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Ent vs Ent rhino surgeon, who to trust?

I need a sec opinion on post up. want to know if stable and last and if there is collapse or not. I do have trouble breathing. But seems to improve slowly every 3 to 4 months. IMO maybe swell/allergies. I went to 2 ent doctors and they say my it loos stable, no collapse. But the rhino surg doc said I have collapse because there no graft but then he read my report and it says I have graft. So, he goes OK then you don't have valve collapse, shady! And so he mentions other things that need repair.

Doctor Answers (6)

You need the most experienced super-specialist available

+2
Dear Nosejob12;

It sounds like you do need a second opinion, and you are wise to make this inquiry. This question whether there is "collapse or not," needs to be settled and, if you are having trouble breathing after surgery, that is not ideal. Now, it is good to know that you have been improving every three to four months. I am not sure how long it has been since your surgery, but often it takes six to nine months, even 12 months for everything to settle down and give you the final result. Two consultants you saw said there was no collapse, but another surgeon said you did have collapse. Collapse is when the sides of the nose migrate towards the midline with in-breathing, suggesting there is not enough strong cartilage to support the walls of the nose because the inflow of air causes somewhat of a negative pressure.

You should definitely consult with a cosmetic super-specialist.You need someone who has long experience in the field who has handled a lot of revision and repair work. A complete internal examination should be done in which the inside of the nose is anesthetized and the surgeon looks, feels and checks out all the structures so he gets a sense of what is going on.You will want to bring all the medical records with you.The doctor needs to know what was done, how it was done and when it was done. All preoperative photographs should be brought.
I recommend that you read a cosmetic plastic surgery book which has a section on consulting, particularly when there is some patient dissatisfaction.

You also want to visit many websites, especially those who are trained, super-specialized nasal surgeons.You will learn a lot.You need to understand the anatomy, and you can glean all that from studying. Be prepared before you go for consultation and you will get a lot more out from it. I am sure you can be helped. Remember that timing is very important -- too early is not good. Remember that the nose takes time to ripen and mature.

Best wishes from Beverly Hills, California.

Robert Kotler, MD, FACS



Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 52 reviews

Best surgeon for rhinoplasty is one who does good functioning noses as well as attractive noses.

+1
Best surgeon for rhinoplasty is one who does good functioning noses as well as attractive noses. Wait a full year, then see a very experienced rhinoplasty surgeon who does noses u like.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Rhinoplasty

+1
It would be necessary to examine you in person to determine the cause of your breathing problem.  It could be some other internal obstruction. Only an exam would be able to sort it out, but by all means, get more than one opinion.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 7 reviews

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Look for a double board-certified ENT and facial plastic surgeon

+1
Look for a  nasal surgeon who is  double board certified by the American Board of Otolaryngology AND  by the American Academy of Facial Plastic and Reconstructive Surgery. Also look for a surgeon who is performed thousands of functional and cosmetic nasal surgeries for best results. For more information, diagrams and our  before and after photo gallery, please see  the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 54 reviews

Valve collapse

+1
Your best option is to get yet another opinion by a doc who is board-certified by both the American Board of Otolaryngology and the American Board of Facial Plastic and Reconstructive surgery.  With in-office tests and exams, the degree, location, and etiology of your periodic obstruction can be determined.  Valve collapse is unlikely to be the main cause of episodic plugging.  Best wishes. 

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Ent vs Ent rhino surgeon, who to trust?

+1
I really don't understand yuour question. You have seen three doctors, all of whom said don't do anything and you say everything keeps getting better. If you inhale vigorously through your nose and the sides collapse, you probably need another graft it would seem, but no way to know without an exam and you have had three of those already that have told you the nose is stable.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.