Do I Have a Deviated Septum? Symptoms and What to Do Next

A deviated septum is a common condition that often goes unnoticed until it starts causing nasal symptoms such as nasal congestion, trouble breathing, or frequent sinus infections. The nasal septum, made of bone and cartilage, separates your two nasal passages. When it’s off centre, this can reduce airflow and cause discomfort.

Here we’ll explain how to spot the symptoms of a deviated septum, how to check at home, and what treatment options are available.

Everyday Impact Score

Could your deviated septum be affecting your life more than you think?

Many people live with a deviated septum without realising how much it disrupts their daily comfort, sleep, or breathing. Use this quick score to reflect on your nasal symptoms, and help decide whether it’s time to seek advice.

How to use this score

• Read through each level below.
  
   
• Circle or tick the description that matches your experience.
  
   
• If you score 2 or higher, it could be worth speaking with a specialist.
  
   

Your Everyday Impact Score

Score

What it means

0

I breathe comfortably through my nose day and night. I rarely notice any nasal congestion.

1

I sometimes feel one side of my nose is blocked, but it clears up easily or doesn’t bother me.

2

I often have a blocked nose or sleep on one side for better breathing. Over-the-counter sprays help, but only for a short time.

3

I have nasal congestion most days, rely on mouth breathing, or wake up with a dry mouth. It affects my sleep or exercise.

4

My nose feels blocked nearly all the time. I feel tired or frustrated, and it’s affecting my daily life.

What to do next

If you score 2 or above, consider discussing options such as:

• Septoplasty
  
   
• Septorhinoplasty
  
   

Check your score & book your consultation today
Click here to book with Mr Aftab Ahmed

How can you check if you have a deviated septum?

While only a healthcare provider can give a proper deviated septum diagnosis, you can try a simple deviated septum self test at home:

• Stand in front of a mirror in bright light. Gently lift the tip of your nose, can you see if your septum looks crooked or leans to one side?
• Close one nostril and breathe through the other, then swap. Is one side clearly harder to breathe through?
• Think about whether you often feel more blocked on one side or have a preferred sleeping position for easier breathing.

If these checks suggest an issue, it’s a good idea to see a doctor specialising in ear nose and throat conditions.

What does the septum do?

The nasal septum is the wall of bone and cartilage that divides your nasal cavity into two. A straight septum allows air to flow smoothly through both nostrils, helping with breathing, humidifying air, and filtering particles. When the septum is deviated, it can narrow one or both nasal passages, making it harder to breathe through the nose.

How common is a deviated septum?

A nasal septum deviation is very common. Most people have some level of septal deviation, often without knowing it. However, only more significant deviations tend to cause noticeable nasal obstruction or difficulty breathing.

What are the symptoms of a deviated septum?

Many people with a deviated nasal septum don’t have any issues. But when the septum blocks airflow enough to cause problems, you might notice deviated septum symptoms:

• Nasal congestion or a constantly blocked nose, often worse on one side
• Frequent sinus infections or chronic sinusitis
• Facial pain or pressure
• Noisy breathing during sleep
• Mouth breathing, particularly at night
• A preference for sleeping on one side to improve breathing
• Nosebleeds due to drying of exposed blood vessels

In some cases, a deviated septum may contribute to sleep apnea or worsen existing breathing issues.

How is a deviated septum diagnosed?

A healthcare provider will typically diagnose a deviated septum during a physical exam. They may use a nasal speculum and light to look inside your nasal cavity and assess the position of your septum. Sometimes additional tests are done if sinus infections or other problems are suspected.

When is treatment needed?

If your nasal septum deviation isn’t causing symptoms, you may not need any treatment. But if you have ongoing nasal obstruction, trouble breathing, or repeated sinus infections, your doctor may suggest:

• Nasal steroid sprays or decongestants to reduce swelling and ease nasal congestion
• Septoplasty - a type of nasal surgery that straightens the septum to improve airflow
• Septorhinoplasty - surgery that combines septoplasty with reshaping the nose (rhinoplasty), which can address both breathing issues and cosmetic concerns

What happens during a septorhinoplasty?

Sometimes, people choose to have a septorhinoplasty, which combines septum surgery with reshaping the nose for cosmetic reasons.

Here’s what to expect:

• Consultation: If you are considering septorhinoplasty, there will be an assessment of your breathing issues, discuss any aesthetic goals, and create a personalised surgical plan tailored to your needs.
  
   
• Procedure: The surgery is carried out under general anaesthetic and usually takes 2–3 hours. It may include:
  
   
  • Septoplasty to straighten a deviated septum and improve airflow through the nasal passages
    
     
  • Rhinoplasty to reshape the nasal structure,  for example, smoothing a hump, refining the tip, or adjusting size and symmetry
    
     
• Recovery: Some swelling and bruising are normal for a few weeks. Most people feel comfortable returning to light activities within 10–14 days. Full results become clear as the nose continues to heal over the following months.

The Facts

In the NAIROS study, patients who had septoplasty for a deviated septum reported greater improvements in nasal breathing compared to those who had medical management alone. After 6 months, around 72% of patients who had septoplasty said their nasal function had improved, compared to 45% of those treated with medical therapies like sprays and advice.

When to see a specialist?

If you have ongoing blocked nose, difficulty breathing, or sinus infections that won’t go away, it’s a good idea to seek advice. A specialist can confirm if a deviated septum is causing symptoms and discuss whether deviated septum surgery could help.

Final thoughts

A deviated septum is a common cause of nasal obstruction and breathing issues. While mild cases often don’t need any treatment, options like nasal steroid sprays, septoplasty, or septorhinoplasty can make a real difference in more severe cases.

If you’re worried about your breathing or think you might have a deviated septum treated, consider booking a consultation to explore your options.

Frequently Asked Questions

How to tell if you have a deviated septum?

If you often have a blocked nose (especially on one side), noisy breathing, or a preference for sleeping on one side to breathe better, you may have a deviated septum. A simple self-check is to look inside your nose in a mirror and see if the septum looks crooked, or to test if one side feels harder to breathe through. For a proper deviated septum diagnosis, it’s best to see a healthcare provider or ear nose and throat specialist.

What happens if you don't get a deviated septum fixed?

If a deviated septum isn’t severe, it may not cause symptoms or need treatment. But if left untreated when it is causing problems, it can lead to ongoing nasal congestion, frequent sinus infections, poor sleep, or even contribute to conditions like sleep apnea.

What problems does a deviated septum cause?

A deviated septum can cause several issues, including:

• Nasal obstruction
• Difficulty breathing through the nose
• Noisy breathing at night
• Frequent sinus infections or chronic sinusitis
• Facial pain or pressure
• A tendency toward mouth breathing

Is fixing a deviated septum worth it?

If your nasal septum deviation is causing ongoing nasal symptoms, trouble breathing, or repeated sinus infections, then yes, many people find that septoplasty or septorhinoplasty significantly improves their quality of life.

Why is my left nostril always blocked?

If your left nostril is always blocked, it could be due to a deviated septum leaning towards that side, narrowing the nasal passage. Other causes could include swelling from allergies or nasal polyps. A specialist can check and provide the right diagnosis.

What is the best age to fix a deviated septum?

The best age for septum surgery is usually after the nose has finished growing, typically from the mid to late teens onwards. However, there’s no strict age limit, and adults of any age can benefit if the deviated septum is causing symptoms.

What is the downside of deviated septum surgery?

Septoplasty is generally safe, but like any nasal surgery, there are small risks. These can include temporary nasal congestion, bleeding, or, rarely, a change in the shape of the nose. Most people recover well and feel a big improvement in breathing.