Deviated Septum Surgery Nashville: What to Expect

Dr. Steven Enrich, MD · Published July 28, 2026

Deviated Septum Surgery Nashville: What to Expect

By Dr. Steven Enrich, MD — Board-Certified Otolaryngologist

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Deviated septum surgery, called septoplasty, is a procedure that straightens the cartilage and bone dividing the two sides of the nasal airway to restore normal breathing. The nasal septum sits at the center of the nose. A deviation—meaning it leans noticeably to one side—can narrow one or both nasal passages and cause chronic congestion, frequent sinus infections, or disrupted sleep. According to the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), an estimated 70–80% of the U.S. population has some degree of septal deviation, though only a fraction require surgery.

For patients in Middle Tennessee seeking deviated septum surgery, Nashville-based board-certified otolaryngologist Dr. Steven Enrich brings more than 20 years of surgical experience and fellowship training in Advanced Sinus and Skull Base Surgery. Dr. Enrich practices through Tennessee Breathe Free and is currently accepting new patients of all ages.

What Is Deviated Septum Surgery (Septoplasty)?

Septoplasty is the surgical correction of a displaced nasal septum—the wall of cartilage and bone that runs down the middle of the nose, separating the left and right nasal chambers.

A direct answer first: septoplasty repositions or removes the portions of the septum that block airflow, typically through the nostrils without any external incisions.

How the Procedure Works

The surgeon makes a small incision inside the nose to lift the mucous membrane lining away from the underlying cartilage and bone. Deviated sections are then reshaped, repositioned, or partially removed. The lining is laid back in place and, if needed, soft silicone splints or dissolvable sutures are used to hold everything while the tissue heals.

Septoplasty typically takes 60–90 minutes under general anesthesia, according to the American Society of Anesthesiologists. Most patients go home the same day.

When Septoplasty Is Combined with Other Procedures

Some patients need both structural correction and sinus drainage work at the same time. In those cases, septoplasty is often performed alongside endoscopic sinus surgery (FESS) or balloon sinuplasty. A rhinoplasty (reshaping the outer nose) can also be done at the same time—a combination called a septorhinoplasty.

Key facts: - Procedure time: 60–90 minutes - Anesthesia: general (outpatient) - Recovery before returning to work: typically 1–2 weeks - External scarring: none (incisions are internal) - Insurance coverage: usually covered when medically necessary

Why Do People Need Deviated Septum Surgery in Nashville?

Patients seek deviated septum surgery in Nashville for a range of reasons, most tied to breathing difficulty that medication alone cannot fix.

The septum can be deviated from birth or shift after a nasal injury—a sports collision, a fall, or any direct facial impact. Tennessee's high pollen counts compound breathing problems because already-narrowed nasal passages trap more allergens, worsening inflammation.

Common Symptoms That Lead to Septoplasty

Patients who schedule a consultation typically report one or more of these:

Who Is a Good Candidate?

A good candidate is an adult or older adolescent whose skeleton has fully matured—generally age 16 or older. Dr. Enrich evaluates each patient individually. Diagnostic clarity comes before any recommendation: he reviews nasal endoscopy findings and, where appropriate, CT imaging of the sinuses before confirming a surgical plan. Patients understand every option before agreeing to treatment.

How Does Deviated Septum Surgery in Nashville Work with Dr. Enrich?

Dr. Steven Enrich follows a structured, evidence-based process from the first appointment through post-operative care.

Step 1 — Initial consultation. Dr. Enrich reviews the patient's symptom history, performs nasal endoscopy in the office, and discusses non-surgical options. If medications such as intranasal corticosteroids (e.g., Flonase or Nasonex) or saline irrigation have not provided adequate relief, surgery becomes a serious consideration.

Step 2 — Pre-operative planning. Imaging (CT scan of the sinuses) clarifies the full anatomy. If chronic sinusitis accompanies the deviated septum, Dr. Enrich may recommend combining septoplasty with FESS or balloon sinuplasty in a single operating session.

