Written and medically reviewed by Dr Nizar Hamadeh, MD, MSc (Plastic Surgery), Consultant Plastic Surgeon on the GMC Specialist Register for Plastic Surgery. GMC number 7009480. Last reviewed: 4 October 2026.
If you have been told you have a deviated septum and one side of your nose feels blocked most of the time, the next question is usually practical: can you have surgery on the NHS, or should you go private? Both routes lead to the same basic operation, but they differ in who qualifies, how long you wait, what you pay and whether the outside of the nose can be changed at the same time. This guide explains septoplasty on the NHS and privately, so you can decide which route suits you. If you also want the shape of your nose refined, septorhinoplasty in London combines both in one operation.
What is a septoplasty?
A septoplasty is an operation to straighten the nasal septum, the thin wall of cartilage and bone down the middle of the nose that divides it into two airways. When the septum bends to one side (a deviated or bent septum), it can block airflow on one or both sides. Septoplasty is done from inside the nostrils to improve breathing, not appearance. It is separate from sinus surgery, which treats the sinuses rather than the septum. We explain more in does septoplasty change nose shape.
Can you get septoplasty on the NHS?
Yes, you can get a septoplasty on the NHS, but only when it is needed for a medical reason and you meet local criteria. NHS funding decisions are made by local Integrated Care Boards (ICBs), and each publishes its own policy, so the exact rules depend on where you live.
Most policies share the same core conditions. Published ICB policies, such as those of Cheshire and Merseyside and Humber and North Yorkshire, usually fund a septoplasty when:
- A doctor has confirmed a nasal blockage caused by the septum
- The blockage causes ongoing symptoms that affect your quality of life, such as trouble breathing or poor sleep
- Simpler treatment has been tried first, and other causes, such as overuse of decongestant sprays, have been ruled out
Repeat nasal surgery is generally funded only to improve function, and the NHS does not fund nasal surgery for cosmetic reasons.
If you do not meet your area’s criteria, your consultant or GP can ask the ICB to fund the operation as an exception, through an Individual Funding Request (IFR). These requests need evidence that your case is clinically exceptional, so most are not approved.
How does septoplasty on the NHS work?
The NHS route starts with your GP and usually follows these steps:
- See your GP. Your GP examines you, asks about your symptoms and may suggest treatment first, such as a steroid nasal spray.
- Get a referral. If the blockage continues, your GP refers you to an ear, nose and throat (ENT) department. In England you usually have the right to choose which hospital you are referred to.
- Specialist assessment. An ENT surgeon examines your nose, often with a thin camera, and decides whether surgery is likely to help.
- Funding check. In some areas the hospital must get approval from the ICB before operating.
- Waiting list. You join the waiting list for surgery.
In England, the NHS Constitution sets a maximum of 18 weeks from referral to treatment for non-urgent care, but many ENT waiting lists are longer than this. Waiting times vary widely between hospitals, so ask your GP or the hospital for the current wait, or check the My Planned Care website.
How does private septoplasty work in the UK?
Private septoplasty in the UK is paid for yourself or through private medical insurance, and you choose your surgeon and your date. You can usually book a consultation directly, although many insurers ask for a GP referral and pre-approval before they will cover the cost, so check your policy first.
Going private does not skip the medical assessment. A surgeon still examines your airway and explains whether surgery is likely to improve your breathing. The main differences are speed, choice of surgeon and the option to change the outside of the nose in the same operation.
Is the operation the same on both routes?
The operation itself is the same whichever route you take. It is usually done under general anaesthetic, so you are asleep. The surgeon makes a small cut inside the nostril, straightens or removes the bent cartilage and bone, and closes the cut with dissolvable stitches. Some surgeons place soft silicone splints on either side of the septum for about a week. Most people go home the same day.
What are the risks of septoplasty?
Septoplasty is a common operation and serious problems are uncommon, but every operation carries risks. NHS hospital patient information typically lists:
- Bleeding, occasionally needing nasal packing or a return to theatre
- Infection
- A small hole in the septum (septal perforation)
- Numbness of the upper front teeth or the tip of the nose, usually temporary
- A change in sense of smell
- A nose that remains partly blocked, sometimes needing further treatment
- Rarely, a change in the shape of the nose, such as a dip in the bridge
Your surgeon should explain how these risks apply to you before you agree to the operation.
What should I expect during recovery after septoplasty?
Recovery is the same whether the operation is on the NHS or private. In the first days, some bleeding, swelling and a blocked feeling, like a heavy cold, are normal, and blood-stained watery fluid can drain for the first couple of weeks. Most people need one to two weeks off work, and should avoid strenuous exercise for longer.
