Who Do I See First for a Deviated Septum?

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.  

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.