Seek a rhinoplasty surgeon well versed with this procedure

You should seek out a rhinoplasty surgeon who is well versed with this procedure. Many surgeons who perform many cosmetic rhinoplasty procedures should be comfortable evaluating and treating nasal obstruction. However, this is not always the case and a patient should feel comfortable asking their surgeon how they feel about this. On the other hand, not every E.N.T. surgeon who is comfortable treating nasal obstruction, is comfortable performing a cosmetic rhinoplasty. You may find that the right surgeon is either a plastic surgeon or an otolaryngologist (ENT).

Whether you see a plastic surgeon or an ENT, your surgeon should listen carefuly to your problems, do a careful examination, and be able to point out to you what your fixable issues are, if any.  Sometimes patients with breathing problems need to see an allergist, not a plastic surgeon.  You should feel very comfortable with the consultation and the doctor's expertise, thoroughness and concern for you.

If you are simultaneously considering aesthetic improvement of the nose, you should feel that the surgeon is well versed in aesthetic rhinoplasty.  The plan for your nose should feel very specific to the issues.  the plan should make basic sense.  You may want to look at a number of before - after pictures, to see the doctor's style.

There are many fine surgeons from both the ENT and the plastic surgery camps. 

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I believe that most well-trained plastic surgeons can diagnose and treat your functional nasal airway problem(s) .  The most important step is determining the cause of your functional problem(s) - residual septal deviation, enlarged turbinates, internal nasal valve collapse or external valve issues. Each of these problems require a unique approach to correcting the nasal airway obstruction.   I agree that you should seek out a surgeon that has solid training and extensive experience with nasal surgery. 

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Surprisingly enough, a deviated septum is not usually the cause of nasal airway obstruction. Very few people have absolutely straight nasal septum. The lower lateralturbinates, a swelling of bone covered with mucosa, normally regulates the flow of air through the nose. If the septum is curved or tilted, the turbinates adjust be shrinking or swelling. Ordinarily, one side of the nose is usuallymore obstructed than the other. If one side is always blocked more than the other, then a structural  problem may exist. The flow of air isa dynamic event and the regulation is controlled by numerous structures and factors. It is usually these elements (i.e. interal valve, external valve, turbinates) rather than the static deviated septum that are at fault. A well-trained plastic surgeon should be in tune with the dynamic function of the nose and should be able to adequately diagnose and treat this problem but be sure who ever treats it is knowledgeable about airway dynamics , not just cosmetics.

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