Deviated septum — it’s a term often thrown around. Yet its subtleties, identification, and treatment elude many. 

As a facial plastic and reconstructive surgeon in Denver, Colorado, I’m accustomed to unraveling this topic for my patients. The queries “how to tell if I have a deviated septum?” and “what does a deviated septum look like?” are ones that warrant exploration, as it is super common — affecting most everyone you know.

Let’s start by demystifying the deviated septum. The septum is the thin wall of cartilage and bone that divides the nasal cavity into two nostrils. Ideally, this partition should be centered, allowing for unobstructed airflow. However, in reality, the septum often deviates from this ideal alignment. Mother Nature doesn’t build in straight lines.

In fact, essentially everyone has some degree of septal deviation. But the crucial point lies in whether this deviation causes noticeable symptoms.

So, how can you discern if your septum is deviated? 

The hallmark indicators for deviated septum symptoms typically manifest in the form of nasal congestion, difficulty breathing through the nose, recurrent sinus infections, and snoring or sleep disturbances. However, these symptoms can stem from various nasal conditions, not solely a deviated septum. Thus, a thorough evaluation by a qualified specialist is indispensable for accurate diagnosis and tailored treatment recommendations.

One method to self-assess nasal airflow is the Cottle maneuver. Place your index fingers on each side of your nose and gently pull outward while inhaling. If you experience an improvement in nasal breathing, it could suggest nasal valve collapse, which is often associated with a deviated septum. However, this maneuver is not definitive and should be supplemented with professional assessment. As a rhinoplasty surgeon, I always perform the modified Cottle maneuver on patients who present with breathing problems. This involves using a Q-tip to stent open the nasal valves during breathing. If this improves breathing, the issue is likely nasal valve collapse.

Now, importantly, not all deviations necessitate intervention. Many individuals harbor mild septal deviations without ever experiencing significant symptoms. Conversely, others may have a seemingly trivial deviation that wreaks havoc on their nasal function. It’s the interplay between septal anatomy, valve function and individual physiology that dictates the clinical significance.

For those grappling with bothersome symptoms attributed to a deviated septum, a spectrum of treatment options exists. Conservative measures such as nasal saline irrigation, decongestants, and nasal steroid sprays may provide symptomatic relief. However, when conservative measures fall short, surgical intervention in the form of septoplasty or rhinoplasty may be warranted. These procedures aim to straighten the septum, alleviate nasal obstruction, and restore optimal nasal function.

Navigating the decision-making process surrounding septal surgery demands a holistic approach. Patient education, meticulous preoperative assessment, and open communication are paramount. It’s about empowering individuals to make informed choices aligned with their unique circumstances and treatment goals.

In conclusion, discerning whether you have a deviated septum requires keen awareness of associated symptoms and individual nasal physiology. While almost everyone harbors some degree of septal deviation, not all deviations provoke symptoms warranting intervention. By recognizing the telltale signs and seeking expert evaluation, individuals can embark on a journey toward improved nasal health and enhanced quality of life. 

Importantly, although I am a cosmetic rhinoplasty surgeon, I begin each and every rhinoplasty as a breathing operation. I am not willing to sacrifice the function of the nose as a breathing organ for form. It is my goal that each of my patients experience improved breathing after rhinoplasty with me, as it should be for any surgeon you select to operate on your nose!