The 2025 New Year list of nasal septum deviation correction

Introduction

As we step into 2025, the demand for nasal septum deviation correction surgery, also known as septoplasty, in New York City continues to rise. A deviated septum can lead to a range of issues, from breathing difficulties and chronic sinus problems to sleep apnea and frequent nosebleeds. In this article, we will explore everything you need to know about septoplasty in New York City, including what it is, the causes and symptoms of a deviated septum, candidates for the surgery, different surgical approaches, recovery, risks, and some of the top surgeons in the city.

The 2025 New Year list of nasal septum deviation correction surgery in New York City is revealed!

What is a Deviated Septum?

The nasal septum is the wall that divides the two nasal cavities. A deviated septum occurs when this wall is significantly off - center or crooked. In a normal, healthy nose, the septum runs down the center of the nose, creating two equal - sized nasal passages for optimal airflow. However, when the septum is deviated, it can partially or completely block one or both airway passages.

According to various sources, many people have some degree of septum deviation, but not all deviations cause problems. It is estimated that about 40 - 60% of the population has a deviated septum, but only a fraction of them experience symptoms severe enough to require surgical intervention.

Causes of a Deviated Septum

Congenital Development: Some individuals are born with a deviated septum due to genetic factors or developmental variations. The misalignment may become more noticeable during adolescence as facial features continue to develop, often leading to progressive breathing difficulties.
Facial Trauma: Physical impacts from sports injuries, accidents, or falls can cause immediate septal deviation. For example, getting hit in the nose during a boxing match or a car accident where the nose hits the steering wheel can reshape the septum.
Medical Conditions: Certain conditions can also affect septal alignment. Nasal polyps can cause structural changes, inflammatory processes can affect nasal tissues, chronic sinus infections can lead to gradual deviation, and in rare cases, tumors can cause septal displacement.

Symptoms of a Deviated Septum

Breathing Difficulties: The most common symptom is difficulty breathing through the nose. This can manifest as a feeling of congestion, extra effort for inhalation of air, and loud snoring at night.
Chronic Sinus Infections: A deviated septum can impede the normal drainage of the sinuses, leading to a buildup of mucus and an increased risk of sinus infections.
Nosebleeds: The deviation may expose part of the septum to dry air, causing the nasal lining to become dry and prone to bleeding.
Headaches: Pressure on the sinuses due to the deviated septum can result in headaches, often concentrated around the nose.
Sleep Apnea: In some cases, a deviated septum can contribute to sleep apnea, a serious sleep disorder characterized by pauses in breathing during sleep.

What is Septoplasty?

Septoplasty is a surgical procedure designed to correct a deviated nasal septum. It is also referred to as septal reconstruction or submucous septal resection. The goal of septoplasty is to straighten the partition between the two nasal cavities so that it runs down the center of the nose in the ideal anatomical formation, thereby improving airflow and reducing or eliminating the symptoms associated with a deviated septum.

During a septoplasty operation, which is generally done under general anesthesia, the surgeon will make an incision on the lower portion of the septum, known as the caudal septum, and then work through the nostrils to access the bone and cartilage targeted in the procedure. The steps involved in most septoplasty procedures typically include:

Initial Incision: To expose the deviated septum.
Identifying and Releasing Internal Structures: The surgeon will identify and release the internal structures that are the cause of angulations in the septum.
Realigning the Septum: The septum is then realigned to its proper position.
Reimplanting Crushed Cartilage (when appropriate): In some cases, crushed cartilage may be reimplanted to provide additional support.
Closure of the Incision: Once the septum is straightened, the incision is closed.

Candidates for Septoplasty

Septoplasty is typically indicated for individuals with the following conditions:

Recurrent Rhinitis: Chronic inflammation of the nasal mucosa can be exacerbated by a deviated septum, and septoplasty may help alleviate the symptoms.
Deviated Septum with Significant Symptoms: Those experiencing breathing difficulties, chronic sinusitis, or recurrent epistaxis (nosebleeds) due to septal impaction or septal spur are good candidates for the surgery.
Cosmetic Purposes: In some cases, septoplasty can be performed to straighten a crooked or deviated nose for aesthetic reasons, either alone or in combination with rhinoplasty.

However, not everyone is a suitable candidate for septoplasty. Patients presenting with acute sinus or nasal infection, untreated diabetes, bleeding diathesis, or severe hypertension are generally not recommended for the surgery. Children with underdeveloped cartilage may also not be suitable candidates, as their nasal structures are still growing.

