Septoplasty is an operation to straighten the nasal septum, the wall of cartilage and bone that divides the nose into left and right passages. It is done to improve breathing, through the nostrils, and does not change the outside of the nose.
This page explains when a deviated septum causes problems, how it is diagnosed, when surgery makes sense compared with sprays, what the recent clinical trials found, and what recovery looks like if you travel to Ankara for the operation.
What is a deviated septum?
A septum is rarely perfectly straight. ENT Health, the patient site of the American Academy of Otolaryngology–Head and Neck Surgery, estimates that as many as 80 percent of people have a septum that is off-centre. Most of them have no symptoms and need no treatment.
The deviation becomes relevant when it narrows one or both nasal passages enough to obstruct airflow. It can follow a knock to the nose, but it is also common in people who have never had an injury.
What symptoms can it cause?
- Blocked nose, often worse on one side
- Breathing through the mouth, especially at night
- Noisy breathing or snoring
- Repeated sinus infections, if drainage is affected
- Nosebleeds from a dry area over a sharp bend or spur
- Facial pressure or headache in some cases
Many of these symptoms also occur with allergy, rhinitis, enlarged turbinates, nasal polyps or a weak nasal valve. That is why the examination aims to find out which structure is actually responsible.
How is it diagnosed?
Diagnosis starts with your history and an examination of the nose inside and out. Dr. Serdar Başer, an ENT – head and neck surgeon, uses a thin endoscope to look along the whole length of the septum, including its back part, which cannot be seen with a light alone.
| Part of the assessment | What it shows |
|---|---|
| History and symptom questionnaire | How much the blockage affects daily life and sleep |
| Endoscopic examination | Position of the deviation, spurs, turbinates, polyps |
| Before and after a decongestant spray | How much of the blockage is swelling of the lining and how much is structural |
| Nasal valve manoeuvres | Whether the side wall of the nose collapses on breathing in |
| CT scan (when needed) | Sinuses and bony anatomy, usually if sinus disease is suspected |
An AAO-HNS clinical consensus statement on septoplasty notes that a CT scan may not accurately show the degree of septal deviation. The decision therefore rests mainly on the endoscopic examination, not on imaging alone.
Sprays or surgery: when is septoplasty the right step?
Medical treatment comes first when the lining of the nose plays a large part, for example in allergic rhinitis. A typical course is a saline spray followed by a steroid nasal spray used correctly for several weeks.
| Situation | Usual first step |
|---|---|
| Mild deviation, symptoms mainly from swelling or allergy | Medical treatment |
| Clear deviation, persistent blockage despite adequate medical treatment | Septoplasty is considered |
| Repeated nosebleeds from a septal spur, not controlled medically | Septoplasty may be considered |
| Septum blocks access needed for sinus or other nasal surgery | Septoplasty as part of that operation |
| Deviation found by chance, no symptoms | No treatment needed |
These situations broadly follow the AAO-HNS clinical indicators for septoplasty, which list nasal obstruction unresponsive to medical management as the main indication.
What does the evidence say?
For many years septoplasty was performed widely without strong comparative evidence. A 2018 systematic review found no studies comparing it with non-surgical treatment and concluded that firm conclusions were not possible. Since then, two randomised trials have changed the picture.
| Study | Who took part | Main finding |
|---|---|---|
| Dutch trial, The Lancet 2019 | 203 adults in the Netherlands | Health-related quality of life at 12 months was better after septoplasty than after non-surgical management; the effect was sustained up to 24 months |
| NAIROS trial, Health Technology Assessment 2024 | 378 adults at 17 UK NHS hospitals | At 6 months the symptom score (SNOT-22) was 19.9 after septoplasty versus 39.5 with steroid and saline sprays (lower is better); baseline severity predicted the degree of improvement |
| Meta-analysis, European Archives of Oto-Rhino-Laryngology 2025 | 3 randomised trials, 721 participants | Septoplasty improved obstruction and symptom scores at 6 and 12 months, not at 3 months; complication rates were low |
These are averages across groups. The NAIROS trial also recorded more adverse events in the surgical group than in the medical group, which is why the decision is made individually, weighing symptom severity against the risks of surgery.
