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Most crooked septums need no surgery
When surgery helps
The body adapts, so where someone sits on the spectrum matters. Someone who literally can't breathe out of one nostril because the septum is so deviated should get it fixed, and people who have had the surgery describe it as life-changing for their sleep, athletic performance, and focus.
Inflammation, not structure
For a lot of people the problem has less to do with structure and more to do with tissues that are constantly inflamed, and some of that inflammation is caused by chronic mouth breathing.
What nasal strips do
Nasal strips can help in the meantime. For some people the nostrils flutter or collapse on a breath in, or are just too narrow, and holding them open with two fingers makes breathing much easier. The strips can allow about 30% more airflow and can reduce snoring significantly for some people.
Why are most septums at least slightly crooked?
The septum is cartilage in front and thin bone behind, and the parts can grow at different rates or get pushed off-center by birth or injury. Imaging studies of adults find some degree of deviation in a majority of people. Most are too mild to affect breathing. The septum divides the nose into two passages, and they are rarely the same width.
What is the nasal cycle?
The lining on each side of the nose alternately swells and shrinks, so one nostril carries most of the airflow while the other rests. The switch happens every few hours in most people, though the timing varies. It was described in the 19th century and later measured with airflow sensors. A person with a deviated septum may notice the cycle more on the narrow side.
How do nasal strips open the nose?
An external strip has springy bands that pull the outer walls of the nose outward. This widens the internal nasal valve, the narrowest part of the nasal airway. Studies have measured an increase in nasal cross-sectional area and a drop in airflow resistance with strips. The internal valve sits about two centimeters inside the nostril.