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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?

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36 Doctor Answers | Asked by Banker Mama in Chicago, IL

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Depends on the surgeon's training

An ear, nose and throat doctor (otolaryngologist) is more qualified to fix a deviated septum. Deviated septum is a functional problem associated with breathing and is a procedure that is frequently done in most ear, nose, and throat doctors’ offices and surgery centers. Most facial plastic surgeons have additional training in facial cosmetic and reconstructive surgery after their ear, nose, and throat background that can easily and readily address a deviated septum with or without any... more

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... more

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... more

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... more

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.

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

3 reviews

Dallas Facial Plastic Surgeon

innovationsfps.com

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

10 reviews

Dallas Plastic Surgeon

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.

Deviated nasal septum

It appears that you will require a revision septoplasty to repair your deviation. This can be a complex procedure and one that may require use of ear or rib cartilage. Your nasal airway obstruction may also be due to valve collapse or turbinate hypertrophy. Seek and experienced nasal/rhinoplasty surgeon for the best functional result.

Nasal obstruction surgery

You should go to a surgeon who is well trained in dealing with nasal surgery both functional and cosmetic. Facial Plastic surgeons are trained to treat both aspect of nasal surgery and have spent at least five years training in head and neck region. I believe, they are best suited to deal with functional nasal surgery.

Facial Plastic Surgeon, Plastic Surgeon, or Otolaryngologist

Facial Plastic Surgeons, Plastic Surgeons, and Otolaryngologist are all trained (in theory) to perform Septoplasty. However, some individuals from each of these groups devote a greater portion of their practice to Nasal surgery. Secondly, some Surgeons are just more experienced and better skilled than others. Word of mouth and evaluation of postoperative results will help guide a patient in his/her decision.

Surgeon for septoplasty

Unfortunately, there is no simple formula to finding the 'best' surgeon for a septoplasty. While some may tell you otherwise, I truly believe that there are ENT, facial plastic, and plastic surgeons who can do the job. The fact is that there are those who are skilled at nasal surgery and those who are not. It really depends on the surgeon's training and experience. Unfortunately, the burden is placed on the patient to find a skilled surgeon, and the patient must rely on the... more

Ryan Greene, MD, PhD

19 reviews

Fort Lauderdale Facial Plastic Surgeon

www.DrRyanGreene.com

Tips For Finding the Right Surgeon

Finding the right surgeon to correct your problematic breathing can be difficult. It is easy enough to paint with a broad brush such as find someone that specializes in rhinoplasty but go to the yellow pages or the Internet and everyone 'specializes' in rhinoplasty. Certainly, you can ask around and this is usually a good start but remember that studies show that a doctor's personality usually has more influence over whether they are considered a top doc than... more

Both types of surgeons could possibly help you...

An experience nasal surgeon-either a Plastic surgeon or an Otolaryngologist could help you. I find two reasons for continued nasal obstruction after a prior septoplasty-either the first surgeon did not do a good job or there is a dynamic component to the obstruction that the septoplasty did not correct. This means that you may have a weakness in the nostril area or even in the support of the tip that if corrected may offer you improved breathing. You may also have other factors such as... more

Ivan Wayne, MD

13 reviews

Oklahoma City Facial Plastic Surgeon

www.oumedicine.com

Expertise for a Deviated Septum

There are a number of excellent board certified plastic surgeons and ENTs who perform septoplasty. The important aspect is to find an experienced surgeon with expertise in the procedure who you are comfortable with and an understanding of your objectives.

The surgeon not the specialty is the key

Surgeons trained as otolaryngologists-head and neck surgeons are well trained in the treatment of nasal septal deformities. Surgeons trained as plastic surgeons are well trained in the treatment of nasal septal deformities. It is best to find out about the experience in nasal surgery to determine who to have perform your surgery, the specialty is irrelevant.

Robert Mounsey, MD

5 reviews

Toronto Facial Plastic Surgeon

revesse.ca

Both plastic surgeons and ENTs generally good for deviated septum repair

Many plastic surgeons are very skilled at repairing deviated septums. Many ENTs are also very skilled at repairing deviated septums. I'd recommend you get two opinions, one from each specialty for your own peace of mind.

Plastic Surgeon or ENT Doctor are good for deviated septum surgery

Both of these specialists are good choices for deviated septum surgery so long as they perform rhinoplasty and septoplasty weekly as part of their practice.

Find a Rhinoplasty Surgeon who has experience correcting both functional and cosmetic issues

Choosing a qualified surgeon is the most important decision you can make when deciding to under go nasal surgery. First and foremost, choose an surgeon who specializes in nasal surgery and who has experience correcting both functional problems (such as a deviated septum) and cosmetic problems. While most ENT doctors routinely perform a septoplasty to correct a deviated septum, not all ENTs perform rhinoplasty. Similarly, not all plastic surgeons who are able to address cosmetic... more

Plastic Surgeon is a good choice for deviated septum

Often patients seeking a rhinoplasty complain about some breathing problems which are caused by deviated septum. An experienced board certified plastic surgeon should be able to examine your nose and evaluate the problems. During the consultation you should be explained what is causing the nasal airway obstruction in your case. Both procedures rhinoplasty and septoplasty can be done at the same. The septoplasty can be covered by most of insurance plans; the predetermination has to be done... more

Fixing a Deviated Septum

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... more

Surgeon dependent not specialty dependent

Anytime there is nasal obstruction, you should focus on the cause of nasal obstruction which can be from septal deviation as well as internal and external valve collapse, enlarged turbinates, septal perforation, and a host of other medical conditions which can cause nasal obstruction. Within the fields of facial plastic surgery and plastic surgery you should focus on finding a surgeon with extensive experience in the functional aspects of the nose.

