Septoplasty in Switzerland: correcting a deviated septum to breathe better

Having a nose that is permanently blocked on one side, breathing through your mouth at night, waking up with a dry throat, running out of breath during sport: these everyday problems are often linked to a deviated nasal septum. Septoplasty is the procedure that corrects it. Unlike cosmetic rhinoplasty, it is above all functional surgery, most often performed by an ENT doctor, and generally covered by compulsory health insurance when medically justified. This page explains how to recognise a troublesome deviation, how the diagnosis is made, which treatments to try first, how the procedure is performed, what to expect from recovery, how coverage works in Switzerland and where to be treated in each of the 26 cantons.

The nasal septum separates the two nasal cavities; when it is deviated, it can obstruct one side of the nose. Septoplasty straightens it from inside the nostrils, with no visible scar and without changing the external shape of the nose. It generally takes thirty minutes to an hour and a half, often as day surgery. The nose remains blocked and crusty for one to two weeks; breathing then gradually improves. When medically justified, it is covered by basic insurance, with the usual deductible and co-payment. If a cosmetic change is wanted at the same time, it is called septorhinoplasty; see our page on rhinoplasty in Switzerland.

The septum is a vertical wall that divides the inside of the nose into two cavities. At the front, it is made of a plate of flexible cartilage, the quadrangular cartilage; at the back, of thin plates of bone, the perpendicular plate of the ethmoid and the vomer. It is covered on each side by a mucous membrane rich in blood vessels.

A perfectly straight septum is rare

Most adults have a slightly deviated septum without any symptoms. A deviation becomes a problem when it narrows a nasal cavity enough to impair airflow, or when it encourages other problems such as repeated bleeding or sinusitis.

Causes

Growth

During childhood and adolescence, the cartilage and bones of the septum grow at different rates. The septum may bend, or form a ridge or spur.

Injuries

A fall, a sports impact or an accident, sometimes in childhood and long forgotten, can fracture or displace the septum. Contact sports common in Switzerland, such as ice hockey and football, are classic causes.

Birth

Passage through the birth canal can sometimes deform the newborn's septum.

Previous surgery

More rarely, a previous procedure on the nose has left a residual deviation.

Types of deviation

The position of the deviation matters as much as its size. A small deviation at the front of the nose, at the nasal valve, the narrowest passage, is often more troublesome than a marked deviation further back, where the nasal cavities are wider.

The symptoms of a deviated septum are often played down for years. Recognising them is the first step.

• A permanently blocked nose, often always on the same side.
• Mouth breathing, especially at night, with a dry mouth and throat on waking.
• Snoring or unrefreshing sleep.
• Getting out of breath more quickly during sport, needing to breathe through the mouth.
• Repeated nosebleeds, often on the same side.
• Sinusitis or colds that drag on.
• Increased sensitivity of the mucous membranes, with crusting.
• Difficulty tolerating a night-time ventilation mask, in people treated for sleep apnoea.

The nasal cycle: not to be confused

It is normal to breathe slightly better on one side than the other, alternately, during the day: this is the nasal cycle, linked to the alternating swelling and shrinking of the mucous membranes. An obstruction that always remains on the same side, whatever the time, points more towards an anatomical cause such as a deviation.

Other causes of obstruction

A blocked nose is not always due to the septum. Allergic rhinitis, chronic non-allergic rhinitis, enlarged turbinates, polyps, a weak nasal valve, chronic sinusitis or overuse of decongestant sprays can also be responsible, alone or combined with a deviation. That is why a full examination by a doctor, ideally an ENT specialist, is essential before any decision.

The interview

The doctor asks about the nature of the problem, how long it has existed, the side affected, variations during the day and with the seasons, snoring, sleep, bleeding, infections, allergies, treatments tried and any injury. Some doctors use a short standardised questionnaire to measure the severity of the symptoms and compare them after treatment.

Anterior rhinoscopy

Using a speculum and a light, they examine the front of the nasal cavities, the front part of the septum and the turbinates.

Nasal endoscopy

A fine scope, rigid or flexible, is introduced into each nostril after an anaesthetic and decongestant spray. It shows the whole septum, the turbinates, the back of the nasal cavities and the entrance to the sinuses. The examination is quick and only mildly uncomfortable.

The test before and after decongestion

By comparing breathing before and after a decongestant spray, the doctor distinguishes what is due to the mucous membrane, which shrinks, from what is due to the structure, which does not change.

The valve manoeuvre

By gently pulling the cheek outwards near the side of the nose, or supporting the ala from inside, they assess the role of the nasal valve.

Airflow measurements

Some centres objectively measure nasal resistance or inspiratory airflow, by rhinomanometry or flow measurement. These measurements complement the examination and can support a coverage request.

Imaging

A CT scan is not needed for a simple deviation. It is requested if chronic sinusitis or polyps are suspected, or before associated sinus surgery.

Endoscopic examination of the nose, carried out in the consulting room in a few minutes after local anaesthesia with a spray, shows the septum, the turbinates and the entrance to the sinuses. A sinus CT scan is requested when chronic sinusitis or polyps are suspected, or to plan more extensive surgery. For an isolated, obvious deviation, it is not always necessary.

Before proposing surgery, the doctor checks whether part of the obstruction can be treated with medication. This is often the case when the mucous membrane is inflamed, which worsens the effect of a deviation.

Saline rinses

They clean the nasal cavities, remove secretions and allergens, and improve comfort. They are useful both before and after surgery.

Corticosteroid sprays

Used regularly for several weeks, they reduce inflammation of the mucous membrane and the size of the turbinates, particularly in allergic rhinitis. Their effect is gradual.

Antihistamines

In cases of allergy, they relieve sneezing, itching and discharge, with a more limited effect on obstruction.

Decongestant sprays

They unblock the nose quickly, but prolonged use beyond a few days leads to dependence and rebound swelling, called rhinitis medicamentosa. They are not a long-term treatment.

Nasal dilators

Adhesive strips or small devices placed in the nostrils can improve airflow, particularly at night or during sport, when the valve is involved.

If obstruction persists despite properly conducted medical treatment for several weeks, and a significant deviation is found, septoplasty becomes a logical option. A large randomised study has also shown that, in adults with troublesome obstruction linked to a deviation, septoplasty brought greater improvement than medical treatment alone.

Anaesthesia

Septoplasty is usually performed under general anaesthesia. In some cases, particularly for limited corrections, local anaesthesia with sedation may be offered.

The incision

The surgeon makes an incision inside one nostril, on the mucous membrane of the septum. No incision is visible from the outside.

Elevation of the mucosa

They carefully lift the mucous membrane on each side of the septum, like lifting a tablecloth, to expose the cartilage and bone.

The correction

They remove or straighten the deviated parts: bony spur, ridge, curved portion of cartilage. They always keep an L-shaped strip of cartilage, along the bridge and at the front, which supports the nose. The cartilage removed can be straightened and replaced, or kept as a graft if rhinoplasty is combined.

Repositioning

They put the mucous membrane back on the straightened septum and hold it in place with fine stitches, sometimes with silicone splints placed on each side. Compressive packing is now used less and, when it is used, is removed quickly.

Combined procedures

The surgeon can reduce the size of the turbinates, treat the nasal valve or, as part of endoscopic surgery, open the sinuses. These steps are decided at the consultation.

Technical variants

The procedure generally takes thirty minutes to an hour and a half, longer with combined procedures. It is often performed as day surgery, sometimes with a night in hospital or at the clinic depending on the anaesthesia and your health.

Septoplasty leaves no visible mark and rarely causes bruising around the eyes, since the nasal bones are not moved. The discomfort comes mainly from inside: blocked nose, crusts, secretions.

A blocked nose in the first few days

This is the main discomfort. The lifted mucous membrane swells, the splints or any packing take up space, and clots form. It is only after a few days, and especially after the splints are removed, that you begin to breathe through your nose. It is therefore normal not to feel any immediate improvement.

Crusts and rinsing

For two to three weeks, crusts form in the nasal cavities. Saline rinses several times a day soften and remove them. Do not pull them off with your fingers.

Nose-blowing

Avoid blowing your nose hard for about two weeks, so as not to cause bleeding. When you sneeze, keep your mouth open.

The upper teeth

Numbness of the upper incisors or palate is possible for a few weeks, as small nerves run near the base of the septum. It generally disappears on its own.

Work

For office work, a return is often possible after about a week. A physical job, one exposed to dust or requiring exertion needs more like two weeks. For a medically justified septoplasty, a certificate of incapacity for work is issued under the usual rules.

Sport and altitude

Gentle exercise resumes around the third week, intense sport after four to six weeks. Contact sports have to wait longer. Avoid significant pressure changes, such as diving, for several weeks, and talk to your doctor before a stay at high altitude or a flight.

Septoplasty is a common and safe procedure. Complications are uncommon, but it is important to know about them.

Bleeding

Slight bleeding is normal in the first few days. Heavy bleeding is rare; it may require new packing.

Septal haematoma

A collection of blood between the mucous membrane and the cartilage can cause complete, painful obstruction. It must be drained quickly to prevent infection or damage to the cartilage.

Infection

Rare, it is treated with antibiotics.

Septal perforation

A small hole can form if the mucous membrane is torn on both sides at the same point. It may go unnoticed or cause crusting, bleeding or whistling. It is treated according to its size and the discomfort it causes.

Adhesions

Bridges of scar tissue, called synechiae, can form between the septum and the turbinates, especially if the turbinates have been operated on. Splints help prevent them; they can be simply divided if they cause problems.

Residual deviation

Part of the deviation may persist or reappear, particularly because of the memory of the cartilage. A revision is sometimes necessary.

Collapse of the bridge

Excessive removal of cartilage can, rarely, weaken the support of the nose and cause the bridge to collapse. Keeping a sufficient L-shaped framework prevents this risk.

Changes in sense of smell

A temporary reduction in the sense of smell is common during healing; lasting impairment is exceptional.

Warning signs

Heavy bleeding that does not stop when sitting with the head tilted forward, fever, nasal pain that increases with complete obstruction, redness or swelling of the nose, a purulent discharge. Contact the team without delay; in an emergency, call 144.

Most patients who have surgery for a significant deviation notice a clear improvement in their nasal breathing, often most appreciated at night and during exertion. Sleep may become more refreshing, and the mouth less dry on waking. Bleeding linked to a spur often disappears.

