Rhinoplasty on nose with a small deviated spectrum? (photos)

went to an ENT who said a plastic surgon would get lost in my nose , because i have small deviated spectrum . in my left nostril breathing, my breathing is decent , but a bit blocked , not prefect . The ent said if i do Rhinoplasty without fixing the deviation , that the result might fail after a few months , because of the nose elasticity memory and deviate spectrum. So if i want rhinoplasty and i also have a deviate spectrum without breathing problem , i need to fix both ?

Doctor Answers 12

Rhinoplasty, some advices:

Thank you very much for sharing your concerns with us.

The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.

In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Dr. Emmanuel Mallol Cotes.-

Dominican Republic Plastic Surgeon
4.7 out of 5 stars 145 reviews

Cosmetic rhinoplasty and functional septoplasty

A septoplasty is only performed for medical necessity i n the back of the nose when there is blockage of airflow due to twisted bone and cartilage.  Medical necessity must be documented at the time of examination and consultation. Significant blockage must be present in order to do a septoplasty.  A septoplasty will not change the shape of the nose.  A cosmetic rhinoplasty is performed to change the shape of the and must be paid for by the patient.   Both procedures can be performed at the same time the same anesthetic with the same recovery period. Consider a chin implant to help with weak and recessive chin profile to help balance the face and chin to the overly projecting nose.  For more information and many examples, please see the video and the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Rhinoplasty on Nse with Deviated Septum

It would be foolish not to straighten a deviated septum as part of rhinoplasty surgery. A very important part of any cosmetic procedure is to maintain or improve nasal function.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 37 reviews

Rhinoplasty and septoplasty

It is important to address any breathing issues that might accompany cosmetic deformity of the nose.  Performing a rhinoplasty and a septoplasty together give you the best option of improvement in breathing and also in the overall appearance of the nose.
Dr. J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

Rhinoplasty and deviated septum

These two operations are done together. The deviated septum only needs to be done if it causes the nose to be crooked or because the airway is affected. All specialists in rhinoplasty are trained in both procedures.

Dennis Barek, MD
Great Neck Plastic Surgeon
5.0 out of 5 stars 6 reviews

Rhinoplasty and septoplasty

Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. You may also benefit from a cephalic rotation of your tip to turn up your tip slightly and a conservative dorsal hump reduction.  Spetoplasty and spreader grafts can be performed to help improve your breathing. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 reviews

Rhinoplasty on nose with a small deviated septum?

The internal and external nasal areas that you described and would like improved can be addressed with a nasal surgery (rhinoplasty) and a septoplasty which are typically done at the same time. A natural appearing nose can be achieved when the procedures are performed by an artistic plastic surgeon with extensive experience in nasal surgery.
Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on a limited two dimensional photo without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Deviated septum without breathing problems

Septal deviation without breathing difficulties does not need to be fixed.  However, if the septal deviation is leading to a deviated nose externally, and that is bothersome, the septum can be fixed at the same time as the rhinoplasty.  If the rhinoplasty involves reduction of the hump which would then lead to transecting the area of the septum that reveals the deviation, the nose could appear crooked after the surgery. Your surgeon will be able to determine the best treatment given your anatomy.

Jennifer Parker Porter, MD, FACS
Bethesda Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews


Thank you for your question and photographs.I would recommend that you schedule a consultation with a board certified plastic surgeon who specializes in rhinoplasty. A skilled board certified plastic surgeon would not get “lost in your nose”. If you are having difficulty breathing and your ENT discovered that you have a deviated septum and you would also like something correct with the appearance of your nose, then a septoplasty and rhinoplasty can be performed at the same time. The septoplasty may be covered by your insurance plan but the rhinoplasty will be self-pay.
Best of luck in your endeavors!

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 64 reviews

Septal issue

A septoplasty alone can be performed but if you want correction of any other issues like tip shape or dorsal hump, etc.. a full rhinoplasty would be necessary.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.