Is a revision rhinoplasty combined with a septoplasty recommended in my case? (Photos)

Question

Hello everyone, I had a primary rhinoplasty in 2020, which addressed a dorsal hump but didn’t resolve all of my concerns. My nasal tip remains bulbous and droopy, so I’m planning to undergo a revision rhinoplasty. During a recent CBCT (done for unrelated reasons), I discovered how deviated my septum is (see pictures). This aligns with my ongoing symptoms: nasal resistance and loud breathing. I don’t believe the septum was addressed during my rhinoplasty, and breathing neither improved nor worsened post-op. Given these factors, I’m wondering: 1. Would it be advisable to combine a septoplasty with the revision rhinoplasty? 2. Could a septoplasty improve, or could it worsen some of the external asymmetry of my nose? 3. Should I thus prioritize finding a surgeon experienced in both functional and cosmetic revision rhinoplasty? I truly appreciate your time and insights. Thank you in advance.

Gary M. Horndeski, MD · Answer

You would benefit from a rhinoplasty and septoplasty. The septum can be straightened and the bony abnormality can be removed as well. You would also benefit from tip refinement and change the nasal columella angle.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

An internal nasal evaluation would be needed to determine what type of airway work you might benefit from. I do see that your septum is crooked and that could be causing breathing problems.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a revision rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. Septoplasty can be performed at the same time to help improve your breathing. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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

Best wishes and good luck.

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

Is a revision rhinoplasty combined with a septoplasty recommended in my case? (Photos)

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