Results are less good when the obstruction has other untreated causes: allergic rhinitis, enlarged turbinates, a weak valve. That is why the assessment must identify all the causes and, if necessary, treat them at the same time. Septoplasty does not cure an allergy, does not always stop snoring and does not treat sleep apnoea on its own.

Recent studies show that septoplasty clearly improves nasal breathing and quality of life in most well-selected patients, namely those whose symptoms are genuinely linked to a deviated septum and in whom medical treatments have not been enough. Results are less good when the obstruction has other untreated causes, such as an allergy or a narrow nasal valve, hence the importance of a complete diagnosis before deciding.

Septoplasty improves breathing when the deviated septum is the main cause. It does not change the external shape of the nose, does not cure an allergy, does not stop colds and does not guarantee that snoring will disappear. Discussing with the ENT specialist what the procedure can and cannot achieve, based on the examinations, allows you to approach it with the right expectations.

Septoplasty has a special place: unlike most of the procedures presented on this site, it is in principle a benefit of compulsory health insurance when it treats medically established nasal obstruction. Here is how it works in practice.

The condition: a medical indication

Basic insurance covers effective, appropriate and cost-effective services intended to treat an illness. Nasal obstruction due to a deviated septum, documented by examination and, ideally, after failure of medical treatment, meets this definition. The ENT specialist records the indication in your file and, if necessary, in a report to the insurer.

Cost-sharing

As for any basic insurance benefit, you pay your deductible, if not yet reached, then a co-payment of 10% of costs, capped each year. For a hospital stay, a flat daily contribution to hospital costs is added, according to the rules in force.

Outpatient or inpatient

The trend is to perform many procedures on an outpatient basis when medically possible, and some appear on lists of procedures that should in principle be performed without hospitalisation. Your doctor will tell you which form is planned for you, depending on your health and any combined procedures.

Free choice of hospital

For a hospital stay, you can in principle choose a hospital on any canton's hospital list, even outside your canton of residence. Basic insurance and the canton then cover the costs up to the tariff applicable in your canton; any difference may remain at your expense if you do not have supplementary insurance covering this case.

Supplementary insurance

Supplementary hospital insurance, in the semi-private or private ward, allows in particular free choice of doctor and a single or double room. It may also cover certain costs not covered by basic insurance, depending on the conditions of your policy.

Accidents

If the deviation results from an accident, accident insurance is in principle responsible: the employer's compulsory accident insurance for employees, or health insurance with accident cover for others. Keep the documents relating to the accident, even an old one, and tell your doctor about it.

Combination with a cosmetic procedure

If you want to take advantage of the procedure to change the shape of the nose, the cosmetic part is billed separately and remains at your expense. A prior cost approval request that clearly distinguishes the two parts is then strongly recommended.

These principles are general: the exact rules depend on your policy and your situation. If in doubt, ask your insurer for a written answer before the procedure.

Septoplasty is performed mainly by specialists in otorhinolaryngology and head and neck surgery, in both public hospitals and the private sector. Unlike purely cosmetic procedures, provision is therefore spread throughout the country, including in regional hospitals.

University hospitals

Geneva, Lausanne, Bern, Basel and Zurich have university ENT departments, which treat all nasal conditions, including complex cases, revisions and combinations with sinus surgery.

Cantonal and regional hospitals

Most cantons have an ENT department or clinics at their cantonal hospital, where routine septoplasties are performed. This is often the nearest option for patients in medium-sized cantons.

ENT specialists in private practice

Many ENT specialists in private practice see patients, make the indication and operate in clinics or hospitals with which they work. They are often the most accessible contact for a first opinion.

Private clinics

They treat patients with supplementary insurance, or those who combine a cosmetic procedure. Plastic surgeons also perform septorhinoplasty there.

Because septoplasty is performed in cantonal and regional hospitals, provision is much closer to home than for cosmetic surgery. For 49 cities, this table shows where you can generally be treated and the type of provision available. It does not replace information from your doctor, who will refer you according to your situation.

For a septoplasty covered by basic insurance, the cost is paid by the insurer and, for a hospital stay, by the canton, according to the applicable tariffs. Your share depends on your deductible and co-payment. For procedures not covered or for patients who want private treatment, the table below positions the procedures relative to one another, taking septoplasty alone as a base of 100.

For the cosmetic part of a septorhinoplasty, differences between cities are detailed on our page on septoplasty prices in Switzerland.

These profiles are fictitious, inspired by common situations in Switzerland. They show how the decision is made and how coverage works.

Julien, 28, Fribourg: a nose blocked since adolescence

Julien had always breathed badly on the left and slept with his mouth open. His family doctor referred him to an ENT specialist at the cantonal hospital, who found a C-shaped deviation. After six weeks of corticosteroid spray without improvement, a septoplasty was performed as day surgery, covered by basic insurance. Julien went back to work after a week.

Sabine, 41, Zurich: allergy and deviation

Sabine had a blocked nose, mainly in spring. The ENT specialist found a moderate deviation and enlarged turbinates, made worse by a birch pollen allergy. He treated the allergy first. As the symptoms persisted outside the season, he proposed septoplasty with turbinate reduction, scheduled for the autumn.

Marco, 23, Lugano: a blow while playing football

Marco had taken a ball full in the face. His nose was slightly deviated and he breathed badly on the right. The procedure, following an accident, was covered by his employer's accident insurance. He resumed light training after three weeks and contact after three months.

Hélène, 55, Neuchâtel: repeated bleeding

Hélène had regular nosebleeds on the same side. Endoscopy revealed a spur that was drying out the mucous membrane. Her short septoplasty put an end to the bleeding.

Reto, 62, Chur: a poorly tolerated night-time mask

Reto, treated for sleep apnoea, could not tolerate his nasal mask. His ENT specialist found a significant deviation and a weak valve. After septoplasty with valve strengthening, the mask became much more comfortable.

Laura, 30, Geneva: form and function

Laura breathed badly and also wanted to reduce a hump. She opted for a septorhinoplasty. Her insurer agreed to cover the functional part after a cost approval request; the hump reduction remained at her expense, billed separately.

"Packing is always needed for days"

Prolonged packing has become rare. Silicone splints or simple stitches are often enough.

"Septoplasty changes the shape of the nose"

It is performed from the inside and does not, in principle, change the external appearance.

"You breathe better the next day"

In the first few days, the nose is very blocked. Improvement comes after the splints are removed and healing has taken place.

"The operation cures allergies"

Septoplasty corrects the structure; the allergy must be treated separately.

"A deviated septum must always be operated on"

Only a troublesome deviation not relieved by medical treatment justifies a procedure.

"Decongestant sprays are enough"

They provide relief for a few days, but prolonged use makes obstruction worse.

"The operation is never reimbursed"

When medically justified, septoplasty is covered by basic insurance.

A few weeks before

Stop smoking. If you have allergies, have them treated. If you have been using decongestant sprays for a long time, start withdrawing from them with your doctor. Check the coverage arrangements with your insurer, particularly if a cosmetic procedure is combined.

Two weeks before

On medical advice, suspend products that encourage bleeding. Organise one to two weeks off and someone to accompany you home.

The day before

Buy saline solution and prepare soft tissues, pillows and a humidifier. Follow the fasting instructions.

Tobacco smoke irritates the nasal mucous membrane, slows the movement of the cilia that clear mucus and maintains chronic inflammation, a source of blocked nose and sinusitis. Vaping can also dry out the mucous membrane. Stopping smoking often improves nasal breathing, reduces the risk of complications after septoplasty and promotes healing. Stopping for several weeks before and after the procedure is strongly recommended.

Geneva

The ENT department of the University Hospitals treats all nasal conditions, including complex cases. Many ENT specialists in the city see patients and operate in clinics. For routine septoplasty, the choice is wide, in the general ward as well as privately.

Vaud

The university ENT department in Lausanne works alongside clinics in the canton's regional hospitals, notably on the Riviera and in Morges, Nyon, Yverdon and Payerne. Patients from northern and eastern Vaud can often have surgery close to home.

Neuchâtel

The cantonal hospital network provides routine consultations and procedures; ENT specialists also work in private practice. Complex cases can be referred to Lausanne or Bern.

Jura

The Hôpital du Jura provides basic provision; complex cases are often referred to Basel or Bern. For routine septoplasty, treatment within the canton is often possible.

Fribourg

The Fribourg cantonal hospital offers bilingual provision, supplemented by ENT specialists in private practice. Lausanne and Bern are close for complex cases.

Valais

The Hôpital du Valais offers ENT consultations in French and German. Patients from the resorts often have surgery in the valley.

Bern

The university ENT department in Bern, regional hospitals and many private practices offer a wide choice; Biel/Bienne offers bilingual provision.

Solothurn

The cantonal hospitals in Solothurn and Olten handle routine procedures; Bern and Basel are close by.

Basel-Stadt

The university ENT department in Basel and many private practices cover all needs.

Basel-Landschaft

The cantonal hospital and the proximity of Basel offer easy access.

Aargau

The cantonal hospitals in Aarau and Baden have ENT departments; many ENT specialists work in private practice.

Zurich

The university ENT department, cantonal and regional hospitals from Winterthur to Uster, and many private practices offer the widest choice in the country.

Schaffhausen

The cantonal hospital handles routine procedures; Zurich and Winterthur are close by.

Zug

The cantonal hospital and ENT specialists in private practice provide local provision; Zurich and Lucerne are half an hour away.

Schwyz

Regional hospitals and the proximity of Lucerne and Zurich offer several options.

Lucerne

The Lucerne cantonal hospital is the reference centre for Central Switzerland.

Uri

The cantonal hospital provides basic provision; Lucerne treats more complex cases.

Obwalden

Patients often turn to Lucerne, about twenty minutes away.

Nidwalden

Lucerne, a quarter of an hour away, is the usual centre.

Glarus

The cantonal hospital provides basic provision; Zurich for complex cases.

St. Gallen

The St. Gallen cantonal hospital is the reference centre for Eastern Switzerland, supplemented by private practices.

Appenzell Ausserrhoden

St. Gallen, close by, treats most patients.

Appenzell Innerrhoden

St. Gallen, about three-quarters of an hour away.

Thurgau

The cantonal hospitals in Frauenfeld and Münsterlingen, as well as St. Gallen and Winterthur, offer several options.

Graubünden

The Chur cantonal hospital is the reference centre; distances from the valleys are long.