What aftercare advice is given after septoplasty?
Your hospital gives you written aftercare advice before you go home, and you should follow your own surgeon’s instructions. Advice commonly includes:
- Breathe gently and avoid blowing or sniffing hard in the first days
- Avoid heavy lifting and strenuous exercise, which can increase swelling and bleeding
- Use saline rinses if advised, to reduce crusting
- Seek medical help if you notice heavy fresh bleeding, a high temperature or increasing pain
NHS or private: how do they compare?
| NHS | Private | |
|---|---|---|
| Cost | Free at the point of use | Self-pay or private medical insurance |
| Who qualifies | Only patients who meet local ICB criteria | Anyone the surgeon assesses as suitable |
| Waiting time | Depends on your local hospital; often several months | Usually weeks |
| Choice of surgeon | You can choose the hospital, but not usually the surgeon | You choose |
| Changing the shape of the nose | Not funded for appearance | Possible with septorhinoplasty |
| Repeat surgery | Only to improve function | Function and appearance |
Is there a difference in outcomes between NHS and private septoplasty?
The operation is the same on both routes, so the result depends mainly on your anatomy and on the surgeon’s experience with septal surgery, not on who pays. What differs is how quickly you are treated, whether you choose your surgeon and whether the shape of the nose can be changed at the same time. On either route, it is reasonable to ask the surgeon how often they perform the operation and what result to expect in your case.
Can the shape of your nose be changed at the same time?
The NHS will not change the shape of your nose for appearance. Published ICB policies allow rhinoplasty alongside a septoplasty only when the outside of the nose must be corrected to relieve a blockage, for example after an injury. If you want your breathing and the look of your nose improved in one operation, that is a private septorhinoplasty. It straightens the septum and reshapes the outside, for example the bridge or the nasal bones, with one recovery instead of two.
Which route is right for you?
The NHS route suits you if your main problem is breathing, you meet your area’s criteria and you are comfortable with the wait. A private route suits you if you want to choose your surgeon, have surgery sooner, or also want to change the shape of your nose. Some people start on the NHS pathway and move to a private consultation once they know the waiting time in their area.
Whichever route you choose, start with a proper examination of the inside of your nose. A deviated septum is only one cause of a blocked nose, and the right treatment depends on the cause.
Frequently asked questions
Can I pay to skip the NHS waiting list for septoplasty?
No. You cannot pay to move up an NHS waiting list. You can choose to have a private consultation or operation instead, and still use the NHS for the rest of your care.
Does private medical insurance cover septoplasty?
Many policies cover septoplasty when it is needed to treat a breathing problem, usually with a GP referral and pre-approval. The cosmetic part of a septorhinoplasty is not normally covered, so check your policy before booking.
Does septoplasty change the shape of the nose?
Septoplasty is designed to improve breathing, not to change appearance, and in most cases the outside of the nose looks the same. Read more in does septoplasty change nose shape.
How soon will I breathe better after septoplasty?
Most people notice a difference once the early swelling settles, usually within a few weeks. The full benefit can take a few months as the inside of the nose heals.
Booking a private consultation in London
At a consultation at 10 Harley Street, Dr Nizar Hamadeh examines the inside and outside of your nose, checks your breathing and explains the options that suit your anatomy and goals. If you are also considering a change in shape, he follows the Royal College of Surgeons’ two-stage consent process, with a cooling-off period before any cosmetic surgery. He operates at The Fitzrovia Hospital, the Cadogan Clinic and HHV.
You can start with an initial video call, but surgery is only ever planned after an in-person examination. Book a consultation
About the author
Dr Nizar Hamadeh is a Consultant Plastic Surgeon on the GMC Specialist Register for Plastic Surgery (GMC 7009480), seeing patients at 10 Harley Street, London. He qualified in medicine in 1997, trained in otolaryngology and head and neck surgery at university hospitals in Paris and Brussels, and holds an MSc in Plastic Surgery. His practice focuses on aesthetic and functional rhinoplasty, including septoplasty and septorhinoplasty, alongside facial rejuvenation. He operates at The Fitzrovia Hospital, the Cadogan Clinic and HHV. He was a finalist for Best Surgical Result at the Aesthetics Awards 2025. Read Dr Hamadeh’s full profile.
Sources
- NHS Cheshire and Merseyside ICB: Reshaping the nose (rhinoplasty/septoplasty) policy
- NHS Humber and North Yorkshire ICB: Surgery for nasal deformity policy
- NHS: My Planned Care
Medical disclaimer
This article is for general information only and does not replace a personal consultation with a qualified doctor. Every nose is different and results vary. If you have concerns about your nose or your breathing, speak to your GP or a qualified specialist.