Types of Surgical Approaches for Septoplasty

Closed Septoplasty

This is the most common type of septoplasty. It involves making an internal incision to expose the cartilage. The advantage of the closed approach is that there are no external scars. The surgeon works through the nostrils to access and correct the deviated septum. This approach is suitable for many cases where the deviation is not too severe and does not require extensive exposure of the nasal structures.

Open Septoplasty

An open septoplasty is a less common choice for deviated septum surgery. It involves making an incision on the outside of the nose (hidden at the columella) and the inside. This more advanced approach is useful when the front part of the septum (caudal septum) badly deviates and a more extensive septoplasty procedure is required. Although it leaves a small external scar, the open approach allows for better visualization and access to the nasal structures, enabling more precise correction.

Endoscopic Septoplasty

Some septoplasty surgeries can be performed with a minimally invasive endoscopic approach. This approach works well for a posterior - based septal deflection where an incision towards the front of the nose can be avoided. The surgeon uses an endoscope, a thin tube with a light and camera, to view and correct the septum through small incisions inside the nose. The endoscopic approach is associated with less tissue trauma, reduced pain, and a faster recovery time compared to the open approach.

Preparing for Septoplasty

Proper preparation is essential for a successful septoplasty procedure. Patients are usually advised to:

Avoid Certain Medications and Supplements: Medications and supplements that may thin the blood, such as aspirin, non - steroidal anti - inflammatory drugs (NSAIDs), and some herbal supplements, should be avoided for a few days prior to surgery to reduce the risk of bleeding.
Stop Smoking: Smoking can decrease blood flow to the skin and compromise the healing of the surgical site. Patients are typically advised to stop smoking at least 2 weeks before surgery.
Stop Nasal Sprays: All nasal sprays, except for saline, should be stopped 2 weeks before surgery to ensure the nasal tissues are in the best condition for the procedure.
Fasting: Patients are usually instructed not to eat or drink for 6 hours before the scheduled surgery to prevent complications during anesthesia.

The Septoplasty Procedure

On the day of the procedure, the patient will be admitted to the operating room. Septoplasty is usually performed under general anesthesia, with an anesthesiologist present to monitor the patient's vital signs throughout the surgery. The following are the general steps of the septoplasty procedure:

Anesthesia: Once the patient is under general anesthesia, 1% lidocaine with epinephrine is often used to provide local anesthesia mainly to shrink the blood vessels and reduce bleeding during the procedure.
Incision: The septoplasty incision is made either through a closed or open approach as described earlier.
Dissection: A plane right over the cartilage is used to expose the cartilage and adjacent bone posteriorly and inferiorly. The surgeon must be extra cautious not to create any rents in the flap of tissue that is raised off of the underlying structures, as this can predispose to septal perforations (a hole in the septum).
Removal: Once full exposure is obtained, the deviated segment of cartilage and/or bone is removed. It is important to leave a sufficient amount of septal cartilage in place to prevent the collapse of the nose. If an open approach is used and a septal reconstruction is planned, a segment of cartilage may be removed, reoriented, and supported, and then placed back into position.
Closure: Once the septum is straightened, the incision is closed. Internal nose splints are often sutured into place to hold the cartilage and tissue flaps (mucopericondrium) together. Packing is rarely needed.

The duration of the septoplasty procedure can vary depending on the complexity of the case. It can take anywhere from 30 to 90 minutes, but more complex cases may take longer.

Recovery from Septoplasty

Recovery from septoplasty is an important part of the overall process. Patients can expect the following during their recovery:

Initial Discomfort: During the first few days to weeks, the nose will be stuffy, and there may be light bleeding from the nose for the first 48 hours, although severe bleeding is rare. Patients may also experience mild to moderate tenderness or pain at the front of the nose, as well as swelling.
Follow - up Appointments: The internal nasal splints are usually removed at the first follow - up appointment, which is typically about 1 week after the surgery. The doctor will also monitor the patient's progress and check for any signs of complications.
Restrictions: It is important to avoid strenuous activity such as exercise or heavy lifting for at least 1 week after the surgery. Patients should also avoid blowing their nose for a few days to prevent dislodging the sutures or causing bleeding. They are often advised to sleep with their head elevated for a few days to reduce swelling.
Full Recovery: Full recovery and stability of the tissues can take up to one year, but most patients should start to notice significant improvement in their breathing within a few weeks. However, it may take several months for the internal healing to be complete, and the final results of the surgery may not be fully apparent until then.