Ticino

Hospitals in the Ticino cantonal network and ENT specialists in private practice offer consultations in Italian.

In Switzerland, a large proportion of the population suffers from hay fever. Hazel and alder pollen can appear from late winter, birch pollen in spring, grass pollen from May to July, and mugwort and ragweed pollen in late summer in some regions. In someone with a deviated septum, allergic inflammation swells the mucous membrane and markedly worsens obstruction.

Why treat the allergy first

A large part of the symptoms may disappear with appropriate treatment: avoiding allergens as far as possible, corticosteroid sprays, antihistamines, sometimes desensitisation. If symptoms persist outside the pollen seasons, the deviation probably plays a role of its own.

Scheduling the procedure

It is better to have surgery outside your allergy season, so that healing is not disrupted by repeated sneezing and significant congestion.

After the procedure

Septoplasty does not cure the allergy. Treatment will need to continue during the high-risk seasons, but breathing will generally be better than before during these periods.

Allergy testing

If an allergy is suspected, skin or blood tests, carried out by an allergist or ENT specialist, identify the allergens involved and guide treatment.

When a blocked nose is accompanied by sneezing, itching, watery eyes or seasonal symptoms, an allergy may be the cause, alone or combined with a deviation. Allergy testing, by skin tests or a blood test, allows the allergy to be treated in a targeted way. Correcting the septum without treating a significant allergy often gives a disappointing result; the two approaches are complementary.

Many people with a blocked nose have been using decongestant sprays sold in pharmacies for months, or even years. These products constrict the blood vessels of the mucous membrane and unblock the nose within minutes. But their effect wears off, and when you stop, the mucous membrane swells more than before: this is rhinitis medicamentosa. The dose is then increased, and a vicious circle sets in.

The signs

Needing to spray several times a day to breathe, the nose blocking again shortly afterwards, being unable to sleep without the spray.

Withdrawal

It is done gradually, often by stopping on one side first, with the help of a corticosteroid spray and rinsing. The first few days are uncomfortable, then the mucous membrane returns to normal within a few weeks.

Before surgery

Withdrawal is advisable before septoplasty, as it allows the real contribution of the deviation to the obstruction to be assessed and promotes better healing.

The inferior turbinates, on the side wall of each nasal cavity, are covered with a mucous membrane rich in blood vessels that swells and shrinks. When they are permanently enlarged, through allergy, chronic irritation or compensation on the side opposite a deviation, they contribute to obstruction.

They can be reduced in several ways: by radiofrequency or other techniques that reduce the tissue beneath the mucous membrane while preserving it, by partial resection of the turbinate bone, or by moving the turbinate outwards. The modern principle is to reduce volume while preserving the mucous membrane, which is essential for warming and humidifying the air. Excessive reduction could cause troublesome nasal dryness. The ENT specialist decides on the procedure after the examination, often at the same time as the septoplasty.

In some people, the middle turbinate, one of the bony plates inside the nose, contains an air cavity that makes it swell. This anatomical feature, visible on a CT scan, can contribute to nasal obstruction or impair sinus drainage. It is often associated with a deviation of the septum to the opposite side. When it is troublesome, the ENT specialist can reduce this turbinate endoscopically, during the same procedure as the septoplasty.

The internal nasal valve is the narrowest passage of the nasal cavities. A septal deviation at this level is very troublesome, but the valve can also be narrow or collapse on breathing in because of weakness of the lateral cartilages, particularly with age or after rhinoplasty. A simple test, gently pulling the cheek outwards near the side of the nose, gives a first indication. If the valve is involved, septoplasty alone may not be enough: the ENT specialist or surgeon may propose strengthening it with cartilage grafts, often taken from the septum itself, placed along the septum or in the ala of the nose.

Adhesive strips placed on the nose and small dilators placed in the nostrils mechanically open the nasal valve. They can improve comfort at night or during sport, and help judge whether valve surgery would be useful. They have no effect on a deviation of the septum located further back. If they bring clear relief, tell the ENT specialist: it is useful information for the diagnosis.

At night, nasal obstruction is often more troublesome than during the day: when lying down, the mucous membrane swells more, and you switch to mouth breathing. The consequences are common: dry mouth and throat on waking, broken sleep, snoring, a feeling of tiredness.

Snoring

It comes from vibration of the tissues of the throat, particularly the soft palate. A blocked nose contributes by encouraging mouth breathing and increasing inspiratory effort. Septoplasty improves snoring in some patients, but not all. The ENT specialist can assess the respective roles of the nose and throat.

Sleep apnoea

This involves repeated pauses in breathing during sleep, often noticed by a partner, with daytime sleepiness. It requires a sleep study, carried out in a specialist centre or at home, and specific treatment, often a ventilation device. Septoplasty does not cure apnoea, but good nasal breathing makes it easier to use a nasal mask.

Children

In children, heavy snoring with mouth breathing is more often linked to the adenoids or tonsils than to the septum. An ENT opinion is useful.

Good habits

Sleeping with the head slightly raised, humidifying the bedroom, rinsing with saline in the evening and treating any allergy often improve comfort at night while you decide.

Snoring is often the first reason a partner urges someone to seek advice. Septoplasty can reduce snoring linked to a blocked nose, but it does not always solve snoring that comes from the throat or soft palate. A full examination, sometimes a sleep recording, shows how much is due to the nose. It is useful to discuss it together before the procedure to adjust expectations.

Switzerland has many endurance athletes, mountaineers and lake divers. For them, nasal breathing is particularly important.

Endurance sport

During intense exertion, everyone breathes through the mouth. But at moderate intensity, good nasal breathing filters, warms and humidifies the air, which is particularly useful in cold weather. Many runners, cyclists and cross-country skiers who have had a deviation corrected describe more comfortable breathing.

Altitude

Mountain air is cold and dry. A well-functioning nose warms and humidifies it. After septoplasty, the healing mucous membrane tolerates dry air poorly: it is wise to wait a few weeks before a stay at high altitude and to keep the nose well moisturised.

Diving

Pressure changes put strain on the sinuses and ears. Nasal obstruction can complicate equalisation. After septoplasty, diving is not advised for several weeks, and the ENT specialist's approval is needed before resuming.

Contact sports

Ice hockey, football and rugby players and combat sports practitioners are exposed to nasal injuries. After septoplasty, they generally wait several weeks before contact, and protection can be discussed.

Many endurance athletes — runners, cyclists or cross-country skiers — discover after septoplasty that they breathe more easily through their nose during moderate exertion. Breathing through the nose warms and humidifies the air, which is particularly welcome in cold weather. Training should be resumed gradually during the first month, avoiding maximal efforts that increase pressure in the nose.

Children often bump their noses. Most knocks have no consequences, but certain signs require prompt medical attention: a nose that remains blocked on one or both sides after the knock, severe pain, swelling of the septum visible at the entrance of the nostrils, a deformed nose. A septal haematoma that goes unnoticed can become infected and destroy the cartilage, leading to deformity of the nose during growth. It must be drained quickly.

Apart from these emergencies, surgery on a child's septum is avoided, as it contributes to the growth of the nose. If a deviation severely impairs breathing, limited and cautious surgery may be discussed by a paediatric ENT specialist. Most often, the end of growth is awaited.

In Switzerland, basic insurance is offered in several models, which do not change the benefits covered but do change the rules for accessing specialists.

If you do not follow the rules of your model, the insurer may refuse to cover a consultation. If in doubt, check before booking an appointment with the ENT specialist.

For a hospital stay, the law in principle allows you to choose a hospital on any canton's hospital list, including outside your canton of residence. Your canton of residence and basic insurance cover the costs up to the tariff applicable in your canton. If the chosen hospital is more expensive, the difference may remain at your expense, unless supplementary insurance covers it or the choice of an out-of-canton hospital is medically justified, for example in an emergency or for a service not available in your canton. For an outpatient procedure, other tariff rules apply; your insurer can advise you.

A deviation resulting from an accident is in principle covered by accident insurance. For employees working at least a certain number of hours per week, the employer's accident insurance also covers non-occupational accidents. For others, such as children, students or retired people, it is the accident cover included in health insurance. It is important to report the accident, even an old one, and to keep the documents that prove it: certificates, reports, photos. If the accident happened many years ago, coverage can be discussed; your doctor and insurer will advise you.

Many patients who seek advice for a blocked nose wonder whether they should take the opportunity to change the shape of their nose as well. There is no right or wrong answer, but a few guidelines help.

When septoplasty alone is enough

If you are happy with your nose and only your breathing bothers you, septoplasty alone is the simplest and shortest procedure, with the quickest recovery, and it is in principle covered by basic insurance.

When septorhinoplasty makes sense

If your nose is visibly deviated, if a hump or tip has bothered you for a long time, or if the nasal valve needs strengthening with procedures that affect the external structure, combining both in a single procedure avoids a second anaesthetic and a second recovery period.

The practical consequences

A septorhinoplasty takes longer, is often accompanied by bruising and an external splint, and the aesthetic result takes a year to emerge. The cosmetic part is billed separately and remains at your expense.

Choosing the practitioner

For septoplasty alone, an ENT specialist is the natural contact. For septorhinoplasty, an ENT specialist trained in facial surgery or a plastic surgeon experienced in rhinoplasty. See our page on rhinoplasty in Switzerland.

The sinuses are air-filled cavities in the bones of the face, which open into the nasal cavities through small openings. Chronic sinusitis, with congestion, thick discharge, facial pain and sometimes loss of smell for more than three months, requires an ENT assessment with endoscopy and often a CT scan.

The link with the septum

A significant deviation can narrow the area where the sinuses open, impair their drainage and encourage infections. It can also prevent access to the sinuses during endoscopic surgery.

Endoscopic sinus surgery

When prolonged medical treatment is not enough, the ENT specialist can widen the openings of the sinuses endoscopically, from inside the nose, without an external incision. Septoplasty is often performed at the same time.

Polyps

Nasal polyps, benign growths of the mucous membrane, require specific medical and sometimes surgical treatment. They are often associated with asthma and loss of smell.

Coverage

Medically justified sinus surgery is covered by basic insurance, like septoplasty.

