If you have persistent nasal obstruction after septoplasty (deviated septum repair), you’re not alone. But what causes this frustrating and uncomfortable problem?

A deviated septum is a very common condition that happens when the wall of narrow bone and cartilage in your nose becomes misaligned from its normal position. It can end up blocking or reducing airflow, leading to difficulty breathing, problems with snoring, headaches, and chronic sinusitis (sinus infections). Nasal Obstruction Treatment

Septoplasty is a procedure in which cartilage and bone of the septum are trimmed and reshaped using minimally-invasive techniques. Most people experience significant relief from nasal obstruction symptoms after septoplasty, but some people experience persistent issues.

Initial Swelling and Nasal Obstruction Following Surgery

Immediately after surgery, it’s normal to experience some nasal congestion and swelling. You may have nasal splits to help stabilize the cartilage or to prevent bleeding, and this can usually be removed within 48-72 hours.

Within days, most people are already experiencing some relief from the frustrating symptoms previously caused by a deviated septum. Once surgical recovery is over, which usually takes 2-4 weeks, the nasal passages should be more open, leading to better nasal drainage and breathing, but results can depend on the person.

Persistent Nasal Obstruction After Septoplasty

In some cases, people may discover they experience persistent nasal obstruction after a septoplasty. This can be due to several reasons, including obstruction caused by issues other than the deviated septum that was repaired, individual factors that may cause tissue and cartilage to reshape over time, or problems with the initial procedure.


An extremely common reason for nasal obstruction is untreated allergies, which can cause a great deal of congestion and inflammation of the nasal and sinus tissues and membranes, leading to sinusitis and a chronic feeling of nasal obstruction. In Southern California, the year-round pollen and warm weather can make allergies especially difficult for some people, although allergies causing feelings of nasal obstruction can also be caused by mold, dust, and animal dander.

Hypertrophic Turbinates

The sidewalls of the nose (turbinates) are made of bone and soft tissue, and perform the important function of filtering dirt, pollen, allergens, and other irritants so that you can get a lungful of clean air with every breath through the nose. Some people may have enlarged (hypertrophic) turbines, which compromises this filtering process—often leading to obstruction in the nose, congestion, and sinusitis.


A polyp is an abnormal growth of cells on a mucous membrane. They can develop in the nose, often where the sinuses open into the nasal cavity. Some people experience no issues from nasal polyps, while for those with large polyps, they may experience nasal obstruction and discomfort.

Nasal Valve Collapse

The nasal valve is the most narrow part of the nasal airway, located in the middle to lower part of the nose. Its job is to limit airflow to the nose, but it can cause nasal obstruction if it collapses, sometimes called nasal valve stenosis. A nasal valve collapse can be caused by previous nasal surgery or traumatic injury.

Natural Changes in the Nose’s Structure

Even after a well-performed septoplasty, some people may begin to experience nasal obstruction due to a septum that has shifted or become misaligned. Over time, some nasal tissue and cartilage may shift naturally or become reinjured, leading to the same problems that had been previously corrected through deviated septum repair.

Nasal Obstruction Treatment After Septoplasty

A woman blowing her nose at the doctor

If you experience ongoing or recurrent nasal obstruction and other nasal issues after septoplasty, it’s a good idea to get it checked out by an expert Ear, Nose, and Throat (ENT) specialist that specializes in the field of Nose & Sinus Surgery or Rhinology. At the Southern California Sinus Institute, Dr. Cohen is one of the leading ENT specialists and Rhinologists for diagnosing these types of complex issues and can develop non-surgical or surgical treatment plans, depending on the cause. To determine the cause of persistent nasal obstruction after an initial sinus surgery, Dr. Cohen uses the latest in ENT diagnostic techniques, right in the office.  These include nasal endoscopy and/or in-office sinus CT scans.

Dr. Cohen can prescribe medications to manage allergies or other issues causing nasal obstruction, or can perform surgical procedures to repair the issue, as needed.

Many of Dr. Cohen’s patients come from other parts of California and from around the country for his expertise in revision sinus surgery—which is very different from primary sinus surgery. Dr. Cohen is also a leading provider of the following procedures for issues that can cause nasal obstruction:

Considered the best sinus surgeon in Los Angeles, Dr. Alen Cohen is an expert at successfully treating patients for nasal obstruction following septoplasty and for other nasal and sinus disorders. If this is an issue impacting you—schedule an appointment today!