Who Do I See First for a Deviated Septum?

Speaking in generalities, if you have concerns both for breathing and for the appearance of the nose, you are best off with a Facial Plastic Surgeon.  The reason for this is that their training is the most specific for handling both of these concerns.  Does this mean that a General Plastic Surgeon can't improve your breathing? No.  Does this mean that your ENT can't give you a nice looking nose? No.  It is just that these two specialists are primarily trained in only one aspect of nasal surgery, not both.  An interesting survey of ENT's that I saw recently asked this very question.  If a patient with a deviated septum also had aesthetic concerns, what would you do?  90% would refer the patient to a Facial Plastic Surgeon.

Plastic surgeons and ENT doctors both perform rhinoplasties. Select a board-certfied surgeon that has good experience in rhinoplasty and septoplasty surgery. Best of luck. Dr. Michael OmidiAn in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

An ENT doctor is the best specialist to see for a deviated
septum consultation. An ENT physician diagnoses patients who suffer from problems
associated with the ear, nose and throat, including issues with the internal
structure of your nose. Since a deviated septum can impact your ability to breathe
properly, I would suggest scheduling an appointment with a board-certified ENT
physician as soon as possible to evaluate your condition.

It is probably best to look for a nasal surgeon who has performed thousands of septoplasties and rhinoplasties. Many ear, nose, and throat doctors perform only the internal component. Most plastic surgeons perform only the external component. A facial plastic surgeon can perform both of these operations under one anesthetic. Just remember the nasal obstruction and deviated septum component is billed to insurance and the cosmetic is billed directly to the patient.  

That would depend on the type of surgery required to correct the cosmetic and functional issues rather than the specific specialty. If you also have nasal polyps most plastic surgeons would not do that while most ENT facial plastic surgeons would. For the usual septoplasty and rhinoplasty without or without turbinate surgery either specialty would do and the important thing is which specific surgeon you choose rather than the specialty. In fact a number of surgeons are fully trained and cerified in both specialties. I have revised septorhinoplasties originally performed by ENT facial plastic surgeons and I am sure some ENT facial plastic surgeons have revised septorhinoplasties originally peformed by plastic surgeons. The specific surgeon is more important than the specialty in such cases.