Rhino/Septo seperate? (Medical concerns)

I have a deviated septum and a dorsal hump. I was approved for surgery through benefits for the deviated septum but decided to save and pay for both the rhinoplasty and septoplasty through a plastic surgeon. After the consultation the surgeon said I was not a a candidate due to my immunosuppressive medications I take for crohns (imuran) I have decided to still complete my septoplasty but I'm curious if it's a good idea for me to get rhino in the future if and when I get off my medication

Doctor Answers 7

Septorhinoplasty Candidate

Dear froggers, I would suggest that you seek a secondary opinion to determine candidacy for these procedures. Patients who have Crohns or other auto-immune diseases  can still have surgery and I have personally operated on many. Each patient is an individual situation however if you can get clearance for septoplasty then a septorhinoplasty would most likely be cleared as well. It is important to have the combined procedure of septorhinoplasty performed. The "septoplasty" portion will address the deviated septum and functional aspects of the nose and the "rhinoplasty" portion will address the aesthetic concerns. Speak with your Crohn's physician and see what he/she has to say on this matter. Best regards, Michael V. Elam, M.D.


Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Rhinoplasty

The best time to go for rhinoplasty is simultaneously with septoplasty ( if desired for functions reasons) as some of the cartilage from the septoplasty portion which can he used during a rhinoplasty (in both functional and cosmetic cases) will be discarded otherwise.

Jacob Sedgh, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Rhinoplasty in the immunocompromised patient

The issue is the immunosuppression and surgery not necessarily what type of surgery.  If you need a septoplasty for functional reasons, breathing.  Then it makes sense to address cosmetic concerns at the same time.  In a patient who is taking Imuran I would extend the antibiotics beyond the normal perioperative amount of time to a complete  therapeutic dose.  I have performed rhinoplasties on many patients with Crohn's disease and other auto–immune diseases and immune deficiencies.  Rhinoplasty is not a sterile operation but the risk can be managed.  I would not recommend a septoplasty without correcting the cosmetic deformity because the tissue that is removed with a septoplasty can be helpful in reshaping the nose.

Edward Farrior, MD
Tampa Facial Plastic Surgeon
4.4 out of 5 stars 14 reviews

Rhinoplasty & Imuran

The fact that you are taking imuran is going to potentially affect your healing process no matter which surgery you get. So, first, speak with your Chron's doctor as to the safety of having surgery. If you get approval, I would suggest that you have both surgeries at once since then, there is only one recovery. 

Kindly,

Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Rhino/Septo seperate? (Medical concerns)

I have performed nasal surgery previously on a patient who was on this medication and she healed OK - However, in her circumstance, she could not come off the medication and her breathing issues were severe. I would coordinate with your Crohn's doctor as well as your surgeon, consider how important either or both of these surgeries are to you, and take it from there. If for any reason you did not heal well, and had a septal perforation or a less than ideal rhinoplasty result would you regret having proceeded? If so, I would be very cautious. Hope that helps!

Jeffrey Watson, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Rhino/Septo seperate? (Medical concerns)

froggers,

It's a good thing you brought up your Crohn's disease and the Imuran (Azathioprine) with your surgeon. This medication is an immunosuppressant, which can affect wound healing and increases your risk for infection. These are not risks you want in any surgery, aesthetic or functional. If you would like to proceed with a septorhinoplasty, I recommend coordinating with your Crohn's specialist to determine if you could safely be off of the Imuran for a short term before and after your surgery. Safety comes first. 


Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Rhino/septo Separate?

It is probably best to be off your Imuran prior to the septoplasty as well as a rhinoplasty to prevent any immunosuppressive complications. Best to have a long discussion with your doctor who placed you on the Imuran and get clearance from them before undergoing nasal surgery. There's no reason to have two separate nasal surgeries for both functional and cosmetic purposes. Both procedures can be done simultaneously. In addition, cartilage from inside the septum may be needed for cartilage grafting purposes for the rhinoplasty, so it's important not to get that discarded with the septoplasty procedure

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 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.