Septoplasty (Breathing)

Septoplasty (Breathing)

Septoplasty is a surgical procedure in which a crooked or deviated septum is straightened. The septum is a crucial component to how the nose both looks and functions. The septum separates the nose into two different sides. On each side air is brought into the nasal cavity during breathing. Once air enters the nose several important things happen. The air is humidified and warmed. Air is also filtered of undesirable particles before passing further into our airway and lungs. The flow of air through our nose also influences how we smell. Interruption in any of these functions can have a significant negative impact on daily living. A deviated septum may disrupt some or even all of these functions. Symptoms for a deviated septum may range from minor annoyance to significant limitation of simple daily task. Dr. Lee states, “Some patients don’t even realize how much their life is restricted by their breathing until after surgery. It’s like when people with poor vision get glasses for the first time. They can’t believe how much of a difference it makes.

“Not being able to breathe through their nose can be a significant frustration for patients. If the problem is structural, surgery can improve and even cure many patients. Making the correct diagnosis is key to determining if surgery can help a patient. — Michael Lee, M.D.


Successful treatment for patients with nasal obstruction begins with proper diagnosis. Obstruction most often occurs at the nasal septum, nasal valve areas, or small bones in the nose called turbinates. Even still, other causes may be present as listed below. Identifying which structures are responsible provides the basis for determining what procedures are needed. The diagnosis is also important to determine if the obstruction is something that surgery can correct. Dr. Lee explains, “if the breathing problems are from something out of place such as a deviated septum or large turbinate, then surgery is likely to help. If the symptoms are related to allergic responses alone then surgery is not likely to help.” Many times there is a combination of true anatomic structures that are causing obstruction and the presence of allergic responses. In these cases surgery may be indicated but patients should also realize they will likely require medical treatment.

Indications for nasal airway surgery may include:

  • Deficiency of the external nasal valve
  • Deficiency of the internal nasal valve
  • Septal deviation
  • Septal spur formation
  • Septal perforation
  • Septal deficiency
  • Inferior turbinate hypertrophy
  • Middle turbinate concha bullosa
  • Nasal mass or polyp


Often septoplasty involves removing deviated cartilage from the nose to improve the passage of air. This cartilage is often used in rhinoplasty (reshaping of the nose) to make the nose more aesthetically pleasing. Patients that have at one time or another considered making aesthetic changes to their nose should consult a rhinoplasty surgeon before undergoing a septoplasty. Having both surgeries performed at the same time not only limits recovery to one operation but also maximizes the overall result. Dr. Lee is board certified both in Otolaryngology-Head and Neck Surgery (ENT) and in Plastic Surgery. He has published numerous peer-reviewed articles and book chapters on both rhinoplasty and septoplasty. He has lectured both nationally and internationally on the topics of aesthetic rhinoplasty and functional nasal surgery. With dual board certification, Dr. Lee specializes in treating the nose both aesthetically and functionally. Dr. Lee asserts, “Many times a nose that looks bad also has obstruction. This is particularly true when there is a significant deviation. I believe in treating the nose to maximize both the look of the nose and the way if functions.”


Educating patients on their exam findings in first and foremost for Dr. Lee. He states, “It is extremely important to educate patients on nasal obstruction and how this relates to their particular exam findings. I want them to make an educated decision on proceeding forward with surgery when indicated.” As a Plastic Surgeon he also believes it is important to listen to any aesthetic changes they would like made. It is important to Dr. Lee that the procedure creates a functional nose that is also aesthetically pleasing. “Artistically creating a nose that is balanced and harmonious with the face is the goal of aesthetic rhinoplasty. Using the cartilage I take during the septoplasty can help achieve the aesthetic goals as well,” says Dr. Lee.


Dr. Lee strongly believes that great surgery requires a meticulous attention to detail. Successful surgery of the airway begins with confirming the suspected problems. This is done in a very methodical manner studying each area that is a problem and correcting that problem. Dr. Lee helps many of his patients using an open approach septoplasty. This requires a very small incision hidden underneath the nose. All other incisions are made inside the nose. These incisions allow Dr. Lee to then visualize the entire septum and identify where the problem is located. It is not uncommon that the deviation is in places not always addressed with other approaches. Once identified, each area is corrected to open the nasal airway throughout. All potential areas of obstruction are treated to maximize the surgical result.


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