As a surgeon that has completed full residencies and holds current board certifications in both Plastic Surgery and ENT (American Board of Plastic Surgery and American Board of Otolaryngology-Head and Neck Surgery), I can tell you that an accurate diagnosis is a vital step toward treating your symptoms.
To simplify a bit, nasal breathing problems can have three different causes, all of which need to be carefully evaluated before determining the correct treatment:
1. Fixed obstructions. A deviated septum, a septal spur or any other anatomical obstruction that is always present are examples of fixed obstructions.
2. Variable obstructions. When we have a cold, tissue lining the nose (especially over the turbinates) swells-up and causes blockage and a "runny nose." Environmental allergies also cause this phenomenon.
3. Functional obstructions. The nose is often not well-supported lower-down along its sidewalls (where there is a lack of cartilage framework). This area acts as a "bellows" that can collapse when you breathe in, similar to how a straw collapses if you suck-in strongly. Trauma to the nose, particularly when the nasal bones are broken, typically causes septal deviation. However, very often nasal obstruction is multifactorial, and your treating physician should perform a careful analysis of all three potential causes of obstruction. In other words, just because you have a deviated septum does not mean that you are assured relief by just straightening it, as other factors may be involved.
In summary, a careful evaluation of nasal function is critical to all surgery of the nose, even if there is no preoperative breathing problem. As I think you can surmise from other answers, there will be excellent Plastic Surgeons and ENT Surgeons that can successfully treat your problem. Just as there are many Plastic Surgeons and some ENT Surgeons that are not as experienced and competent.
Hope this helps.
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