Great question! Here are some helpful suggestions:
1. Rhinoplasty today should leave you with the aesthetic results you desire and a nose that has no difficulty breathing. There is no point to have a nose surgery to correct a crookedness for example but not to correct breathing issues. Likewise, it does not make sense to "do a septoplasty" but then the nose still does not look right. So you want to chose a board certified plastic surgeon who has experience in rhinoplasty who can address both the functional ( breathing) and aesthetic (appearance) issues.
2. Fixing a "deviated septum" may not correct your breathing problems: Approximately 60% of people who had septoplasties still had breathing problems. You need to know what the problem is for you before you can have the right "solution".
3. Touching one part of the nose but not the others is fraught with disaster. The nose is like a tent. It needs the proper support; take that away and it will collapse. There is no such thing as "only fix the bump". So you want someone who can understand and manage what you need.
4. Go for the consultation, see the before and after and ask about experience. That will be of some value. What is really best is to see if you questions can be answered in a way that makes sense to you and with a plan that feels right. If you feel confused or intimidated, it is not right.
What a difficult task it is to choose a surgeon to do a
rhinoplasty. So many doctors out there claim to be experts and who is to really
say? You have to ask around. Talk to patients, doctors and especially nurses if
you can find one that works in the OR.
When it comes to rhinoplasty vs. septoplasty vs.
septorhinoplasty, in general most top rhinoplasty experts are using septal
cartilage and correcting any issues with the septum as a routine part of nasal
surgery. I am not sure I can think of one case in the last 12 years when I didn’t
do some work on the septum when doing a rhinoplasty. I think it is nearly
impossible to separate the two. If a septum is crooked it will need to be
addressed to make the nose straight. Most maneuvers I use to change the
projection and rotation of the nasal tip rely the the shape and strength of the
septum it often needs enhancement during rhinoplasty surgery.
I hope this helps with your decision.
It's important to go to a board certified facial plastic surgeon or a plastic surgeon who specializes in performing lots of nose surgery. Look for a surgeon who has performed thousands of septoplasty and rhinoplasty procedures for best results. Look at their testimonials, readings, reviews, and before and after photo gallery to get an idea of Who can deliver the results that you require
A septoplasty and a rhinoplasty are 2 completely separate procedures that can both be performed at the same time under one anesthetic.
For many examples of rhinoplasty, please see the link below
Often the Plastic Surgeon who performs Rhinoplasty will take portions of the septum to highlight and enhance the tip of the nose. Thus, modern plastic surgery of the nose involves the nose plus the septum. When large amounts of septum need removal with straightening, this gives the surgeon ample material to give straighten the nose, provide support for breathing, and give the tip a beautiful perk. Ask your primary doctor first, then friends who may have had the surgery, and visit a few doctors who can show you their work. Sometimes insurance may help with the septoplasty, but insurance will only cover a portion of the operation. Blue Cross for example, while providing coverage for reconstructive surgery, will request records of prior conservative treatment such as nasal sprays, allergy medication or testing, and other doctor's reports in order to even consider covering a septoplasty. Most experienced doctors performing modern rhinoplasty are not inclined to embark through this paperwork Remember, many people have some deviation of the septum and do perfectly fine without an operation. Only when it contributes to blockage as shown by careful documentation and patient honesty, will it be considered medically necessary. Do not submit to surgery if price is the key consideration and you are able to get the entire operation covered at no cost to you. Best wishes in your search.
Sifting through credentials can be confusing. I would definitely go see a board certified doctor in either Plastic Surgery or Facial Plastic Surgery. Most Facial Plastic Surgeons are also Board Certified in Ear, Nose and Throat so they have a large depth of knowledge in nasal surgery, both cosmetic (rhinoplasty) and functional (septoplasty). Some Board Certified Plastic Surgeons don't have as much experience with nasal surgery, but those that specialize in rhinoplasty are very well qualified as well. First hand referrals are always a good source of information as well. Good luck!
Both can be performed at the same time through a closed approach with no visible scarring.
Kenneth Hughes, MD
Los Angeles, CA
A crooked nose deformity can be caused by several different mechanisms or a combination of them. A deviated septum may be contributing, the interplay between your nasal cartilages and the upper bony pyramid also affect the size, shape and direction of the nose. I would recommend seeing a facial plastic surgeon with expertise in this area.
The first step is to contact the American Society of Plastic Surgeons (ASPS) for a listing of Board Certified Plastic Surgeons in your area. Another good avenue would be to contact the hospital for a listing of Plastic Surgeons who have hospital privileges. Not every plastic surgeon does Rhinoplasty surgery. Consult with Plastic Surgeons who are very experienced in Rhinoplasty surgery.
With regard to the functional aspect of your nose, a septoplasty will address any nasal obstruction caused by a deviated septum. A crooked nose can to some degree be addressed with the septoplasty. But, often times a rhinoplasty will have to be performed to straighten the bony and external cartilaginous portions of the nose. Choosing a good rhinoplasty can be difficult because not all plastic or facial plastic surgeons have the experience to produce a good result. It takes time and lots of cases to develop skills to become a really good nose surgeon. It will take a lot of research and consultations on your part to find someone with whom you trust and feel comfortable. Thank you for your question. Best of luck.