Objective To analyze the safety of nasal septum deviation correction surgery combined with deviated nose plastic surgery under nasal endoscopy. Methods A total of 70 patients who underwent nasal septum deviation correction surgery in the Plastic Surgery Department of Nantong Chunshushang Medical Beauty Clinic from July 2022 to May 2024 were selected as the research subjects, and they were randomly divided into routine group and experimental group, with 35 patients in each group. The routine group was given nasal septum deviation correction surgery by the two-line tension-reduction method under nasal endoscopy, and the experimental group was given nasal septum deviation correction surgery combined with deviated nose plastic surgery under nasal endoscopy. The operation condition, pain degree and complications were compared between the two groups. Results The operation time and hospitalization time of the experimental group were shorter than those of the routine group, and the differences were statistically significant (P <0.05). The VAS score of the experimental group at 1 week after operation was lower than that of the routine group, and the difference was statistically significant (P <0.05). The incidence of complications in the experimental group was 2.86%, which was lower than 20.00% in the routine group, and the difference was statistically significant (P <0.05). Conclusion The combination of nasal septum deviation correction surgery and deviated nose plastic surgery under nasal endoscopy has good safety. It can effectively shorten the operation time and hospitalization time, relieve pain, and the incidence of postoperative complications is low, which is conducive to promoting the rapid recovery of patients.