When is it better to wait or choose another option?
Septoplasty is not the right step for everyone with a blocked nose. ENT Health notes that it is typically not performed in young children unless the problem is severe, because the face is still growing.
- The main cause is allergy or rhinitis that has not yet been treated properly
- The blockage comes mostly from the nasal valve or turbinates rather than the septum
- There is an active infection or an untreated bleeding disorder
- Daily decongestant spray use is causing rebound swelling
- Expectations focus on snoring or sleep apnoea alone, without nasal symptoms
In these situations the first step is usually to treat the other cause, or to plan a different or combined procedure.
How is septoplasty performed?
- The operation is usually done under general anaesthesia; local anaesthesia is an option in selected cases.
- An incision is made inside one nostril, and the lining of the septum is lifted from the cartilage and bone.
- The deviated parts are straightened, repositioned or removed, while an L-shaped frame of cartilage is kept to support the nose.
- The lining is laid back over the septum.
- Soft silicone splints or dissolving quilting stitches hold the layers together and reduce the risk of a blood collection.
ENT Health reports an average operating time of about one to one and a half hours, depending on the deformity. Because everything is done through the nostrils, there is normally no external scar and no bruising around the eyes.
Can it be combined with other procedures?
The septum is often only one part of a blocked nose. Common combinations are:
- Turbinate reduction, if the inferior turbinates are enlarged. See turbinate reduction.
- Septorhinoplasty, if the front part of the septum or the whole nose is crooked, or if you also want a change in shape. See rhinoplasty.
- Sinus surgery, if chronic sinus disease is present.
Adding procedures changes the recovery: once the outside of the nose is reshaped, swelling and bruising should be expected and the stay in Ankara follows the rhinoplasty plan.
What does recovery look like?
| Period | What to expect |
|---|---|
| First 48 hours | Blocked nose, mild oozing; a small gauze pad under the nose |
| Days 1–5 | Rest, head raised when sleeping; no nose blowing |
| Days 5–7 | Internal splints removed; saline rinses for crusting |
| About 1 week | Return to desk work and light activities for most people |
| About 4 weeks | Strenuous exercise again, once healing allows |
| Months 2–6 | Internal healing completes; breathing settles |
Cleveland Clinic patient information describes an initial recovery of about one to two weeks, with healing of the cartilage and bone continuing for several months.
Planning a trip to Ankara
Ankara is reached through Esenboğa International Airport (ESB). The clinic is located at the Maidan Business and Living Centre in Çankaya.
| Step | When | What happens |
|---|---|---|
| First contact | Weeks before | Symptoms, any previous scans and medication history shared over WhatsApp |
| Arrival and consultation | Day −1 | Endoscopic examination, plan and informed consent |
| Surgery | Day 0 | Septoplasty; usually home or to the hotel the same day or next morning |
| Rest | Days 1–5 | Saline rinses, short walks, avoiding nose blowing |
| Splint removal | Day 5–7 | Internal splints removed, nose checked |
| Fly home | Day 6–7 | Usually possible after the final check |
What are the risks?
Septoplasty is generally a low-risk operation, but no surgery is risk-free. Individual risks are discussed at the examination and during informed consent.
- Bleeding and infection
- Septal haematoma or abscess (a collection of blood or pus)
- Septal perforation (a hole in the septum)
- Adhesions between the septum and the side wall
- Temporary numbness of the upper front teeth or tip of the nose
- Persistent or recurrent blockage
- Rarely, a change in the support or shape of the nose
In the 2019 Lancet trial, one septal abscess and two perforations occurred among the 102 patients assigned to surgery.
The information on this page is for general guidance and does not replace a medical consultation. Whether septoplasty is right for you can only be decided after an in-person examination.