Can any doctors who are experts on caudal septal deviation share their possible approaches for this problem?

Question

Hello looking for doctors who deal with caudal septal deviation frequently in their rhinoplasty surgery to share how they often approach this issue. Since cartilage has memory what are the limitations? What if caudal septum is very long? There is conflicting information written on caudal septal trim.

John Michael Thomassen, MD · Answer

The septal cartilage can be scored and straightened with a spreader graft for support.  If too long it can be trimmed but usually suturing the medial crura to the septum can be enough to shorten ptotic tip.

Gerald Minniti, MD, FACS · Answer

The caudal septum, the part nearest the skin in between the nostrils, can curve in a number of planes and has a direct effect on the overlying tip cartilages and nostril apertures.  Looking back at any subject will usually find conflicting information, because as time goes on we have a better understanding of the physical world around us, including the fields of medicine and surgery. A perfect example is cartilage 'memory', which hounded early surgeons relying on destructive techniques to straighten cartilage. Today, an open approach allows precision excision of non-structural septal cartilage and placement of permanent structural cartilaginous grafts to get predictable and durable septal straightening. BTW, there is no such thing as a 'caudal septal deviation' specialist.

Ronald J. Edelson, MD · Answer

Many surgeons try to straighten a deviated caudal septum using a variety of methods. I just cut out the lower portion of cartilage usually about 3 millimeters. Has worked every time and it’s simple. Surgeons stopped doing it that way when they converted over to open rhinoplasty.

Tanveer Janjua, MD · Answer

It is a common problem. IMHO the easiest way is to use a hemitransfixion incision (only on one side) then isolate the deviated caudal septum. It is then cut. A pocket is made in the midline between the medial crura and it is placed in that spot in exact midline and held with through and through absorbable sutures. Has worked well for my patients.
Regards
Dr. J

Dean Toriumi, MD · Answer

Hi Beautyqueen2023,
Thanks for your question. Caudal septal issues are among the most challenging that a rhinoplasty surgeon has to deal with. The reason being that there are a variety of reasons someone might have problems with their caudal septum (eg. intrinsically weak cartilage, overgrown cartilage, prior surgery resulting in distortion of the caudal septum, etc.). This is the main reason that you see so many different potential treatment options regarding the caudal septum. In my practice, I employ a variety of techniques (eg. caudal septal replacement grafts, caudal septal splinting, caudal septal resection and reconstruction) depending on the needs of the patient. The most important thing is that your surgeon uses an appropriate technique based on your anatomy in order to achieve the functional and aesthetic outcomes that you are looking for.

Can any doctors who are experts on caudal septal deviation share their possible approaches for this problem?

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Can any doctors who are experts on caudal septal deviation share their possible approaches for this problem?

Answers (7)

Answer: Caudal Septal Deviation

Answer: Caudal Septal Deviation

Answer: Caudal Septal Deviation

Answer: Caudal Septal Deviation

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Recommended reading

Everything you need to know about Septoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.