context: A deviated septum can make it hard to breathe. But what is your septum and do you really need surgery to fix it? The nasal septum is the thin wall of bone and cartilage that separates the right and left nostrils. Most people have a septum that is at least slightly off-center. If your wall is way off, you have a deviated septum. Some people were born that way. For others, a nose injury was to blame. If you have a deviated septum, and it doesn't affect your breathing or lead to frequent sinus infections, also known as sinusitis, you can probably leave it alone. You may want to talk to your doctor about treatments other than surgery. But if your deviated septum blocks one or both nostrils so that it's hard or impossible to breathe through your nose, you may want to consider surgery. That stuffy nose can create a breeding ground for bacteria to grow. This causes painful inflammation and infection, which may keep you from getting better. If this is the case, an operation might help. Doctors call surgery to straighten the septum âseptoplasty.â It's usually done by an ear, nose, and throat specialist. Some people also get plastic surgery on their nose, to change its shape, at the same time. Your surgeon won't have to cut the skin on your face, where someone might see it. He can use instruments that he puts into the nostrils. Before your surgery, your doctor may tell you to avoid medications that include ibuprofen or aspirin, because they can make bleeding more likely. On the day of the operation you'll get some type of anesthesia. You may or may not be awake for the surgery, which will take about an hour and a half. Your surgeon will trim your septum and make it straighter. Sometimes, he may need to cut the bone in order to place it in the right position. You may also get silicone splints to keep your septum supported. Your doctor may decide you need nasal packing. This is when gauze-like material is placed in the nasal cavity to absorb blood or other fluids. He will remove them at your first follow-up appointment. If the specialist recommends surgery, you should feel free to ask about the risks and benefits. There's a chance you could have complications, such as: Bleeding Infection Bad reactions to anesthesia Slight tear or hole in the septum Sometimes after surgery, you might continue to have symptoms of sinusitis until the infection clears up completely. Or, if there were other blockages in your sinuses, such as polyps, there may still be some lingering breathing or drainage issues. Some people find that they have problems with their sense of smell after the procedure. These risks are slight. Your doctor should talk to you about all your concerns prior to surgery. The benefits can be life-changing. You might breathe better and have fewer sinus infections. You should be able to go home after the operation, but you will need someone to drive you home. There are some things that you'll need to remember in the days and weeks following surgery: Avoid heavy lifting and other hard activities. Keep your head raised when you sleep. You might need to use an extra pillow. Avoid blowing your nose. Make sure to get all your instructions in writing -- for care of your nose and for medications -- before you head home. It's very important to follow your doctor's advice to avoid complications.