The nasal septum is the wall of cartilage and bone that divides the nose into two sides. In a perfect world it sits exactly in the middle, giving each nostril equal airflow. In reality, the majority of people have some degree of septal deviation — but for many, it is mild enough to cause no noticeable symptoms.

For others, a deviated septum significantly narrows one or both sides of the nasal airway, causing chronic nasal obstruction, difficulty breathing, recurrent sinus infections, nosebleeds, and disrupted sleep. When a deviated septum is causing meaningful symptoms, surgical correction — called septoplasty — is highly effective and covered by most insurance plans.

An estimated 80% of people have some degree of septal deviation. The question is not whether it is perfectly straight, but whether it is causing symptoms significant enough to affect your quality of life.

Symptoms of a deviated septum

Nasal Obstruction

Difficulty breathing through one or both sides of the nose — often worse on one side

Nasal Cycle Awareness

Noticeable alternating congestion from side to side, more pronounced than usual

Recurrent Sinus Infections

A deviated septum can obstruct sinus drainage and predispose to sinusitis

Frequent Nosebleeds

Turbulent airflow over a deviated septum can dry and irritate the nasal lining

Sleep Disruption & Snoring

Nasal obstruction forces mouth breathing during sleep, contributing to snoring and poor sleep quality

Facial Pressure

Pressure or discomfort related to impaired nasal airflow and sinus drainage

What causes a deviated septum?

Most septal deviations develop in one of two ways. Some are congenital — present from birth or resulting from compression during delivery — and become more apparent as the face grows. Others develop from trauma — a broken nose from a sports injury, a fall, a car accident, or any direct blow to the face. The deviation may not cause noticeable symptoms immediately after an injury, but can become problematic years later.

It is also worth noting that a deviated septum frequently coexists with enlarged turbinates — the bony structures inside the nose that warm and humidify air. Turbinate swelling can compound the obstruction caused by a deviation and is often addressed at the same time as septoplasty.

Septoplasty vs. rhinoplasty — what is the difference?

Functional Surgery

Septoplasty

Goal: improve nasal breathing
Internal procedure — no external incisions
Does not change the external appearance of the nose
Typically covered by insurance when medically indicated
Recovery: 1–2 weeks, return to normal activity

Aesthetic Surgery

Rhinoplasty

Goal: change the shape or appearance of the nose
May involve internal and external incisions
Changes the external appearance of the nose
Cosmetic rhinoplasty not covered by insurance
Recovery: several weeks, swelling resolves over months

When both functional correction and cosmetic reshaping are desired, a combined correction can address both in a single procedure. Dr. Samarrai performs both septoplasty and combined correction and will advise which approach is appropriate based on your goals and examination findings.

Insurance coverage Septoplasty is generally covered by insurance when medically indicated. Unlike cosmetic rhinoplasty, septoplasty to correct nasal obstruction from a deviated septum is considered a functional, medically necessary procedure and is covered by most insurance plans including Medicaid when there is documented obstruction that has not responded to conservative treatment. We will help you verify your coverage before scheduling.

What to expect — the septoplasty procedure

Consultation & examination

Dr. Samarrai performs a thorough nasal examination including nasal endoscopy to assess the degree and location of the deviation, turbinate size, and overall nasal anatomy. She will discuss your symptoms, prior treatments, and surgical goals.

Outpatient surgery under general anesthesia

Septoplasty is performed under general anesthesia as an outpatient procedure — you go home the same day. The surgery is done entirely through the nostrils with no external cuts and no bruising of the outer nose.

The procedure

The lining of the septum is elevated, the deviated cartilage and bone are reshaped or removed, and the lining is repositioned. Turbinate reduction may be performed at the same time if enlarged turbinates are contributing to obstruction.

Recovery

Most patients go home within a few hours. Expect nasal congestion and mild discomfort for the first week as swelling resolves. Most patients return to desk work within a week and notice significant improvement in breathing within 2–4 weeks as swelling subsides.

Frequently asked questions

How do I know if my septum is deviated?

Many people have a deviated septum without knowing it. The signs are nasal obstruction — typically worse on one side — along with any of the symptoms described above. Diagnosis is made by nasal examination and, in some cases, endoscopy or CT imaging. Dr. Samarrai can assess your nasal airway at a consultation and tell you whether a deviated septum is contributing to your symptoms.

Can I try anything before considering surgery?

Yes. Nasal steroid sprays can help reduce mucosal swelling and improve airflow, particularly if allergic inflammation is contributing. Nasal dilator strips and saline irrigation can also provide symptomatic relief. However, these measures address swelling — not the underlying structural deviation. If the septum itself is the primary obstruction, medical management will provide limited long-term benefit and surgery is the definitive treatment.

Will septoplasty change how my nose looks?

No — a standard septoplasty is an internal procedure that does not alter the external shape of the nose. If you are also interested in changing the appearance of your nose, that would be addressed through rhinoplasty or combined correction, which can be combined with septoplasty in a single procedure.

How long does it take to notice improvement after septoplasty?

There is typically swelling inside the nose for several weeks after surgery, so the full benefit is not immediately apparent. Most patients notice meaningful improvement in breathing within 2–4 weeks, with continued improvement over the following months as residual swelling resolves.

Is septoplasty covered by insurance?

Septoplasty for documented nasal obstruction is generally covered by most insurance plans including Medicaid when there is a functional indication and conservative treatment has been tried. We will work with you to verify your specific coverage before scheduling any procedure.

Serving Brooklyn & Staten Island

Seaside ENT sees patients at 6818 3rd Ave, Brooklyn, NY 11220 in Bay Ridge and 1191 Forest Ave, Staten Island, NY 10310. Dr. Samarrai speaks both Arabic and English. Most major insurance plans are accepted including Medicaid.

General ENT | Brooklyn & Staten Island

Struggling to breathe through your nose?

Call Seaside ENT to schedule a nasal airway evaluation with Dr. Samarrai. Most insurance accepted.

Call (917) 992-3873

· Brooklyn & Staten Island