Plastic Surgery and Repair of a Deviated Septum

Every subspecialist has a particular practice emphasis. Plastic surgeons are well trained in the functional, structural, and aesthetic elements of a septorhinoplasty. It is ideal to consult with a plastic surgeon to not only correct your functional airway obstruction but to also lend aesthetic harmony to your face.

Who Should Correct a Deviated Septum?

Hi Banker Mama, You first need to be diagnosed. The cause of your nasal obstruction needs to be determined by a surgeon who specializes in the function of the nose. Certainly ENT surgeons are well trained in the diagnosis and treatment of functional nasal breathing problems. There are facial plastic surgeons and plastic surgeons that are just as qualified to correct the problem. You should seek out a physician who uses either Somnoplasty or Coblation in their office, radiofrequency... more

Michael A. Persky, MD

21 reviews

Los Angeles Facial Plastic Surgeon

drpersky.com

Make sure nasal surgery is a mainstay of their practice.

You can use the services of either a General Plastic Surgeon who specializes in cosmetic and functional nasal surgery, or an ENT/Facial Plastic Surgeon who specializes in the aforementioned. Board-certification is a must. Preoperative evaluation of your breathing issues with a CT scan may bring forth other issues that are better treated by an ENT/Facial Plastic Surgeon such as polyps or sinus problems. Otherwise for a straight-forward deviated septum the only matter of importance is the... more

Any sinus problems?

Both plastic surgeons and otolaryngologists are trained in the correction of functional problems of the nose, so either would be a good choice. If you have frequent sinus problems, e.g. sinusitis, you may need to have a procedure that allows the sinuses to drain better (functional endoscopic sinus surgery, FESS), best performed by an ENT. Your primary care physician may be able to start the ball rolling with a CT scan if this is the case and refer you on to either a plastic surgeon or ENT... more

"General" Plastic or "Facial" Plastic?

Plastic Surgeons and Facial Plastic Surgeons are both well-trained in surgery of the head and neck area, including Cosmetic and Functional Rhinoplasty and Septoplasty. When it comes to functional problems with the nose causing breathing difficulties, it is important to have a thorough evaluation of the nose in order to arrive at the proper diagnosis and treatment plan. Many factors can cause nasal obstruction, including previous surgery on the nose, and the septal deviation may not be the... more

Yes

Plastic Surgeons (Certified by the American Board of Plastic Surgery) are well trained in both the cosmetic and functional aspect of the nose. I would suggest, however, to go to a plastic surgeon who does a lot of nasal surgery. Some plastic surgeons do not do a lot of nasal surgery and a phone call to the office can clarify that for you.

Deviated septum rarely the main cause of breathing problems

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... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

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... more

Figure out the problem first

The most important issue is to determine the cause of the obstruction, which may not be structural in nature. There are many causes including allergies which may better be treated with medications rather than surgery. First, figure out the problem. This may take several specialists including an allergist, ENT specialzing in sinus disease, and plastic surgeon. It is also likely to have a CT or MRI scan to evaluate other potential causes for the obstruction. Take your time and evaluate your... more

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Redo Rhinoplasty

There are some great answers here. I agree that both ENT (facial plastic surgeons) and plastic surgeons are well trained to handle this issue. However, what you should focus on is finding a surgeon that also has experience in redo rhinoplasties. Trying to fix a problem a second time around can lead to additional challenges. A board certified ENT or plastic surgeon is a good place to start, but make sure you find someone who has experience with redo (revision) rhinoplasties. I hope this helps! more

Go to an ear, nose, and throat doctor for breathing problems.

If you like the shape of your nose, you don't need a plastic surgeon ( or even a facial plastic surgeon). You need someone who specializes in fuctional problems of the nose and sinuses. And you need a good evaluation. Breathing problems are often not caused by a deviated septum. Make sure you have a board certified ENT doctor.

Plastic Surgeons and Facial Plastic Surgeons can both help you

Both Plastic Surgeons and Facial Plastic Surgeons (usually ENT physicians) can help with your problem. The key is that they have a special interest in nasal surgery, both functional and cosmetic. You need a doctor who spends a significant amount of his or her practice focused on the nose. So ask how many nasal surgeries they do each year and compare the answers you hear. Also, ask to speak with a patient or 2 who have had a procedure like the one proposed for you and see if they are happy. more

Plastic surgeons are well-trained

Turf wars abound in cosmetic and plastic surgery venues. American Board of Plastic Surgery has been around since 1931. Plastic Surgeons have won the Nobel Prize in Medicine for kidney transplant. Plastic surgeons are on the forefront of stem cell work and tissue engineering. Plastic Surgeons were the doctors to perform facelifts and rhinoplasties since the turn of the 20th century (Jacques Joseph 1904). Plastic Surgeons have rigorous training that involves thorough training in rhinoplasty,... more

Accurate diagnosis and treatment plan are more important

As a surgeon that has completed full residencies and holds current board certifications in both Plastic Surgery and ENT (American Board of Plastic Surgery and American Board of Otolaryngology-Head and Neck Surgery), I can tell you that an accurate diagnosis is a vital step toward treating your symptoms. To simplify a bit, nasal breathing problems can have three different causes, all of which need to be carefully evaluated before determining the correct treatment: 1. Fixed obstructions. A... more