Step 3 — Surgery. The procedure is performed under general anesthesia at an accredited outpatient surgical facility in the Nashville area. Dr. Enrich performs the correction through internal incisions, repositioning or trimming the displaced cartilage and bone.

Step 4 — Recovery. Nasal congestion and mild discomfort are normal in the first week. Most patients return to desk work within 7–10 days. Strenuous activity is restricted for 2–3 weeks. Nasal packing is not always required; Dr. Enrich uses internal splints or dissolvable sutures based on each case.

Step 5 — Follow-up. Office visits at one week and again at six weeks confirm healing and allow Dr. Enrich to clear any crusting with gentle endoscopic debridement.

Dr. Enrich's fellowship training in Advanced Sinus and Skull Base Surgery means he handles complex anatomy with the same precision applied to routine cases.

Deviated Septum Surgery vs. Non-Surgical Options: What Nashville Patients Should Know

Not every deviated septum requires an operation. Knowing the difference helps patients make informed decisions.

Option Best For Typical Result
Nasal corticosteroid spray (e.g., Flonase) Mild obstruction with inflammation Reduces swelling; does not fix structural deviation
Nasal dilator strips (e.g., Breathe Right) Nighttime snoring, mild blockage Temporary relief; no structural change
Septoplasty Structural deviation blocking airflow Permanent correction of the deviated anatomy
Septoplasty + FESS Deviation plus chronic sinusitis Corrects both structural and drainage problems
Septorhinoplasty Deviation with cosmetic nasal concerns Corrects function and external appearance

Medications and nasal rinses work well for inflammation-driven obstruction. When the blockage is structural—the cartilage or bone physically narrows the airway—no spray removes that tissue. Surgery is the only option that permanently corrects the anatomy.

Dr. Enrich will not recommend septoplasty unless conservative treatments have genuinely failed or imaging confirms obstruction severe enough to justify intervention. This evidence-based approach protects patients from unnecessary procedures.

What Is Recovery Like After Deviated Septum Surgery?

Recovery from septoplasty follows a fairly predictable timeline, though individual healing varies.

Days 1–3: Nasal congestion, mild swelling, and slight oozing are expected. Patients should sleep with the head elevated and avoid blowing the nose.

Days 4–7: Congestion begins to ease. Any internal splints are removed at the one-week office visit. Most patients feel well enough to return to sedentary work.

Weeks 2–3: Physical activity can resume gradually. Contact sports and heavy lifting remain off-limits.

Week 6 and beyond: The nasal passages reach close to their final open feel. Full internal healing can take 3–6 months, according to the AAO-HNS, because cartilage remodels slowly.

Tips to Speed Recovery

Most patients report a clear improvement in nasal airflow within 4–6 weeks. Those with a combined septoplasty and FESS procedure typically notice additional sinus pressure relief as inflammation fully resolves.

Why Choose Dr. Steven Enrich for Deviated Septum Surgery in Nashville?

Dr. Steven Enrich is a board-certified otolaryngologist practicing at Tennessee Breathe Free in Nashville, Tennessee. His background sets him apart in several practical ways.

Fellowship training in Advanced Sinus and Skull Base Surgery. This subspecialty training is beyond the standard otolaryngology residency. It prepares surgeons to manage complex nasal and sinus anatomy—the same precision matters during septoplasty.

More than 20 years of surgical experience. Volume and experience reduce operative risk and improve outcomes. Dr. Enrich has performed septoplasty procedures across a wide range of anatomical variations.

Shared decision-making. Every patient receives a clear explanation of their diagnosis, the non-surgical alternatives, and what surgery involves before any consent is discussed. Patients leave informed, not pressured.

Pediatric and adult care under one roof. Older adolescents with breathing problems caused by septal deviation can be evaluated by the same surgeon who treats adults—no separate referral needed.

