Nasal obstruction can be from many different causes. One common cause is a deviated septum. The septum is made up of cartilage and bone. A crooked septum can be a result of nasal trauma, congenital (naturally grew that way) or post-surgical. The majority of septal surgery is performed with incisions that are hidden inside the nose and removes portions of the cartilage and/or bone that is crooked and blocking nasal airflow. This type of surgery doesn’t change the shape of the nose on the outside. However, some patients require an open approach to their septal surgery with a more involved septal reconstruction, which may change the external appearance of the nose.