasal strips help deviated septum?

They can! It depends on your individual circumstances. Many people benefit from using nasal strips to lift and open inflamed nasal and sinus passages.

What is deviated septum surgery?

Deviated septum surgery is formally referred to as septoplasty. A surgeon works through the inside of a patient’s nose to create a small incision in the septum. Once the incision is made, the surgeon can remove or resculpt excess cartilage or bone in order to even out the breathing spaces in both nostrils and nasal passages.

Most often during deviated septum surgery, your surgeon will also address any turbinate inflammation, valve collapse or sinus issues that may be present in order to maximize your breathing through both nasal passages.

Some patients may also elect during deviated septum surgeries to also change the outer appearance of their nose or repair any cosmetic deformities.  This is called a rhinoplasty. You may have heard rhinoplasties referred to as nose jobs. These help improve the outside appearance of the nose. The complete procedure is known as a septorhinoplasty.

  • There are newer procedures in development; some people can undergo a balloon septoplasty or a partial septoplasty in the office and avoid actual surgery

Can a deviated septum return after surgery?

In most qualified and excellent surgeon’s hands the chance for redeviation of the septum is less than 3-5% without subsequent trauma to the nose.  However up to 25% of patients report nasal congestion or obstruction redeveloping after deviated septum surgery.  This is because congestion may often be due to other causes besides the structural issues associated with the nose.  These causes include severe allergies and/or severe inflammation due to irritants (i.e. smoking, vaping, fumes etc.) or chronic sinusitis.  So it’s not that a deviated septum might return after surgery, but that the symptoms of one may persist (or return) after surgery.

How much does deviated septum surgery cost with insurance?

Deviated septum surgery without insurance coverage generally range from about $4,000 to $6,000, if one is not also getting a rhinoplasty.  With insurance one’s copays and deductibles decide the actual cost to the patient; thus it could be completely free or a nominal cost of $500 to $2500.

How long does deviated septum surgery take?

Septoplasties generally last from 30-60 minutes. They are not especially long surgeries.  If a rhinoplasty is combined with the procedure, then it can take 90 -180 minutes all together.

How long does someone’s nose bleed after deviated septum surgery?

You will get a drip pad to help collect oozing of blood that drips from your nose after your deviated septum surgery. It may ooze for up to 2-3 days following surgery, but heavy bleeding should prompt a call to your doctor.

How long does it take to recover from deviated septum surgery?

Recovery time after deviated septum surgery depends on a few factors.

  • Most patients fully recover in 2-3 weeks and are back to work after 3-5 days from surgery; furthermore there’s no outside bruising or swelling with simple deviated septum repair
  • Septorhinoplasty patients heal in 3-6 weeks but are back to work in 7-10 days from surgery; outer bruising and swelling may last up to 3 weeks
  • Some patients may experience numbness near the tip of their nose and mild loss of smell; this always returns to normal within 1-2 months
  • Exercise after septoplasty is fine after 7-10 days and after septorhinoplasty after 3 weeks.

Can you correct a deviated septum without surgery? How can you help a deviated septum without surgery?

There are some alternatives to septoplasty that may help someone ease the symptoms of a deviated septum or nasal obstruction. Nasal steroids and allergy medications may help some people; others use nasal strips or nasal irrigation to try to open up their nasal passages.

Can a deviated septum cause snoring or sleep apnea?

It is a very common cause of snoring and ones snoring can definitely be helped in loudness and severity with deviated septum repair.  However it is unlikely to cure sleep apnea.  This is a common misconception. What a deviated septum can do is make your sleep apnea worse or more difficult to treat.

What other problems does a deviated septum cause? nose bleed from deviated septum

People have lots of questions about the effects of a deviated septum, so…

  • Can deviated septum cause a runny nose? Yes—it can cause a runny nose as well as postnasal drip which are both common symptoms of a deviated septum. Deviated septums also tend to cause stuffy noses and difficulty breathing
  • Can deviated septum cause nosebleeds? Yes; when the surface of the nasal septum becomes dry, it can lead to nosebleeds
  • Can a deviated septum cause clogged ears?  Deviated septums can lead to ear fullness and negatively impact middle ear ventilation
  • Does deviated septum cause bad breath? It can! Especially if your breathing patterns are impacted where you are constantly mouth breathing
  • Can a deviated septum cause headaches? Yes usually one sided
  • Does a deviated septum cause snoring? Oftentimes, yes. It’s common for deviated septums to cause snoring. Many people experience loud breathing and snoring while they sleep with a deviated septum; but remember, just because you don’t snore, it doesn’t mean you don’t have a deviated septum

Dr. Alen Cohen at the Southern California Sinus Institute May Be Able to Help With Your Deviated Septum

If you are experiencing a deviated septum and want relief from your symptoms, Dr. Alen Cohen at the Southern California Sinus Institute may be able to help. Reach out to us today to speak to someone about your circumstances.

Dr. Cohen is recognized year after year as one of the Best Deviated Septum Surgeons in Los Angeles.  He is Founder and Director of Los Angeles’ premier nose and sinus center, the Southern California Sinus Institute which serves the greater Los Angeles, San Fernando Valley and Ventura County areas. The Southern California Sinus Institute was founded in 2009 by Dr. Cohen and specializes in the medical and surgical treatment of patients with all nasal and sinus disorders including nasal obstruction, deviated septum, hypertrophic turbinates, environmental allergies, acute and chronic sinusitis, nose and sinus polyps, recurrent severe and debilitating sinus infections and sinus headaches.