When 3 surgeons tell you 3 different things, how do you know which one is right?

I went to a top ENT surgeon and awkardly told him how I was having trouble breathing through my nose. I said that I broke it and it collapses when I breathe, which is true. He looked up my nose and said that I had the same amount of room to breathe thruboth sides and there was no need to operate. A 2nd top ENT said that I had a Z shaped septal deviation. The 3rd top ENT surgeon said the cartilages in my nose were weak and my deviated septum was not the problem, but rather my narrow nostrils.

Doctor Answers 4

Listen to the most experienced and specialized of the 3 surgeons.

Dear rosiecon12 in Beverly Hills, California:      In nasal surgery, top training, long experience, a high degree of specialization and talent as exemplified by before and after photos are the hallmark of the surgeons that most people would like to have.  Using those criteria, evaluate the surgeons whom you saw.  It is unusual for surgeons to disagree on whether the septum is deviated or not.  On the other hand, sometimes it can be deviated but not causing enough nasal blockage.  Remember, you do not operate on the inside of the nose unless there is a breathing problem.  Just getting a sense of how much air comes out the nose when you exhale is enough to make a decision as to whether or not surgery should be done.  That is the most important thing.  Just having a deviated septum, but without consequences of it such as blocked breathing, snoring, sinus infections, or a condition made worse by allergies, is not enough reason to have surgery.  There has to be a functional consequence of abnormal anatomy before one should consider having an operation to change the anatomy. 
Best wishes, Robert Kotler, MD, FACS Over 4,500 nasal procedures performed

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 87 reviews

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Why don't you see one or two more plastic surgeons?  without examining you it is difficult to say who is telling you the truth.

Andre Aboolian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 60 reviews

Nasal breathing

It is difficult to asses without having examined you myself.  However, based on your comments, it seems that your nasal airway may be wide enough but there is a mild septal deviation with some collapse of the nasal valve ("narrow nostrils" may be collapsing due to weak cartilages).  Mild septal deviation doesn't always cause breathing issues but nasal valve collapse will.  I would recommend that you see a surgeon who is double board certified in Facial Plastic & Reconstructive Surgery, and ENT. 

Sunny Park, MD, MPH
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Nasal Airway Obstruction

Hello,Without the privilege of examining you, it sounds like all three surgeons are seeing the same thing: apparently wide nasal passages (static), a deviated septum, and nasal valve collapse with rapid inspiration.  The first may not be cognizant of dynamic issues, the second may put too much stock in the concept of septal deviation as a cause of airway obstruction, and the third is cognizant of everything. Good studies show how unimportant mild septal deviations are and how important the 'internal valve' is for airflow.Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 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.