Polyps are benign growths of the mucous membrane of the sinuses and nose, often associated with chronic inflammation, asthma or intolerance to certain anti-inflammatories. They cause a nose blocked on both sides, loss of smell and discharge. They are not corrected by septoplasty: treatment relies first on cortisone-based sprays, sometimes more specific treatments, and endoscopic sinus surgery if necessary. A septal deviation can be corrected at the same time when it contributes to the symptoms.

A perforation is a hole that goes right through the septum. It can result from surgery, but also from other causes: overuse of decongestant sprays, cocaine use, repeated cauterisation for bleeding, certain inflammatory diseases, injury.

Symptoms

A small perforation may cause no symptoms. Others cause crusting, bleeding, a feeling of a dry or blocked nose, or whistling when breathing, especially if they are small and located at the front.

Simple treatments

Rinsing, greasy ointments and humidification limit crusting. A silicone button can be placed to close the hole.

Surgical closure

When symptoms are significant, surgical closure may be proposed, using flaps of mucous membrane and sometimes a graft. It is a delicate procedure, performed by ENT specialists experienced in it.

Prevention

During septoplasty, the surgeon prevents perforation by carefully lifting the mucous membrane and avoiding opposing tears on both sides. Stopping smoking and following post-operative care also contribute to prevention.

In a minority of patients, symptoms persist or reappear after septoplasty. The most common causes are residual deviation, particularly very far forward or very high, adhesions between the septum and turbinates, a nasal valve that has remained narrow, untreated enlarged turbinates or a troublesome perforation. The ENT specialist then performs a new endoscopic examination to identify the cause. A revision is often more targeted than the first procedure. It is discussed after complete healing, generally several months after the first procedure.

Arrival

You arrive having fasted, accompanied. The anaesthetist sees you again, the surgeon answers your final questions and you sign the consent form.

The procedure

Under anaesthesia, the surgeon performs the correction from inside one nostril. A gauze placed at the back of the throat protects the airway from blood. The procedure generally takes less than two hours.

Waking up

You wake up with a blocked nose, with a small gauze pad under the nostrils to collect slight discharge. Your throat may be slightly irritated.

Discharge

After a period of monitoring, you go home the same day or the next day, with your instructions, prescriptions and, if necessary, a certificate of incapacity for work.

If you catch a cold, flu or sinusitis in the days before septoplasty, tell the team. An active respiratory infection increases the risks associated with anaesthesia and healing; the procedure is often postponed for a few weeks. This postponement has no consequence for the result.

Similarly, a significant allergy flare-up or a recent asthma attack must be reported, so that the team can judge whether it is better to change the date. It is better to operate on a calm nose: healing is quicker and comfort in the first few days much better. Tell the team as soon as symptoms appear, to free up the date and agree on a new one; ask in advance about the facility's postponement conditions, to avoid any surprises.

Day 1

Blocked nose, breathing through the mouth, slight blood-tinged discharge, sometimes a headache. Rest with your head raised, drink often, and apply cool compresses to your forehead if it helps.

Days 2 and 3

Swelling of the mucous membrane peaks. Secretions thicken. Gentle saline rinses begin according to the instructions. Sleep is often disturbed by mouth breathing.

Days 4 to 6

The discomfort decreases. You feel better, but the nose remains blocked while the splints are in place. Short, quiet walks.

Around day 7

Removal of the splints at the practice or hospital. Breathing clears markedly, even if crusts and swelling persist for a few weeks.

In the first few nights, mouth breathing dries the throat and can disturb sleep. Sleeping with your head raised on two pillows, keeping a glass of water by the bed, humidifying the bedroom and applying lip balm make nights more comfortable. A little blood on the pillow is common; a pillowcase protector saves you worrying about it. Sleep improves markedly as soon as the splints are removed.

After septoplasty, the prescription generally includes simple painkillers, nasal rinsing solutions and sometimes a nasal ointment or spray. Aspirin-type anti-inflammatories are often avoided in the first few days, as they encourage bleeding. Do not take decongestant sprays without medical advice. If you are on long-term treatment, for example for an allergy, ask when to resume it.

During the first two weeks, avoid blowing your nose hard, which could cause bleeding or displace the healing septum. When you sneeze, keep your mouth open so that the air escapes through the mouth rather than the nose. A persistent cough must be reported, as it can increase pressure in the nose. Gentle saline rinses replace nose-blowing during this period.

After septoplasty, many patients are surprised that their nose is still blocked for two to three weeks. The mucous membrane is swollen, crusts form, and any splints take up space. This is not a failure: breathing gradually improves as the mucous membrane heals. Saline rinses are the best way to speed up this phase. If obstruction persists beyond three months, a check-up allows the cause to be identified.

During healing, crusts form on the mucous membrane and can cause a congested feeling, or even an unpleasant smell. This is common and temporary. Regular rinsing, a nasal ointment if prescribed and good humidity in the room limit it. Do not remove the crusts with your fingers; they come away on their own. A strong smell with fever or purulent discharge requires medical attention.

Eating and drinking

Mouth breathing is drying: drink plenty. Warm, soft dishes are more pleasant in the first few days. Avoid alcohol, which encourages bleeding.

Sleeping

Two pillows or a wedge pillow limit swelling. A humidifier in the bedroom and a lip balm improve comfort.

Washing

Warm rather than very hot showers, so as not to encourage bleeding. Avoid saunas and hot baths for two weeks.

Exertion

Avoid carrying heavy loads and bending forward for one to two weeks.

Screens and reading

Possible from the next day, sitting comfortably.

After septoplasty, the mucous membrane and any splints make pressure changes uncomfortable in the first few weeks. Stays at high altitude and scuba diving should be avoided until healing is complete and the ENT specialist has given approval, generally after four to six weeks. Once healed, a nose that breathes better often makes pressure equalisation easier, particularly for divers.

You cannot drive on the day of the procedure, because of the anaesthesia. Driving can resume after a few days, once you are no longer taking painkillers that cause drowsiness and you feel well. Arrange for someone to accompany you home.

Your family doctor is often the starting point. They record your symptoms, try a first treatment such as rinsing and a corticosteroid spray, look for an allergy, and refer you to an ENT specialist if symptoms persist. Depending on your insurance model, their referral may be required for the specialist consultation to be covered. After the procedure, they can provide local follow-up, extend a certificate of incapacity for work if necessary and see you if you have any doubts.

• Does my deviation explain all my symptoms, or are there other causes, such as an allergy, enlarged turbinates or a weak valve?
• Which medical treatment should I try first, and for how long?
• Which procedures are you planning: septoplasty alone, turbinate reduction, valve strengthening, sinus surgery?
• Will the procedure be day surgery?
• Will you use splints or packing, and for how long?
• How long will I be off work?
• What are the risks in my case?
• How will coverage by my insurance work?
• When can I resume sport, flying, diving?

For a medically justified septoplasty, the doctor issues a certificate of incapacity for work for the necessary period, often one to two weeks depending on your job. This certificate allows your employer and, where applicable, your loss-of-earnings insurance to cover your absence according to the rules of your employment contract. If a cosmetic part is combined, incapacity related to that part does not in principle follow the same logic; your doctor will tell you what they can certify. Inform your employer of the date of the procedure in advance, without any obligation to specify the nature of the operation.

For a septoplasty covered by basic insurance, tariffs do not vary according to private market logic: they follow agreed tariffs. That is why this table does not show any price difference.

Adolescents

Once growth is complete, around sixteen to eighteen, septoplasty can be performed if symptoms are significant. Before then, medical treatments are preferred. Young athletes, often affected by injuries, frequently have surgery at this age.

Young adults

This is the age at which many troublesome deviations are treated, often after years of a blocked nose that was played down. Recovery is quick.

The forties and fifties

Symptoms may become more pronounced with the onset of rhinitis, sinusitis or valve collapse. The assessment must identify all these causes.

Older people

With age, the tip of the nose droops and the lateral cartilages weaken, narrowing the valves. Septoplasty can be combined with support for the tip and valve. Anaesthesia and the management of treatments, particularly anticoagulants, require particular attention.

Some occupations expose the nose to irritants: wood or flour dust, chemicals, fumes, dry and air-conditioned air. Bakers, joiners, hairdressers, farmers, cleaning staff or industrial workers may develop irritant rhinitis that worsens a deviation. Suitable respiratory protection and regular rinsing are useful. After septoplasty, these occupations often require slightly longer time off, while the mucous membrane heals. If rhinitis is linked to your work, talk to your doctor: it may call for specific management.

Nasal breathing and the resonance of the nasal cavities matter to singers, wind musicians, actors and teachers. Obstruction can impair breathing between phrases and change vocal timbre. After septoplasty, the voice may sound nasal for a few weeks while the mucous membrane goes down; a lasting change is rare. It is wise to plan several weeks without important performances and to discuss it with the ENT specialist from the consultation onwards. Many voice professionals then appreciate freer breathing.

A blocked nose gives a muffled voice, as with a cold, because air no longer resonates normally in the nasal cavities. A septoplasty that frees breathing can restore the voice's natural resonance, which singers and speakers often notice. Conversely, a voice that lets too much air through the nose has a different cause, linked to the palate, and is not affected by septoplasty.

During pregnancy, hormones often make the nasal mucous membrane swell: this is pregnancy rhinitis, common in the second and third trimesters. It generally disappears a few weeks after childbirth. It should therefore not be confused with obstruction due to the septum. Septoplasty is not performed during pregnancy; rinsing and, on medical advice, certain suitable sprays bring relief. If symptoms persist after childbirth and breastfeeding, an ENT assessment is then useful.

The nose must be clear, but not too open. The mucous membrane of the turbinates warms and humidifies the air; if it is over-reduced, the nose can become dry and crusty and, paradoxically, give a feeling of obstruction, because airflow is no longer perceived normally. This rare disorder is mainly described after very extensive turbinate reductions. That is why current techniques reduce turbinate volume while preserving their mucous membrane. After septoplasty, temporary dryness is common and responds well to rinsing and humidification.

Using decongestant sprays for months

They create dependence and make obstruction worse.

Having surgery without treating the allergy

Septoplasty does not correct allergic inflammation, which can spoil the result.

Expecting an immediate improvement

In the first few days, the nose is very blocked; improvement comes gradually.

Blowing your nose hard too soon

This risks bleeding.

Neglecting rinsing

It limits crusts and adhesions and speeds up recovery.

Ignoring the rules of your insurance model

A specialist consultation without prior referral may not be reimbursed, depending on the model chosen.

