Is Rhinoplasty More Complicated After Having Septoplasty?
- Asked by Peter Hewitt 1 in uk
- 4 years ago
I had Septoplasty to help with breathing and it worked. I am now considering Rhinoplasty to remove a bump on the bridge and reshape the nose. Is septoplasty minor compared to a 'nose job' ? Would it likely make any future cosmetic operation much more complicated?
I keep hearing Revision Rhinoplasty is a lot riskier and harder in achieving good results. Some cartilage was taken from the nose at the time (from the septum I think). Is this needed to reshape the nose?
Lastly, how long shoud I leave the scar tissue to heal from Septoplasty before Rhinoplasty? Thanks.
Rhinoplasty is more complicated than septoplasty
Septoplasty will have no bearing on a rhinoplasty procedure unless septal cartilage is needed to reconstruct the nose and there is none left. This will make the rhinoplasty much more difficult. If this is a simple reductive rhinoplasty whereby the hump is removed and the bridge is narrowed and the tip is refined, then the septoplasty will have no bearing on the effect of the nose job. A rhinoplasty is more complicated than a septoplasty. A patient should wait approximately two months after the septoplasty before embarking on a rhinoplasty to make sure all the edema and swelling has subsided prior to undergoing the nose job.
Web reference: http://www.seattlefacial.com
Rhinoplasty after Septoplasty
In the ideal world, you should have both the rhinoplasty and septoplasty performed at the same time. When a septoplasty is performed first, a portion of the septum is removed to improve the air passages. If later the dorsum is lowered during the rhinoplasty, there is a possibility that the nose maybe destabilized. This makes the surgery mildly more difficult, but an experienced rhinoplasty surgeon will be aware of these issues and account for it.
Web reference: http://www.drmichaelbogdan.com
Tougher nose job
Yes, it's more difficult. A big difference in what you're reading and what you have is that you've only had the septum worked on. The rest of the nose may be completely virgin tissue. It's up to your plastic surgeon to discern this by reading your septoplasty operative note. Remember to wait at least 6 months (assuming only your septum was worked on) before having surgery. Your last question on cartilage needs is relevant if you need cartilage to achieve the improvements you need. Sometimes it's not necessary to use cartilage, sometimes it is. Again, this will be figured out by the Plastic Surgeon that you meet.
Recent Rhinoplasty Reviews
Rhinoplasty after Septoplasty
It may make the rhinoplasty a bit more difficult it may not. It just depends on what you need done during the rhinoplasty. If grafts are needed then there may not be enought grafts to perform the rhinoplasty in a way that is needed. Then the options may be to use grafts from other areas such as ear or rarely rib cartilage.
However, I would not consider this to be as difficult as a revision or redo rhino.
Rhinoplasty to follow septoplasty
If it is just a cosmetic rhinoplasty it should be ok. However, if you need grafts for spreader purposes or for the tip or columella, the donor sites may be limited if the septoplasty included removal of some of the septum.
See a revision rhinoplasty specialist.
If only the septum was done you should wait 6 months. The rhinoplasty is not really considered a revision in your case if only the septum was done--it is like a primary. Usually, there is enough cartilage present in the septum if needed.
Risks of rhinoplasty after septoplasty
Alexander, septoplasty is a common nasal surgery and we freqeuntly are asked to do rhinoplasties later on in life on these patients. The critical issue that you already alluded to is cartilage. Many surgeons remove a substantial amount when performing a septoplasty, a surgery also called submucous resection. The good news is that having a bump removed on the bridge is a reduction type rhinoplasty, which means generally tissue is taken away.
Occasionally, especially when the nose is narrow and the hump is large, it is necessary to maintain a balanced esthetic width of the nose as well as maintain breathing through the internal nasal valve with placement of cartilage strips called spreader grafts. If there is no cartilage left to harvest from your septum, it may be necessary to use ear cartilage; synthetic material is also available for this purpose. In summary, primary rhinoplasty after septoplasty is often not as complicated as a secondary rhinoplasty, but there are some comples issues to consider.
Hope this helps.
Secondary operations, such as secondary rhinoplasty, are more complicated
With the nose, more so than many parts of the body, secondary operations are more difficult. This is due to scar tissue and tissue changes that occur after the primary or first surgery. It would have been best to have both the rhinoplasty and the septoplasty done at the same time. Good luck with your procedure.
Special considerations after septoplasty
There are a couple of important considerations if a patient has had a prior septoplasty and is now considering a hump reduction. During a septoplasty, care is usually taken to preserve a good "dorsal strut" when resecting deviated cartilage. This means that the surgeon tries to preserve a good strip of cartilage (1 cm or more) along the bridge of the nose.
But reducing the size of a hump during rhinoplasty usually means taking down some more of that dorsal cartilage. If just enough was left from the septoplasty, then too much might be gone after rhinoplasty. In bad cases, this can increase the chance of saddle nose collapse.
The other concerns include difficulty of dissection from previous scar, increasing the risk of septal perforation, and having too little remaining septal cartilage for adequate grafting that might be required. This usually means that consent should be given to allow the surgeon the option of harvesting ear cartilage or rib cartilage, if needed.
All the best,
It's best to have Septoplasty and Rhinoplasty performed at the same time.
You're exactally right. Septal cartilage is routinely used to support, and reshape the appearance of your nasal tip. Profile-bump removal will not be affected, but tip modification might.
You should consult a qualified, experienced Rhinoplasty surgeon for a consultation.
If you post / email me photos, I'll be happy to share my thoughts.
I hope this helps, and best regards.
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.