Guess what? You could have a deviated septum and not even know it.
“Sometimes you just get used to it; other times, you don’t know any differently,” said Dr. Camilo Reyes-Gelves, an ear, nose and throat physician at Augusta University Health.
If you imagine the nose as a triangle divided in two, the septum is the structure that divides your two nasal cavities. It’s supposed to be straight. But sometimes, because of injury or trauma, bad allergies or your unique anatomy, it can “deviate” or move to the left or right, blocking one of your nostrils.
Here’s another clue: If you aren’t overweight and you tend to snore, you could have a deviated septum.
Some estimates say up to 70% of us have a deviated septum, although not all experience any problems with it. It’s when you have allergies, plus a deviated septum, that you can have some issues.
How Anatomy Affects Allergies
There are two reasons why a deviated septum is important when it comes to allergies:
- When allergies cause swelling and runny nose, those symptoms can be much more uncomfortable when your nose is already blocked by a deviated septum;
- Medications have a much harder time getting into your nose and reducing that swelling when you already have an anatomical blockage.
“Your nose is the first stop for many things we breathe,” said Reyes-Gelves. “It’s like a filter. Some of the things we do for allergies are nasal medications, inhalers and irrigation. But if you have a septal deviation, it’s difficult to get the medication in there.”
With only one side of the nose able to receive medication or irrigation, “the healthy side and the diseased side are fighting against each other, which means treatment doesn’t move forward,” he said. Over time, allergies could then cause major inflammation in your nasal tissues, even lead to polyps and eventually chronic sinusitis.
Treating a Deviated Septum
Once it’s confirmed that a person has allergies combined with a deviated septum, depending on how severe the allergies are, surgery to repair the deviated septum may be recommended.
During the surgery, an incision is made inside the nose, and the ENT removes some of the deviated portion, leaving enough of the septum to continue to provide support and shape for the nose. Sutures and internal silicone splints hold the nose in place while it heals. There’s no packing inside the nose, so patients shouldn’t see any bruising around the eyes, which can be common with other nose surgeries. Between one or two weeks later, the ENT will remove the splints in clinic by gently pulling them out.
Patients also should expect to have some trouble breathing through their nose for the first week or so since the tissues inside the nose will be swollen. But once the nose heals and the splints are removed, patients should experience a difference in their nasal breathing. “The surgery helps with ventilation, with washing the nose using an irrigation pump or neti pot, and with medication delivery,” said Reyes-Gelves.
Deviated Septum? Or Nose Job?
Actress Jennifer Aniston (and her Friends onscreen character Rachel Green) are well-known for having surgery to repair a deviated septum and a nose reduction at the same time. So the first question people might ask is: Will the surgery change how my nose looks?
“We explain to patients that the nose can change, but it’s unlikely to happen. It’s not the general rule for septoplasty,” said Reyes-Gelves. “The risk is higher if it’s a particularly bad septal deviation. Even then, any change is very minimal. If you have a round nose or a long nose, for example, that’s not going to change.”
That being said, if you are interested in changing the shape of your nose, now’s the time to ask about it—before surgery, not after.
“You want to do surgery once, and not go in and operate several times. That’s more difficult,” said Reyes-Gelves. “If you want your nose fixed, do it at the same time, the right way.”