In the first few days, you will breathe through your mouth, may sleep badly and will need peace and quiet. Someone must accompany you on the day of the procedure and stay for the first night after anaesthesia. Those close to you can help by preparing simple meals, reminding you to do your rinses and not to blow your nose hard, and watching for heavy bleeding or fever. Reassure them: a very blocked nose for a few days is normal, and improvement follows.

Young children who jump into your arms or accidentally headbutt you can cause bleeding or displace the healing septum. Arrange help for the first few days, avoid carrying the children and explain to them that they must be careful of your face for a while. Vigilance is especially needed in the first two weeks, until the mucous membrane and septum have healed. Also plan calm activities to share sitting down, which allow you to spend time together safely, such as reading or board games.

Observe your symptoms

For a few weeks, note when and on which side your nose blocks, the quality of your sleep, any difficulty during exertion and the seasons concerned.

See your doctor

They try a first treatment and refer you to an ENT specialist according to your insurance model.

Have the ENT assessment

Examination, endoscopy, search for other causes: allergy, turbinates, valve, sinuses.

Try medical treatment

Rinsing and a corticosteroid spray for several weeks, treatment of any allergy, withdrawal from decongestants.

Decide with the ENT specialist

If symptoms persist and the deviation explains them, septoplasty, possibly combined with other procedures, becomes a reasoned decision.

A simple diary kept for two to four weeks helps the ENT specialist and you to assess your symptoms. Each day, note on a scale of zero to ten how blocked your nose is in the morning and evening, the more blocked side, sleep quality, the need to breathe through your mouth during exertion, bleeding, sneezing, use of sprays and particular events such as a cold or exposure to pollen. This diary helps distinguish fixed symptoms, more likely anatomical, from variable symptoms, more likely inflammatory, and measure the effect of medical treatment. It will also be useful for comparison after the procedure.

In older people, a blocked nose often has several causes that add up: an old deviation, a drooping tip that narrows the entrance to the nostrils, lateral cartilages that collapse on breathing in, a drier mucous membrane and sometimes medication that encourages congestion. Septoplasty alone may then be insufficient. The ENT specialist assesses the whole picture and may propose supporting the tip and valve at the same time. Treatments, particularly anticoagulants, are managed in consultation with the GP. In a person in good health, age is not an obstacle.

Septum. The wall that separates the two nasal cavities.

Turbinates. Ridges on the side wall of the nasal cavities that warm and humidify the air.

Nasal cycle. The natural alternation of mucosal swelling between the two sides of the nose.

Nasal endoscopy. Examination of the inside of the nose using a fine scope.

Spur. A sharp projection from the septum.

Deductible (franchise). The annual amount the insured person pays before basic insurance contributes.

Septal haematoma. A collection of blood between the mucous membrane and the cartilage of the septum.

Perforation. A hole that goes through the septum.

Co-payment (quote-part). The insured person's percentage contribution to costs above the deductible.

Rhinitis medicamentosa. Nasal congestion maintained by overuse of decongestant sprays.

Septorhinoplasty. Septoplasty combined with rhinoplasty.

Synechia. A scar adhesion between the septum and a turbinate.

Nasal valve. The narrowest passage of the nasal cavities.

If you would like a first opinion, particularly if you are hesitating between septoplasty alone and septorhinoplasty, describe your symptoms as precisely as possible: side affected, how long, time of day, effect of the seasons, sleep, sport, bleeding, treatments tried, history of injury. If you are considering a cosmetic change, attach front, profile and from-below photos. We will direct you to the most appropriate care, bearing in mind that only an examination by an ENT specialist can establish the indication.

Saline rinses are a simple step, useful both before and after septoplasty. Done properly, they clean the nasal cavities, remove crusts and secretions, and improve comfort.

Equipment

Single-dose saline vials, a seawater spray or a high-volume rinse bottle. After a procedure, the doctor will tell you the recommended type and volume.

Position

Lean your head over the basin, tilted slightly to one side. Insert the tip into the upper nostril, without pushing it in deeply.

The technique

Let the solution flow gently; it comes out of the other nostril or the mouth. Breathe through your mouth during rinsing. Repeat on the other side.

Afterwards

Do not blow your nose hard: let it drain, then wipe gently. After septoplasty, avoid forcing it for two weeks.

Frequency

After the procedure, several times a day for two to three weeks, then less often. For chronic rhinitis, one to two rinses a day are often recommended.

Nosebleeds are common, especially in winter when heating dries the air. A deviation or spur that exposes the mucous membrane to the airflow encourages them.

The right steps

Sit down, tilt your head forward, not back, blow gently to clear clots, then firmly pinch the nostrils between thumb and index finger for ten minutes without letting go. A cold cloth on the back of the neck or forehead can help.

When to seek medical attention

If bleeding does not stop after twenty minutes of pressure, if it is very heavy, if it follows a significant blow, if you take anticoagulants or if the bleeding keeps recurring. In the event of massive bleeding, call 144.

Treatments

The doctor can cauterise a small fragile blood vessel, prescribe a greasy ointment or look for a cause, such as a deviation or spur.

After septoplasty

A slight bloody discharge is normal in the first few days. Heavy bleeding requires you to contact the team.

A deviated septum, by exposing part of the mucous membrane to the airflow, can encourage dryness and repeated nosebleeds, often always on the same side. They are also common in winter, with heating, and in people who take anticoagulants. Moisturising the mucous membrane with ointments or saline sprays, and sometimes cauterising a small blood vessel, is often enough. When a significant deviation keeps the problem going, septoplasty can help.

In Switzerland, long winters and central heating make indoor air very dry. The nasal mucous membrane dries out, forms crusts and bleeds more easily, which accentuates the feeling of a blocked nose, especially at night. A few steps improve comfort: a humidifier in the bedroom, a moderate temperature, regular rinsing, a greasy ointment at the entrance of the nostrils and good hydration. After a septoplasty performed in winter, these precautions also help healing.

Dry air, particularly in winter with heating, dries out the healing nasal mucous membrane and encourages crusting and bleeding. A humidifier in the bedroom, regular rinsing and good hydration help a great deal. Also avoid smoky or dusty environments during the first few weeks, as they irritate the mucous membrane.

A cold in the weeks after septoplasty is unpleasant, as it adds congestion to a nose that is still healing. It is generally not dangerous. Continue rinsing, rest, avoid blowing your nose hard and take the treatments recommended by your doctor. A persistent thick, coloured discharge, fever or facial pain require medical attention to look for secondary infection or sinusitis. If possible, avoid contact with people who have colds in the first few days, and schedule the procedure outside epidemic peaks if you can.

During septoplasty, the surgeon sometimes removes part of the deviated septum. Depending on the technique, this cartilage can be straightened, thinned or cut, then replaced between the two layers of mucous membrane to keep the septum strong. It can also be kept as a graft if rhinoplasty or valve strengthening is combined. The surgeon always keeps a sufficient L-shaped framework along the bridge and at the front of the nose to maintain support. If rhinoplasty is considered later, the operative report will show how much cartilage is still available.

Silicone splints are thin, flexible plates placed on each side of the septum at the end of the procedure. They hold the mucous membrane against the straightened cartilage, limit the risk of haematoma and prevent adhesions forming between the septum and the turbinates. Some have a small channel that lets some air through. They are held by a stitch and removed in a few seconds, generally after five to ten days. Their removal brings marked relief. Some surgeons do not use them for limited corrections and simply use stitches to hold the mucous membrane together.

Septoplasty is usually performed under general anaesthesia, which ensures complete comfort and allows the surgeon to work without time pressure. A gauze placed at the back of the throat protects the airway. For limited corrections, such as removing an isolated spur, some ENT specialists offer local anaesthesia, possibly combined with sedation: the nose is anaesthetised with sprays and injections, and the patient remains awake or drowsy. The choice depends on the extent of the procedure, your health and your preferences, in consultation with the anaesthetist.

In endoscopic septoplasty, the surgeon works while watching a screen connected to a fine scope introduced into the nose. This magnified, bright view is particularly useful for deviations located far back, spurs that are difficult to reach, revisions after a first procedure and combinations with sinus surgery. It often allows more targeted steps, with lifting of the mucous membrane limited to the deviated area. For anterior deviations, the conventional technique under a headlight remains very suitable. Many ENT specialists use one or the other depending on the situation.

For very deviated septa, fractured into several pieces or associated with a very crooked nose, the surgeon can remove almost all the cartilaginous part of the septum, straighten and rebuild it outside the nose, on the operating table, then replace it and fix it firmly. This technique, often performed through the open approach and combined with rhinoplasty, is reserved for difficult cases and for surgeons experienced in it. It allows correction of deviations that would resist conventional septoplasty.

After the procedure, you will receive one or more statements from your health insurer. They show the amounts billed by providers, the share covered, the deductible applied and the co-payment at your expense. Depending on the billing system, the insurer pays the provider directly and bills you for your contribution, or you receive the invoice and claim reimbursement. For a hospital stay, the cantonal share is paid directly by the canton. If a cosmetic part was performed, it is invoiced separately, at your expense. Keep all these documents, and contact your insurer if you have any doubts about an amount.

For a hospital stay, basic insurance covers the general ward: a room with several beds, with care from the hospital's medical team. Supplementary hospital insurance allows you, depending on the level chosen, to be treated in the semi-private ward, in a double room, or the private ward, in a single room, with free choice of doctor. The quality of medical care is the same; the differences mainly concern comfort, the choice of practitioner and sometimes waiting times. For a septoplasty that is often day surgery, these differences matter less.

For cosmetic procedures, each practitioner sets their fees freely, which explains the differences between cities and practices. For a septoplasty covered by basic insurance, billing follows tariffs negotiated between insurers and providers and approved by the authorities, for both outpatient and inpatient care. Amounts vary little between regions, and the insured person pays only their contribution. Price differences comparable to those in cosmetic surgery only appear for the cosmetic part of a septorhinoplasty, or for services outside basic insurance.

• Does my insurance model require a referral from my family doctor before I see the ENT specialist?
• Is the planned septoplasty covered, and is a prior request needed?
• What will my contribution be, given my deductible?
• If I choose a hospital outside my canton, will a difference remain at my expense?
• How will any cosmetic part be billed?
• Does my supplementary insurance cover a semi-private or private room?

The nose is not just a pipe. It filters dust and some microbes thanks to its hairs and mucus, and warms and humidifies cold air before it reaches the lungs. It also contributes to the sense of smell, and therefore taste, and to the resonance of the voice.

