Will a septoplasty fix my crooked nose?

Question

I am considering getting a septoplasty to fix my deviated septum. Will the procedure also fix my crooked nose or will I need a rhinoplasty? Photos attached.

Steven M. Denenberg, MD · Answer

A septoplasty will only rarely straighten a crooked nose, and I highly doubt it would on your nose. Sorry.Also, correcting frontal asymmetries like yours is very difficult. I usually tell my patients that we can get it better, but never 100% straight, unless we also get just incredibly lucky.But there are other changes to the nose that can help with getting it straight. For example, your nose, at least from these photos, looks long, with the tip hanging down some. If you wanted the tip elevated, besides perhaps making you happier with your nose, it would help in correcting the asymmetry, because there are some changes we make to noses -- and elevating the tip is one of them -- that allow us to use other techniques to straighten the nose. And overall, you can imagine that if your nose were to be made smaller in any dimension, or in a few dimensions, any remaining asymmetry would reside on a smaller nose, and the asymmetry would thus be smaller, and it'd bug you less. Hope you followed all of that!How *much* to elevate the tip, or make other changes to the nose? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should always be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and only the surgeon has that information and judgment. Another aside: I also recommend that you not show morphs made by one surgeon to a different surgeon. If a surgeon makes his *own* morphs, you get to see whether he understands the important issues of your nose, and how your nose should be changed. But if you show the surgeon someone else's morphs, and he says "Of course I can make your nose look like that," then you don't really know if he fully understands, or even recognizes, the important changes shown in those morphs. And you don't know if he can make those changes during surgery.)
Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.
Your nose is also a perfect example of why computer imaging by the operating surgeon is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?

William Portuese, MD · Answer

No, a septoplasty is performed in the back of the  nose to improve your  Airflow dynamics. A cosmetic rhinoplasty is performed to straighten the crooked nose.  Both functional nasal surgery such as a septoplasty and a cosmetic rhinoplasty can both be performed simultaneously when needed under one anesthesia with one recovery period.

Will a septoplasty fix my crooked nose?

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Will a septoplasty fix my crooked nose?

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