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?
Deviated Septum Nose Surgery - Go to a Plastic Surgeon?
Doctor Answers (38)
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.
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.
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.
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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.
Plastic surgeon or ENT surgeon for nasal surgery?
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.
Correcting your deviated septum by a plastic surgeon
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
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.
Who treats a deviated septum?
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.