Augmented Rhinoplasty and Sinus Surgery at the Same Time?

Question

I have a low bridge that I want to be higher and a bulbous nose that I want to me nicer shaped. I also want to be know if it will be ok to have a sinus surgery and rhinoplasty at the same time. Attached are the pictures. Any advice with materials and types of surgery would be very helpful. Thanks in advanced.

Houtan Chaboki, MD · Answer

Yes, it's very common to combine a rhinoplasty with sinus surgery.

	However, each case is unique and your plastic surgeon may recommend not to combine procedures. Sinus surgery may involve many potential operations, such as septoplasty or turbinate surgery, among other things. Sinus surgery may be for chronic infection. As other plastic surgeons have mentioned, the main reason not to combine procedures is infection. If an artificial implant is used to build the bridge, then there may be a slightly higher risk of infection.

	Only after a comprehensive evaluation can a rhinoplasty surgeon help determine appropriate options for you.

Scott Trimas, MD · Answer

It is very common to have sinus surgery or septal surgery for breathing problems done at the same time as cosmetic rhinoplasty. It allows for one recovery and often reduces the fees to the patient. The greatest concern is that if you are having an augmentation rhinoplasty at same time is to make sure that the implant is kept in a separate area from the intranasal or internal aspects of the nose to reduce the possibility of infecting the implant. I hope this information helps.

Otto Joseph Placik, MD · Answer

Sinus surgery and rhinoplasty can and is freqeuntly performed at the same time. Your own grafts are the preferable tissue sources and this can range from septal or ear or rib cartilage.

Theda C. Kontis, MD · Answer

I do not believe you are at any increased risk having sinus surgery at the same time as augmentation rhinoplasty. Actually, it is quite common to have these two surgeries performed at the same time. I would recommend you not have any synthetic materials placed in your dorsum, even without sinus surgery, because I believe these have a higher extursion rate. I would recommend using septal, rib or ear cartilage.

Toby Mayer, MD · Answer

This is not a good idea since there is usually infection present when one has sinus surgery. The cosmetic issues are done with your own tissues to raise the bridge and refine the tip. See an experienced rhinoplasty surgeon for this.

Frank Scaccia, MD, FACS · Answer

Combining the two surgeries is common, effective , and efficient if performed by a surgeon skilled in both fields.  I always perform the septoplasty and then sinus surgery first.  If the sinuses are very time consuming and especially if they are very acutely infected with free flowing pus everywhere probably not a good idea to add a foreign body implant to the nose at the same time. However performing a rhinoplasty without a foreign body augmentation (your cartilage is ok) and surgery for chronic sinusitis is very effective and common. I have been doing this for over 25 years and wrote one of the first book chapters on how to do this. You should have someone who is board certified in both facial plastic surgery and otolaryngology to do this. Most general plastic surgeons don't have formal training and or hospital privileges in performing endoscopic sinus surgery.

Robert L. Kraft, MD, FACS · Answer

I am in absolute agreement with Dr. Aldea.  the risk of contamination and infection from combining the operations cannot and should not be minimized. Our responsibility, as surgeons, is to treat patients ethically and NOT to perform procedures in combination with ne another which  we know, by experience and training, to present unnecessary risk.

Olivia Hutchinson, MD · Answer

It is possible to augment the dorsum of the nose using either cartilage grafts or synthetic material, the former is usually preferable since it is your own tissue. Combining cosmetic rhinoplasty with sinus surgery may be feasible although depending on the exact procedures there may be an increased risk of infection.

Steven Wallach, MD · Answer

It is common to have sinus surgery and rhinoplasty surgery performed at the same time.  This should not be a problem.

Peter E. Johnson, MD · Answer

Individuals with chronic or intermittent sinus infections have an altered bacterial flora in the nose. The infections can be controlled with antibiotics and decongestants though if not, surgery to open the sinus and improve drainage may be the best option. We feel that it is best not to combine sinus surgery with rhinoplasty that will involve grafts for shaping the tip, or augmenting the nasal bridge. Grafts, and certainly nasal implants will have a better chance for success in the cleanest of circumstances, and combining the procedures may pose a risk.
	Best of luck,
	peterejohnsonmd

Augmented Rhinoplasty and Sinus Surgery at the Same Time?

Answers (14)

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