The nasal septum is the wall of cartilage and bone that divides the nose into two separate passages. When this structure is significantly crooked or bent—a condition known as a deviated septum—it can severely restrict airflow and cause breathing difficulties. Septoplasty is the surgical procedure performed to correct this internal misalignment, repositioning the septum to the center of the nasal cavity. Many people considering this operation are concerned about whether improving their breathing will change the appearance of their nose.
Understanding Septoplasty: Function Over Form
The primary goal of a standard septoplasty is to correct structural issues inside the nose to improve a patient’s ability to breathe. The procedure focuses on straightening or removing the deviated portions of the bone and cartilage that cause the obstruction. This is a functional surgery, performed for a medical purpose rather than an aesthetic one.
The surgeon works entirely through incisions made inside the nostrils, meaning no external cuts are made. They lift the mucosal lining covering the septum to access the underlying crooked cartilage or bone. The problematic sections are then trimmed, reshaped, or repositioned before the mucosal lining is laid back over the straightened structure.
The Standard Outcome for Nose Appearance
In the vast majority of cases, a standard septoplasty does not change the external shape or appearance of the nose. This is because the procedure is designed to preserve the nasal pyramid, the external supporting structure. The surgeon intentionally leaves a strong, intact strip of cartilage, often referred to as the L-strut, along the top and front edge of the septum.
This preserved segment provides structural support for the bridge and the tip of the nose. Since the work is performed underneath the mucosal lining and away from this outer support structure, the external contours remain undisturbed. The external skin, bone, and cartilage are left intact, ensuring the patient’s nose looks the same after healing as it did before the operation. In some instances where the septum was severely deviated and caused visible crookedness, correcting the internal structure may result in a minor, subtle improvement in symmetry, though this is a secondary effect.
Situations That Result in Aesthetic Changes
While a standard septoplasty is not intended to change the nose’s shape, there are two main scenarios where an aesthetic change may occur. The first is a planned change, involving combining septoplasty with rhinoplasty (a cosmetic procedure), resulting in a septorhinoplasty. This combined surgery is performed when a patient wants to correct breathing issues and simultaneously refine the size, shape, or profile of their nose.
The second scenario is an unintended change, which is a rare but serious complication. If too much septal cartilage is removed, or if the remaining L-strut is damaged or destabilized, the supporting structure of the nose can collapse. This loss of support can lead to a condition known as a saddle nose deformity, characterized by a noticeable depression or caving-in of the nasal bridge. Surgeons take precautions to avoid this complication, often by ensuring the remaining L-strut is at least 10 to 15 millimeters wide to maintain structural integrity.
Differentiating Swelling from Permanent Alteration
A common concern immediately following the procedure is the temporary change in the nose’s appearance due to post-operative swelling and bruising. Significant swelling is a normal part of the healing process after any nasal surgery, including septoplasty. This swelling can make the nose look temporarily wider, larger, or slightly different in shape, particularly around the tip and bridge.
The initial, noticeable swelling subsides dramatically within the first two to four weeks following the surgery. However, residual swelling, especially around the nasal tip, can take much longer to resolve completely. While patients often feel fully recovered within one to two months, the final, subtle reduction in swelling can continue for six months to a full year. Patients should maintain open communication with their surgeon if they have concerns about their nasal appearance during recovery.