I am almost positive that I have a deviated septum, as I have lots of breathing problems. However, I also want my nose fixed for cosmetic reasons, and it'd be nice to do it all at the same time. Who should I see first though? An ENT or just go directly to a plastic surgeon?
Who Do I See First for a Deviated Septum?
Doctor Answers (3)
Facial plastic surgeon for rhinoplasty and deviated septum
It is probably best to look for a nasal surgeon who has performed thousands of septoplasties and rhinoplasties. Many ear, nose, and throat doctors perform only the internal component. Most plastic surgeons perform only the external component. A facial plastic surgeon can perform both of these operations under one anesthetic. Just remember the nasal obstruction and deviated septum component is billed to insurance and the cosmetic is billed directly to the patient.
Choosing a surgeon
That would depend on the type of surgery required to correct the cosmetic and functional issues rather than the specific specialty. If you also have nasal polyps most plastic surgeons would not do that while most ENT facial plastic surgeons would. For the usual septoplasty and rhinoplasty without or without turbinate surgery either specialty would do and the important thing is which specific surgeon you choose rather than the specialty. In fact a number of surgeons are fully trained and cerified in both specialties. I have revised septorhinoplasties originally performed by ENT facial plastic surgeons and I am sure some ENT facial plastic surgeons have revised septorhinoplasties originally peformed by plastic surgeons. The specific surgeon is more important than the specialty in such cases.
Functional and Aesthetic Nasal Concerns: Who to Consult
Speaking in generalities, if you have concerns both for breathing and for the appearance of the nose, you are best off with a Facial Plastic Surgeon. The reason for this is that their training is the most specific for handling both of these concerns. Does this mean that a General Plastic Surgeon can't improve your breathing? No. Does this mean that your ENT can't give you a nice looking nose? No. It is just that these two specialists are primarily trained in only one aspect of nasal surgery, not both. An interesting survey of ENT's that I saw recently asked this very question. If a patient with a deviated septum also had aesthetic concerns, what would you do? 90% would refer the patient to a Facial Plastic Surgeon.