Objective To explore the clinical effect of individualized tension reduction plastic surgery in the treatment of nasal septal deviation. Methods A total of 69 patients with nasal septal deviation admitted to our hospital from October 2020 to September 2022 were selected as the research objects. All patients were treated with individualized tension reduction and plastic surgery. The clinical efficacy, surgical indicators, nasal resistance, postoperative cosmetic satisfaction and complications were observed. Results The total effective rate of clinical treatment in 69 patients was 97.10%. The operation time was (35.32±10.21) min, the intraoperative blood loss was (61.36±4.28)ml, the nasal ventilation time was (3.85±2.82)d, the pain scores at 1 and 3 days after operation were (4.67±0.39)scores and (3.12±0.18)scores, and the hospitalization time was (7.38±1.42)d. The postoperative NCV was (7.25±1.45)cm3 , which was higher than (4.18±1.09)cm3 before operation; the NAR was (0.32±0.07) kPas?L-1, which was lower than (1.22±0.38)kPas?L-1 at before operation (P