Currently accepting new patients. Nashville-area adults and teens with nasal obstruction, chronic sinusitis, or snoring tied to a deviated septum can schedule a consultation directly.

Patients across Middle Tennessee—including those traveling from Murfreesboro, Franklin, Brentwood, and Hendersonville—regularly come to Dr. Enrich for ENT care they trust.

Frequently Asked Questions

How do I know if I need deviated septum surgery?

A deviated septum typically needs surgery when it causes persistent nasal obstruction, recurring sinus infections, or sleep disruption that does not improve with medications like nasal corticosteroid sprays or antihistamines. A board-certified ENT like Dr. Steven Enrich uses nasal endoscopy and, when needed, CT imaging to confirm whether the blockage is structural. If imaging shows the septum is physically narrowing the airway and conservative treatment has failed, septoplasty is usually recommended.

Is deviated septum surgery painful?

Septoplasty is performed under general anesthesia, so patients feel nothing during the procedure. Afterward, the most common complaint is nasal congestion and pressure—similar to a bad head cold—rather than sharp pain. Over-the-counter acetaminophen (Tylenol) manages discomfort for most patients. Dr. Enrich's post-operative instructions specify which pain relievers are safe, since aspirin and ibuprofen increase bleeding risk in the first two weeks after surgery.

How long does it take to recover from deviated septum surgery in Nashville?

Most patients return to desk work within 7–10 days of septoplasty. Strenuous activity is restricted for 2–3 weeks. Nasal congestion gradually improves over 4–6 weeks as swelling resolves. Full internal healing—meaning the cartilage has remodeled completely—can take up to 3–6 months, according to the American Academy of Otolaryngology–Head and Neck Surgery. Dr. Enrich schedules follow-up visits at one week and six weeks to monitor progress.

Will insurance cover deviated septum surgery?

Septoplasty is generally covered by health insurance when it is medically necessary—meaning it is performed to correct a breathing problem rather than for cosmetic reasons. Insurers typically require documentation of the obstruction (such as CT imaging and endoscopy results) and proof that conservative treatments were tried first. Dr. Enrich's team helps patients gather the clinical documentation needed for insurance authorization. Cosmetic rhinoplasty added to the procedure is usually not covered.

What is the difference between septoplasty and rhinoplasty?

Septoplasty corrects the internal nasal septum—the cartilage and bone inside the nose—to improve airflow. Rhinoplasty reshapes the external appearance of the nose. The two procedures address different problems. A septorhinoplasty combines both: fixing the internal deviation and altering the outer shape during a single operation. Most insurance plans cover septoplasty as a functional procedure but treat rhinoplasty as cosmetic unless an injury caused a visible deformity alongside the internal blockage.

Can a deviated septum cause sleep apnea or snoring?

A deviated septum can worsen snoring and contribute to obstructive sleep apnea by narrowing the nasal airway and forcing the body to breathe through the mouth at night. Mouth breathing causes the tongue and soft palate to partially collapse the throat, which generates the vibration of snoring and can trigger apnea events. Correcting the septal deviation with septoplasty often reduces nasal resistance enough to improve CPAP tolerance in sleep apnea patients, though it does not always eliminate apnea on its own.

Conclusion

A deviated septum that blocks airflow, disrupts sleep, or fuels recurring sinus infections is a structural problem—and structural problems rarely resolve on their own. For patients across Middle Tennessee, deviated septum surgery in Nashville with Dr. Steven Enrich offers a proven path to lasting relief. As a board-certified otolaryngologist with fellowship training in Advanced Sinus and Skull Base Surgery and more than 20 years of experience, Dr. Enrich brings both the technical skill and the patient-first approach that ENT care deserves.

If chronic nasal obstruction is affecting daily life, the first step is a straightforward consultation. Dr. Enrich will review the anatomy, explain every option honestly, and help determine whether septoplasty is the right answer. Tennessee Breathe Free is currently accepting new patients of all ages in the Nashville area. Reach out today to schedule an appointment.