When you breathe through your mouth all the time, air reaches the throat and airways cold, dry and unfiltered. The consequences are common: dry throat, irritation, snoring, less refreshing sleep, sometimes worsening asthma. In children, chronic mouth breathing can influence the development of the jaw. Restoring comfortable nasal breathing therefore often improves well-being well beyond the nose itself.

Not all rhinitis is allergic. Some people have a runny or blocked nose on contact with cold, strong smells, smoke, temperature changes or after meals, without any allergy. This is called vasomotor or non-allergic rhinitis. Other forms of rhinitis are linked to medication, hormonal changes, age or occupational exposure. These forms of rhinitis can worsen the effect of a septal deviation. Their treatment relies on avoiding triggers, rinsing and suitable sprays. Septoplasty corrects the structure but does not treat these forms of rhinitis; that is why the assessment must identify them.

Some medicines can encourage nasal congestion: certain blood pressure treatments, certain hormonal treatments, some medicines used in urology or psychiatry, and of course overuse of decongestant sprays. If your nose became blocked after starting a new treatment, talk to your doctor: an adjustment is sometimes possible. Never stop a treatment yourself.

Acute sinusitis often follows a cold: facial pain or pressure, worse when bending forward, thick coloured discharge, blocked nose, sometimes fever. It usually clears up on its own or with simple treatment. Chronic sinusitis lasts more than three months, with congestion, discharge, facial discomfort and often a reduced sense of smell. It requires an ENT assessment. If a deviated septum impairs sinus drainage, correcting it may form part of the treatment.

The sense of smell depends on a small area of mucous membrane at the very top of the nasal cavities. When a deviation or inflammation prevents air from reaching it, the sense of smell decreases, and with it much of the perception of flavours. After septoplasty, the sense of smell is often reduced during healing, then returns. Some patients even notice an improvement compared with before the procedure. A loss of smell that persists, or that occurs without obstruction, requires a specific ENT assessment.

In children, mouth breathing, snoring and a frequently runny nose are most often linked to enlarged adenoids, located at the back of the nose, or large tonsils, and more rarely to the septum. An ENT opinion helps tell the difference. The adenoids can be removed if they cause significant problems. The septum, however, is in principle left alone during growth, except in particular situations.

One year after septoplasty, healing is complete. Most patients breathe much better and no longer think about their nose. If symptoms reappear, they are often linked to rhinitis, seasonal allergy or a cold rather than to the septum itself. Continue rinsing if needed, treat any allergy and seek advice if a fixed obstruction on one side reappears.

Keep the operative report, the results of any CT scan and your insurer's statements. These documents are useful if symptoms reappear years later, in the event of further nose or sinus surgery, or if you consult another ENT specialist. They show exactly what was done and avoid repeating tests.

If you live alone, arrange for a relative or friend to be present for the journey home and the first night after anaesthesia. Prepare simple meals, keep the saline solution, tissues and your medication within reach, and keep your phone close by. Most patients are independent from the next day. In the event of heavy bleeding or feeling unwell, do not hesitate to call the team or 144.

A nose that is "too small"

Many people think their nostrils are too narrow. In reality, the problem often comes from the septum, valve or turbinates, which an examination can identify.

An "allergic nose for life"

An allergy can be treated, often effectively. Symptoms that persist despite properly conducted treatment warrant an examination of the structure of the nose.

Snoring that is purely nasal

Snoring usually comes from the throat. Operating on the septum for this reason alone risks disappointment.

Old wives' remedies

Inhalations, essential oils and other products can irritate the mucous membrane. Saline rinses remain the safest foundation.

For many patients, recovery from septoplasty is easy to organise: no visible scar, little or no bruising, and discomfort mainly from a blocked nose. Working from home often allows you to resume work in the first few days after the splints are removed, if you feel well. For students, a week's break, ideally during the holidays, is often enough. Avoid scheduling important exams or oral presentations in the first week, however, as your voice may sound nasal and your sleep may be disturbed.

For students and apprentices, septoplasty is readily scheduled during school holidays, to allow one to two weeks of rest without missing lessons or exams. Remote group work and reading are possible from the first few days; school sports activities have to wait three to four weeks.

To measure the benefit of the procedure objectively, it is useful to compare your symptoms before and after using the same tool. Your breathing diary or a standardised questionnaire, completed before the procedure and then two to three months afterwards, shows the change in obstruction, sleep and difficulty during exertion. Some ENT specialists use these questionnaires routinely. They also help identify residual symptoms and look for their cause, for example a seasonal allergy or a valve that has remained weak.

Mouth and teeth

A dry mouth at night encourages bad breath, tooth decay and gum inflammation, because saliva no longer plays its protective role. Dentists often spot these signs in people who breathe through their mouth.

The throat

Cold, dry air irritates the throat, causing sore throats on waking and a hoarse voice in some people.

Concentration

Sleep broken by difficult breathing results in tiredness and reduced concentration during the day.

Sport

During moderate exertion, breathing through the mouth loses the advantage of warming and humidifying the air, which can encourage irritation of the airways in cold weather.

These consequences do not on their own justify surgery, but they are a reminder that a blocked nose is not just a minor discomfort. They are worth mentioning at the consultation.

Some deviations do not stay hidden inside the nose. When the front edge of the septum is displaced, it can appear at the entrance of a nostril and make the two nostrils asymmetrical. When the deviation is high or associated with deviation of the bones, the whole nose may look crooked. In these cases, septoplasty alone corrects breathing, but not always the appearance, as the external deviation also involves the bones and lateral cartilages. A septorhinoplasty is then often more appropriate. If the deviation results from an accident, accident insurance may cover correction of both form and function.

For initial guidance, your family doctor remains the main point of contact. For a specialist opinion, see an ENT specialist, in private practice or at your regional hospital. In the event of heavy nosebleeds that do not stop, significant facial injury or difficulty breathing, call 144. For any question about coverage, your health insurer can advise you. And if you are considering an associated cosmetic change, you can send us your request using the form on this page.

Many people treated for sleep apnoea use a device every night that delivers pressurised air through a mask. Nasal masks or nasal pillow masks are often better tolerated than masks covering the mouth, but they require a clear nose. A significant septal deviation can make the pressure unpleasant, cause leaks through the mouth and lead to treatment being abandoned. In this case, the sleep doctor and the ENT specialist can discuss septoplasty together. After the procedure, the device is generally interrupted for a few days or used with a full-face mask, according to the instructions, then resumed with a nasal mask once healing allows. Many patients then find treatment much more comfortable.

Contact sports, very popular in Switzerland — from ice hockey to football, rugby, handball and martial arts — expose the nose to impacts. A fracture of the nose or septum can go unnoticed at the time and only reveal itself years later through obstruction. After a significant blow, a prompt examination allows a septal haematoma to be detected and a displaced fracture to be reduced in the first few days, which often avoids more extensive surgery later. Wearing suitable facial protection, where the rules allow, reduces the risk. After septoplasty, a return to contact has to wait several weeks, according to the ENT specialist's advice.

In practice, several months often pass between the first consultation and the procedure. This time is not wasted: it allows medical treatment to be tried, an allergy to be treated, any withdrawal from decongestants to be carried out, insurance coverage to be checked and a favourable period to be chosen, outside the pollen and cold seasons. This preparation increases the chances of a satisfactory result. If your symptoms are significant, however, your doctor can request a quicker appointment.

• A nose that is always blocked on the same side warrants an ENT examination.
• Medical treatment and looking for an allergy come first.
• Septoplasty corrects the structure from the inside, with no visible scar.
• Recovery is mainly marked by a blocked nose and crusts for two to three weeks.
• When medically justified, the procedure is covered by basic insurance, with the usual contribution.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Septoplasty: prices in Switzerland.

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Our guides

• Rhinoplasty in Switzerland
• Cosmetic surgery in Switzerland

Answers to the questions most often asked by patients living in Switzerland about deviated septum and septoplasty. For an associated cosmetic change, see our page on rhinoplasty in Switzerland.

Understanding septal deviation

What is the nasal septum? It is the vertical wall that divides the inside of the nose into two cavities. It is made of cartilage at the front and thin plates of bone at the back, covered with mucous membrane. It also supports part of the nose and directs the flow of air. When it is deviated, it can narrow one nasal cavity and impair breathing on that side. It also plays a role in airflow, distributing it between the two sides of the nose.

Is it normal to have a deviated septum? Yes, a slight deviation is very common and often causes no problems. It only becomes troublesome if it clearly narrows one nasal cavity, especially at the front of the nose, or if it encourages repeated bleeding or infections. It is the symptoms, not the deviation alone, that justify treatment. That is why an ENT specialist does not propose operating on a deviation discovered by chance, with no associated symptoms.

Where does a septal deviation come from? It can develop during growth, when cartilage and bone grow at different rates, or result from an injury, sometimes long ago and forgotten: a fall in childhood, a sports impact, an accident. More rarely, it is linked to birth or previous surgery. In many cases, no specific cause is found: the deviation simply developed during growth.

Can a deviation get worse with age? The deviation itself changes little in adulthood, but symptoms can increase over time, as the mucous membrane, turbinates and nasal valve change. A nasal tip that droops with age can also narrow the entrance to the nostrils and accentuate the effect of a deviation. A full assessment takes these changes into account, beyond the septum alone.

How can I tell whether my blocked nose comes from the septum? A nose that is always blocked on the same side, whatever the time of day or season, points towards an anatomical cause such as a deviation. A problem that varies with the seasons, with sneezing, suggests an allergy instead. Only an examination by a doctor, ideally an ENT specialist, can tell the difference. Noting for a few weeks when and on which side your nose blocks helps a great deal at the consultation.

What is the nasal cycle? It is the natural alternation of mucosal swelling between the two nasal cavities during the day. You therefore breathe slightly better on one side, then the other. This is normal. A fixed obstruction on one side, on the other hand, should prompt a search for an anatomical cause. It is more noticeable during a cold or an allergy, when the mucous membranes are already swollen.

Does a deviated septum cause snoring? It can contribute to it, by encouraging mouth breathing at night. But snoring usually comes from the throat, the soft palate or the tongue. Correcting the septum sometimes improves snoring, without any guarantee. An assessment of the throat and sleep is useful if snoring is the main reason for seeking advice.

