Deviated Septum Nose Surgery - Go to a Plastic Surgeon?

It may sound strange but I like the way my nose looks, it just doesn't work that well, especially the right nostril. I had an E.E.N.T. doctor do this when I was 17, but the results were not very good. I'm 53 now, and haven't found the obstruction any easier to deal with. Should I go to a plastic surgeon to get the deviated septum fixed?

Doctor Answers 39

Trouble breathing through your nose?

There are numerous ENT, Facial Plastic and Plastic Surgeons who have the training and expertise to address your difficulty breathing after a prior septoplasty or septorhinoplasty. This could simply be a persistent deviation in your septum which narrows your nasal airway on one or both sides. On the other hand, you may have some narrowing of what we call the internal or external valves of your nose. The diagnosis could be easily be made with an examination of the inside and outside of your nose. Be sure to visit a surgeon who specializes in revision nasal surgery, as the level of complexity is greater in these cases. 


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

More important is the plan

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.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 109 reviews

Turf battle redux

Oh, turf battles are fun. ;-)

My colleague here mentioned Jacques Joseph as one of the pioneers of rhinoplasty in the early 1900s, which is quite true. But Dr. Joesph was not a general plastic surgeon.

In fact, Jacques Joseph was originally trained as an orthopedic surgeon. However, given his expertise in nasal surgery (and otoplasty...ear pinning) he was later appointed head of the facial plastic surgery section at the Royal Ear and Nose Clinic of the Charite´ Hospital in Berlin by the Prussian Ministry of Education and Cultural Affairs.

--DCP

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

A plastic surgeon is a great choice

The short answer is "yes". I think either a Board Certified Plastic Surgeon or an Ear, Nose and Throat Surgeon who is also properly trained will do just fine. Don't let your previous experience when you were 17 discourage you-- if you're having difficulty with your airway, there is usually a good and safe solution. Have someone with the proper training and experience examine you and give you some options for correction.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 117 reviews

Plastic or Facial Plastic Surgeon is an excellent choice

Rhinoplasty (or nasal reshaping surgery) can be one of the most challenging surgical procedures. There are many plastic surgeons who perform excellent rhinoplasty procedures. Might I suggest even going one step further and find a facial plastic surgeon for your procedure. Facial plastic surgeons are generally ENT physicians who have gone on to have further training facial cosmetic and reconstructive procedures.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

Where to go?

I would recommend seeing a rhinologist (usually an ENT).  You may not need another septoplasty.  A rhinologist could perform an office sinoscopy, allergy testing, and a CT scan to fully evaluate your problem.  Something as simple as a turbinate reduction could solve the problem.   A rhinologist has the most experience at addressing this problem and arriving at an accurate diagnosis.  Not every deviated septum causes symptoms.  Good luck.

Jeffrey Marvel, MD
Nashville Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Plastic surgeon or ENT surgeon for nasal surgery?

Thank you for your question.

Choosing between a plastic surgeon or an ENT surgeon for your nasal surgery is not  a simple decision, but it is a very important one.

First of all, I would encourage you to consider that an experienced surgeon with the appropriate training can handle most nasal airway / breathing problems.  I know a number of plastic surgeons who are very skilled at nasal airway surgery, and I know a number of ENT surgeons who do a fine rhinoplasty - it's really about whether or not the surgeon has the skills, and not as much about where or through which training program he/she got them.

Having said that, you may not have to choose between them - a number of plastic surgeons are also ENT surgeons, and having trained in both disciplines, may be able to tailor your options using multiple perspectives.  

Bottom line - speak frankly with your surgeon, regardless of whether his/her background is ENT or plastic surgery, and ask the important questions - how much experience do you have, what procedures do you think would help the most, what should I expect afterwards?  Then see a few other surgeons to compare, and choose the person that strikes you as the best surgeon for the job.

Best wishes.

Correcting your deviated septum by a plastic surgeon

To be honest if you are only correcting the functional aspect of your nose I do not think it makes a huge difference.  Both plastic surgeons as well as ENT's are trained in the area of correction of breathing/airway issues.  I think there is a lot of ego issues in medicine today and competition.  The truth is you should go to whomever you have a good connection to assuming you have checked their credentials and they are indeed board certified in which ever field. 

Now if you were planing to address the cosmetic aspects of your nose then the debate over a plastic surgeon vs ENT becomes a bit more sticky but I will save you the pain of the discussion.

Hope that helps

Dr Rahban

Rady Rahban, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 53 reviews

Deviated Septum Nasal Surgery - Plastic Surgeon or ENT?

The most important thing is that you seek out a Board Certified Plastic Surgeon or an Otolaryngologist that has both Expertise and Experience in doing both functional and aesthetic rhinoplasty. It does not matter who you go to as long as the person who does the rhinoplasty is very versed in doing septal reconstruction concomitantly.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 28 reviews

Who treats a deviated septum?

The answer is that you can go to a plastic surgeon, ENT or facial plastic surgeon for evaluation. From the description of your symptoms, your deviated septum may have been repaired but you could have collapse of the nasal valve. Once the basis for your condition is elucidated, the surgeon can recommend a plan of treatment.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 17 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.