Risks and Complications of Septoplasty

While septoplasty is a common surgical procedure with a very low risk of complications when performed by a board - certified plastic surgeon or otolaryngologist, there are still some potential risks involved:

Bleeding: Continued bleeding after the surgery is possible, although it is usually minor and can be controlled with proper treatment. In rare cases, severe bleeding may require additional medical intervention.
Infection: There is a small risk of infection at the surgical site. Signs of infection may include fever, increased pain, redness, or discharge from the nose. If an infection occurs, it can usually be treated with antibiotics.
Poor Scarring: Although septoplasty is generally associated with minimal scarring, in some cases, the scar may be more noticeable or may not heal as well as expected.
Undesirable Aesthetic Result: If the surgery is also being performed for cosmetic reasons, there is a risk that the patient may not be satisfied with the final appearance of the nose. However, experienced surgeons take great care to achieve natural - looking results.
Upper Dental Numbness: Some patients may experience temporary or permanent numbness in the upper teeth or gums as a result of nerve damage during the surgery.
Persistent or Relapse of Deviation: In rare cases, the septum may deviate again over time, requiring a revision septoplasty.
Septal Perforation: A hole in the septum can occur if the tissue flaps are not properly handled during the surgery or if there is an infection. Septal perforation can cause problems such as a whistling sound when breathing, crusting, and nosebleeds.
Saddle Nose (Bridge Collapse): If too much cartilage is removed during the surgery, the bridge of the nose may collapse, resulting in a saddle - shaped deformity. This is a rare but serious complication.
Persistent Nasal Congestion: In some cases, the patient may still experience nasal congestion after the surgery, although this is usually due to swelling or other factors and can improve with time.
Decreased Sense of Smell: There is a small risk of a decreased sense of smell, which may be temporary or permanent.
Septal Hematoma (Blood Collection): A collection of blood in the septum can occur after the surgery, which may require drainage to prevent further complications.

Top Surgeons for Septoplasty in New York City

Dr. David Cangello

Dr. David Cangello is a plastic surgeon in New York City who specializes in septoplasty. He tailors each septoplasty procedure to the individual patient, taking into account the unique anatomy of the septum. Dr. Cangello will determine the most appropriate surgical approach, whether it is a closed, open, or endoscopic technique, based on the patient's needs. He has extensive experience in nasal surgery and can be contacted at (646) 665 - 4222 to schedule a consultation.

Dr. Sam S. Rizk

Dr. Sam S. Rizk is considered one of the best facial plastic surgeons for treating deviated septum. Certified by the American Board of Facial Plastic Surgery and the ABOHNS, he uses advanced septoplasty techniques and technologies to ensure optimal, natural - looking results. He conducts a detailed imaging analysis before surgery to measure the septal deviation and surrounding nasal structures, allowing him to plan the most effective approach for each patient. His surgical approach combines precise measurements of tip angle and nasal rotation to ensure optimal breathing function while maintaining facial harmony. Patients can book an appointment at (212) 452 3362.

Dr. Gary Linkov

Dr. Gary Linkov is a board - certified facial plastic surgeon in New York City. He is the chief of otolaryngology and facial plastic surgery for the Veterans Hospital in Brooklyn, NY, where he operates on complex nasal deformities. At City Facial Plastics in Manhattan, he offers septoplasty to restore the shape and function of the nasal passages. Dr. Linkov can perform septoplasty alone or in combination with rhinoplasty, depending on the patient's preferences. He has a very experienced team and is known for his excellent bedside manners. Patients can contact the office at 212.439.5177 to schedule a consultation.

Dr. Richard Westreich

Dr. Richard Westreich is double board - certified in facial plastic surgery and otolaryngology. He has an intricate understanding of nasal anatomy and contours, allowing him to customize each septoplasty surgery for each patient's unique goals, whether it is functional, cosmetic, or combined. Dr. Westreich uses a variety of techniques, including the foundation rhinoplasty technique for crooked or deviated noses, which helps to support the nose from the ground up and improve breathing and nasal function. He takes an anatomically based natural approach to the surgery, aiming for more natural - looking results. Patients can schedule a consultation at his New York City office to discuss their options.

Dr. Casian Monaco

Dr. Casian Monaco, MD, is a prominent plastic surgeon in New York City who specializes in septoplasty repair. He employs the latest surgical techniques to correct the deviation with minimal discomfort and downtime. His procedure involves a thorough assessment of the internal nasal structure, followed by corrective surgery to straighten and reposition the septum centrally in the nasal cavity. He uses minimal incisions to minimize visible scarring and promote faster healing. Dr.