Can a deviation cause headaches? Rarely. A septal spur touching a turbinate can, in some people, cause facial pain or headaches. This link must be carefully established by the ENT specialist before surgery is proposed for this reason. Most headaches have other causes, which must be looked for before blaming the septum.

Does a deviation encourage sinusitis? It can impair drainage of the sinuses on its side and encourage repeated sinusitis. In this case, septoplasty can be combined with sinus surgery, after an assessment that sometimes includes a CT scan. Treating the deviation then forms part of a more comprehensive approach to the sinuses.

Does a deviation cause nosebleeds? A spur or marked curvature exposes the mucous membrane to the airflow, which dries and weakens it. Repeated bleeding, often on the same side, can result. Correcting the septum often reduces it. A greasy ointment applied to the entrance of the nostril and humidifying the air can also help in the meantime.

What is a septal spur? It is a sharp projection, bony or cartilaginous, that protrudes into a nasal cavity. It can impair breathing, touch a turbinate or cause bleeding. It is easily removed during septoplasty. It is often responsible for localised symptoms and bleeding on the same side.

Can the deviation be seen from the outside? Sometimes. Dislocation of the front edge of the septum may be visible at the entrance of a nostril, and a significant deviation can make the nose look crooked. But many troublesome deviations are invisible from the outside. Only an internal examination can assess the septum as a whole.

Can children have a troublesome deviation? Yes. In children, medical treatments are preferred and surgery on the septum is avoided as far as possible before growth is complete, unless symptoms are significant. After an injury, a prompt examination is useful to look for a septal haematoma. For them, rinsing and treatment of any allergy are often sufficient.

Can a deviation interfere with treatment using a night-time mask? Yes. In people treated for sleep apnoea with a ventilation device, an obstructed nose makes the nasal mask difficult to tolerate. Improving nasal breathing can make treatment easier. The sleep doctor and the ENT specialist can coordinate their care.

What is the difference between septoplasty and rhinoplasty? Septoplasty corrects the septum inside the nose to improve breathing, without changing the external shape. Rhinoplasty changes the shape of the nose. When they are combined, it is called septorhinoplasty. Our page on rhinoplasty details the latter. The choice between them depends on your needs: breathing better, changing the shape of the nose, or both.

Does septoplasty change the appearance of the nose? In principle, no. It is performed from the inside and does not change the external shape. A deviation very far forward may, however, slightly influence the appearance of the tip or nostrils after correction. The surgeon will warn you if your deviation, being very far forward, may slightly change the appearance of the nose.

What is the nasal valve? It is the narrowest passage of the nasal cavities, located under the middle part of the nose, between the septum and the lateral cartilage. A deviation at this level is particularly troublesome. If the valve itself is weak, strengthening it can be combined with septoplasty. It is particularly sensitive in older people and after rhinoplasty.

What are the turbinates? They are ridges covered with mucous membrane on the side wall of each nasal cavity, which warm and humidify the air. If they are too large, they contribute to obstruction. Reducing them is often combined with septoplasty. Their volume varies during the day, depending on position and the state of the mucous membrane.

Why are both sides sometimes blocked? An S-shaped deviation can narrow both cavities at different heights. On the side opposite a curve, the turbinate often enlarges to fill the free space. The two phenomena add up. The examination identifies the contribution of each to the symptoms.

Can the deviation come back after the operation? A small part may reappear, because of the memory of the cartilage, especially after a significant injury. The surgeon limits this risk with appropriate straightening techniques. A revision is sometimes necessary. Post-operative follow-up allows any recurrence to be identified quickly.

Diagnosis and decision

Which doctor should I see? Start with your family doctor, who can refer you to an ENT doctor, a specialist in the nose, throat and ears. The ENT specialist carries out the specialist examination, makes the diagnosis and, if necessary, operates. Some plastic surgeons also perform septoplasty, especially in combination with rhinoplasty. An initial assessment by the family doctor often rules out simple causes, such as rhinitis.

Do I need a referral to see an ENT specialist? It depends on your insurance model. With a family doctor, telemedicine or managed care model, you must in principle first go through your doctor or the designated service. With a standard model, you can consult a specialist directly. Check the conditions of your model before booking an appointment.

What does the examination involve? The ENT specialist asks you questions, examines the front of the nose with a speculum, then often performs a nasal endoscopy: a fine scope is introduced into each nostril after an anaesthetic spray. The examination is quick and only mildly uncomfortable. It shows the whole septum, the turbinates and the entrance to the sinuses. It also allows polyps or other abnormalities to be looked for.

Is a CT scan needed? Not for a simple deviation. A CT scan is requested if chronic sinusitis or polyps are suspected, or before sinus surgery. Your ENT specialist will explain whether they consider it useful in your case.

Can obstruction be measured objectively? Yes, some centres measure resistance to airflow or the flow of air inhaled through the nose. These measurements complement the examination and can help document the indication. They are mainly useful when the indication is in doubt.

Should medical treatment be tried before surgery? Generally yes, especially if inflammation of the mucous membrane or an allergy is present. Rinsing and a corticosteroid spray for several weeks may be enough to improve breathing. If symptoms persist with a significant deviation, surgery becomes a logical option. A treatment followed carefully for six to eight weeks allows its effectiveness to be judged.

Are decongestant sprays a solution? Not in the long term. They unblock the nose quickly, but using them for more than a few days causes rebound swelling and dependence. If you have been using them for a long time, talk to your doctor about gradual withdrawal. Gradual withdrawal, supported by the doctor, is the best solution.

Are nasal strips useful? They can relieve symptoms related to the nasal valve, particularly at night or during sport. They have no effect on a deviation of the septum located further back, but they can help while you decide. They are easy to try and risk-free.

When is surgery really indicated? When nasal obstruction affects daily life, the examination shows a deviation that explains it, and medical treatment has not been enough. Repeated bleeding or sinusitis linked to the deviation are also indications. The decision is made jointly between you and the ENT specialist, according to your symptoms.

Is septoplasty effective? In well-selected patients, it clearly improves nasal breathing in the vast majority of cases. A large randomised study showed a greater improvement than with medical treatment alone in adults with troublesome obstruction linked to a deviation. The most satisfied patients are those in whom the deviation clearly explained the symptoms.

From what age can surgery be performed? Generally once the nose has finished growing, around sixteen to eighteen. In children, surgery on the septum, which contributes to the growth of the nose, is avoided as far as possible unless symptoms are significant. Before this age, medical treatment is generally preferred.

Can an older person have surgery? Yes, if their health allows. In older people, obstruction is often made worse by a drooping tip and a weak valve, which can be treated at the same time. The anaesthetist carefully assesses medical history and treatments.

Can septoplasty be performed if I have allergies? Yes, but the allergy must be treated before and after the procedure. Septoplasty corrects the structure, not the allergy. Without treatment of the allergy, the result may be disappointing. Treatment of the allergy remains necessary after the procedure.

Does septoplasty stop snoring? Not always. It improves nasal breathing and sometimes snoring, but snoring often comes from the throat. In cases of heavy snoring or pauses in breathing at night, a sleep study is useful. Weight loss, if indicated, can also improve snoring.

Does septoplasty treat sleep apnoea? Not on its own. It can improve tolerance of a nasal ventilation mask, but sleep apnoea requires specific treatment. The opinion of a sleep doctor is then invaluable.

Is smoking an obstacle? Smoking irritates the mucous membrane, slows its healing and increases the risk of complications such as perforation. Stopping before and after the procedure is strongly recommended. Stopping also improves the health of the mucous membranes in the long term.

Do I need to stop certain medicines? Yes. Aspirin, anti-inflammatories and certain supplements that encourage bleeding are generally suspended one to two weeks beforehand, on medical advice. Anticoagulants are managed with the prescribing doctor. Never change a prescribed treatment without medical advice.

Can sinus surgery be combined? Yes, if an assessment shows chronic sinusitis or polyps. Septoplasty actually makes access to the sinuses easier. The combination is decided after a CT scan. The decision is based on the examination and, if necessary, a CT scan.

Can a cosmetic change be combined? Yes, this is then called septorhinoplasty. The cosmetic part is billed separately and remains at your expense. See our page on rhinoplasty. The quote must clearly separate the two parts.

Is a second opinion needed? It is not compulsory, but it is useful if the indication seems uncertain to you or if major procedures are proposed. Your basic insurance covers the necessary consultations under the usual rules. A second opinion is particularly useful if extensive surgery is proposed.

The procedure and recovery

How long does septoplasty take? Generally thirty minutes to an hour and a half. With turbinate reduction, valve strengthening or sinus surgery, the procedure takes longer. The surgeon will tell you the expected duration at the consultation.

What anaesthesia is used? Usually general anaesthesia. For limited corrections, local anaesthesia with sedation may be offered. The anaesthetist sees you in consultation before the procedure.

Is there a visible scar? No. The incision is made inside one nostril. Nothing can be seen from the outside, except when an open approach is used in combination with rhinoplasty. This is one of the advantages of the procedure.

Do I need to stay in hospital? Septoplasty is often performed as day surgery, with a return home the same day. A night may be planned depending on the anaesthesia, combined procedures and your health. In all cases, you must be accompanied home.

Will there be packing in the nose? Less often than in the past. Many surgeons use silicone splints, sometimes hollow to let some air through, or simple stitches that hold the mucous membrane in place. If packing is necessary, it is removed after one or two days. Current techniques aim for the greatest possible comfort.

Is removing the splints painful? It is generally quick and causes little pain, with a pulling sensation. It markedly eases breathing. Many patients describe immediate relief on removal.

How long does the nose stay blocked? It is very blocked for the first few days, then gradually clears after the splints are removed. Breathing continues to improve over several weeks as the mucous membrane heals. Swelling of the mucous membrane gradually subsides.

Will I have bruising? Rarely, as the nasal bones are not moved during septoplasty alone. Bruising may appear if rhinoplasty is combined. Septoplasty alone does not generally cause visible bruising.

Is it painful? Pain is generally moderate, often described as a feeling of pressure or a mild headache. The blocked nose and dry mouth are often more bothersome than the pain. Simple painkillers are generally enough.

How should I care for my nose after the operation? With saline rinses several times a day to remove crusts and secretions. An ointment may be prescribed. Do not pull off the crusts. The doctor will show you how to rinse.

