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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?

Asked 39 months ago by Banker Mama in Chicago, IL
Sort 35 expert answers by:
+3

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
Umang Mehta, MD
Bay Area Facial Plastic Surgeon
+3

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
Brent Moelleken, MD
Beverly Hills Plastic Surgeon
+3

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
David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
+2

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
Seattle Plastic Surgeon
+2

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
+1

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
+1

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.
Etai Funk, MD
Houston Facial Plastic Surgeon
+1

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. 
Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon
+1

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.
Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
+1

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
Fort Lauderdale Facial Plastic Surgeon
+1

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
Joseph Campanelli, MD
Minneapolis Facial Plastic Surgeon
+1

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
Oklahoma City Facial Plastic Surgeon
+1

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.
Kris M. Reddy, MD
West Palm Beach Plastic Surgeon
+1

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
Toronto Facial Plastic Surgeon
+1

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.
Deason Dunagan, MD
Huntsville Plastic Surgeon
+1

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.
Andrew Jacono, MD
New York Facial Plastic Surgeon
+1

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
C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
+1

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... more
Gregory Turowski, MD, PhD
Chicago Plastic Surgeon
+1

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
Nick Slenkovich, MD
Denver Plastic Surgeon
+1

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
Sanjay Grover MD
Orange County Plastic Surgeon
+1

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
Chicago Plastic Surgeon
+1

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
William Portuese, MD
Seattle Facial Plastic Surgeon
+1

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
Daniel Reichner, MD
Newport Beach Plastic Surgeon
+1

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.
Anil R. Shah, MD
Chicago Facial Plastic Surgeon
+1

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.
Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon
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