When can I blow my nose? Gently, after about two weeks. Before then, it is better to refrain to avoid bleeding. When you sneeze, keep your mouth open. Blowing your nose too soon can cause bleeding.

When can I go back to work? Often after a week for office work, two weeks for a physical job or one exposed to dust. For a medically justified septoplasty, a certificate of incapacity for work is issued under the usual rules. Working from home sometimes allows an earlier return.

When can I resume sport? Gentle exercise resumes around the third week, intense sport after four to six weeks. Contact sports have to wait longer, according to the surgeon's advice. Also avoid exertion that involves holding your breath, such as lifting heavy loads.

Can I fly? Changes in pressure can be uncomfortable and encourage bleeding in the first few days. Ask your surgeon; generally, you should wait at least one to two weeks. The decision depends on your healing and the length of the flight.

Can I dive? Scuba diving involves significant pressure changes. It is not advised for several weeks after the procedure; the ENT specialist's opinion is needed before resuming. Your ENT specialist will tell you when you can resume safely.

Can I go to high altitude? A stay in the mountains is not forbidden, but the dry, cold air at altitude dries out the healing mucous membrane and encourages crusting. Keep your nose well moisturised and ask your doctor's advice before staying at high altitude in the first few weeks. A humidifier or a seawater spray helps keep the mucous membrane moist.

My upper teeth feel numb: is this normal? Yes, it happens. Small nerves run near the base of the septum. Numbness of the upper incisors or palate generally disappears within a few weeks. If the numbness persists beyond a few months, talk to the surgeon.

Does the sense of smell return? Yes. It is often reduced during healing, then gradually returns. It sometimes even improves compared with before the procedure, thanks to better airflow. Report any loss of smell that persists beyond a few months.

When is the result final? Breathing is generally clearly improved after four to six weeks, and the result is stable at around two to three months. Check-ups allow healing to be monitored.

How many check-ups should I plan for? Often a check-up at around one week for splint removal, then another a few weeks later to check healing and the absence of adhesions. The check-up also allows any adhesion to be treated quickly.

Risks and results

Is septoplasty a risky operation? It is a common and safe procedure. Complications are uncommon: bleeding, septal haematoma, infection, perforation, adhesions, residual deviation. The surgeon will explain the risks relevant to your situation. The surgeon explains how they prevent each of these risks.

What is a septal perforation? It is a hole in the septum, which can form if the mucous membrane has been torn on both sides at the same point. If small, it may go unnoticed; if larger, it causes crusting, bleeding or whistling. It is treated according to the symptoms. It does not always require treatment if it causes no problems.

What is a septal haematoma? It is a pocket of blood between the mucous membrane and the cartilage, which completely blocks the nose and is painful. It must be drained quickly by the doctor to prevent infection or damage to the cartilage. Severe pain with a completely blocked nose requires emergency medical attention.

What is a synechia? It is a scar adhesion between the septum and a turbinate. It can impair breathing. Splints help prevent it; if it forms, it is simply divided in the consulting room. It is treated simply during a consultation.

Can the nose collapse? Rarely. If too much cartilage is removed, the support of the nose may decrease and the bridge may collapse. Surgeons always keep a sufficient framework to avoid this risk. This is one of the reasons for surgeons' caution in removing cartilage.

Can septoplasty fail? If the obstruction had other untreated causes, such as an allergy, enlarged turbinates or a weak valve, the result may be disappointing. A residual deviation is also possible. That is why the assessment must be complete. A complete assessment before the procedure reduces this risk.

Is further surgery sometimes needed? In a minority of patients, a revision is needed for residual deviation, adhesions or a troublesome perforation. It is discussed after healing. A revision is generally simpler once healing is complete.

Can septoplasty change the voice? A nasal-sounding voice is common during the period of swelling. After that, the timbre is generally unchanged, sometimes slightly clearer thanks to better airflow. Most patients notice no lasting change.

Is bleeding normal? A slight blood-tinged discharge is normal for the first few days. Heavy bleeding that persists despite sitting with the head tilted forward requires you to contact the team. Keep the department's number to hand.

Which signs should alert me? Heavy bleeding, fever, increasing pain with complete blockage, redness or swelling of the nose, a purulent discharge. Contact the team without delay; in an emergency, call 144. Do not stay alone with any doubts.

Will my breathing be perfect? It is clearly improved in most patients, but not always perfectly symmetrical. The natural nasal cycle persists, and an allergy can still cause periods of congestion. The improvement is generally clear and lasting.

Is the result lasting? Yes, in the vast majority of patients. The nose nevertheless continues to change with age, and other causes of obstruction may appear later. A new consultation is useful if symptoms return.

Does septoplasty improve sleep? Often, yes: less mouth breathing, a less dry mouth, more comfortable sleep. The effect on snoring and sleep apnoea is more variable. Many patients feel more rested when they wake up.

Does septoplasty improve sporting performance? Many athletes find breathing easier during exertion, particularly in endurance sports. The effect depends on the severity of the initial obstruction. The effect depends on the severity of the obstruction before the procedure.

Does smoking increase the risks? Yes, particularly the risk of perforation and poor healing of the mucous membrane. Stopping is strongly advised. Smoking also delays the healing of crusts.

Are complications covered? For a septoplasty covered by basic insurance, care related to a complication is also covered, under the usual rules. For an associated cosmetic part, the after-effects may not be covered. Check with your insurer if in doubt.

Is infection common? No, it is rare. Antibiotics may be prescribed in certain situations, particularly if splints or packing remain in place for several days. Report any fever or unusual discharge.

Can septoplasty cause a dry nose? Dryness and crusting are common during healing. Lasting dryness is rare; it is more common if the turbinates have been over-reduced, hence the importance of preserving the mucous membrane. Regular rinsing limits this drawback.

Who should perform the procedure? A specialist in otorhinolaryngology (ENT), or a plastic surgeon trained in nose surgery, particularly for septorhinoplasty. Check the title in the MedReg register. Your family doctor can refer you to a specialist.

How can I reduce my risks? Stop smoking, report your treatments and medical history, and follow the instructions: rinsing, no hard nose-blowing, no intense exertion or diving during the specified period, and attend your check-ups. These precautions are simple and very effective.

Organising your septoplasty in Switzerland

Is septoplasty reimbursed in Switzerland? Yes, in principle, when it treats medically established nasal obstruction. It is then covered by compulsory health insurance, subject to your usual deductible and co-payment. The cosmetic part of a septorhinoplasty, however, remains at your expense. The exact rules depend on your policy.

How much will I pay myself? Your share corresponds to the deductible, if not yet reached in the year, then a co-payment of 10% of costs, capped annually. For a hospital stay, a flat daily contribution to hospital costs is added. Your insurer can give you an estimate of your contribution.

Is prior approval from the insurer needed? For a medically justified septoplasty alone, approval is not always required. As soon as a cosmetic procedure is combined, a prior cost approval request that distinguishes the two parts is strongly recommended. If in doubt, ask your insurer for a written answer.

Can I have surgery in another canton? Yes. Free choice of hospital in principle allows you to be treated in a facility on any canton's hospital list, even outside your own canton. Coverage is then limited to your canton's tariff; a difference may remain at your expense without suitable supplementary insurance. Your insurer can inform you of the financial consequences of this choice.

Is supplementary insurance useful? It allows you, in particular, to choose your doctor and be treated in a private or semi-private room. It is not necessary in order to have surgery in good conditions in a general ward. Check the conditions of your policy before the procedure.

What if my deviation results from an accident? Accident insurance is in principle responsible. For employees, this is the employer's accident insurance; for others, the accident cover of their health insurance. Report the accident and keep the documents. Report the accident as early as possible.

Are waiting times long? They vary between hospitals and practices. For a non-urgent procedure, a few weeks to a few months is usual. Your doctor can refer you to a facility with reasonable waiting times.

Do I need to go to a university hospital? Not necessarily. Routine septoplasties are performed in many cantonal and regional hospitals, as well as by ENT specialists in private practice. University hospitals readily take on complex cases and revisions. They are, however, a valuable resource for difficult situations.

Can I have surgery near home? Often yes, as septoplasty is performed in most cantonal hospitals with an ENT department or clinics. Ask your family doctor about local provision.

How many days off should I plan for? Generally one to two weeks. For a medically justified procedure, a certificate of incapacity for work is issued by the doctor. The certificate of incapacity for work is issued by the doctor.

What is the best time of year? If you are allergic to pollen, avoid your allergy season. Autumn and winter, outside cold epidemics, are often suitable. Also avoid periods of cold and flu epidemics.

Can my family doctor help me? Yes. They can refer you to an ENT specialist, issue the referral if your insurance model requires it, carry out the pre-operative check-up and follow the first few days. They can also coordinate follow-up after the procedure.

Can I be treated in my own language? Yes. ENT departments exist in all language regions, and bilingual regions often offer a double choice. State your preferred language when booking.

What should I prepare at home? Saline solution for rinsing, soft tissues, a humidifier, pillows to sleep with your head raised, plenty to drink and easy-to-eat food. Keep what you will need for the first few days within reach.

Do I need someone with me? Yes, for the journey home after anaesthesia, and ideally for the first night. If you live alone, arrange for a relative or friend to be with you for the first night.

Which documents should I keep? The operative report, prescriptions, the certificate of incapacity for work, insurance statements and, in the event of an accident, the related documents. These documents are useful if your insurer has any questions.

Do I need a particular insurance model? No. All basic insurance models cover medically justified septoplasty; only the way you access a specialist varies according to the model chosen. The benefits covered are the same in all models.

Can septoplasty be performed at the same time as tonsil surgery? It can sometimes be combined with other ENT procedures, depending on the surgeon's assessment and your health. The surgeon assesses the value and feasibility of the combination.

Can I get a first opinion quickly? Your family doctor or an ENT specialist can assess your situation. You can also send us your request, particularly if you are considering a septorhinoplasty combining form and function. The more precise your description, the more appropriate the guidance.

How can I get a personalised opinion? Fill in the form on this page, describing your breathing problem, the side affected, your medical history and, if you are also considering a cosmetic change, photos of your nose. We will direct you to appropriate care. Free and without obligation. You generally receive a reply within twenty-four hours of receipt of a complete file.

Describe your breathing problem, the side affected, your medical history and the treatments you have already tried. If you are also considering a change to the shape of your nose, attach front, profile and from-below photos. We will direct you to appropriate care. Free and without obligation.