Is the bump on my rhinion caused by caudal deviation? (Photo)

Question

Hello! Do i need 1 procedure or multiple? I know i have a deviated caudal septum and i am using nasal exercises to strengthen any possible weakness. Doctor told me left bridge was weak and i have a very small cartilage septal spur.. but it was an ent and she admitted she isnt sure about external features. Slight trouble breathing. Left side where caudal deviation is obvious. I also have a lump in the rhinion area, cartilage area not bone on the left side. Can bump be caused by caudal deviation?

Oakley Smith, MD, FRCSC · Answer

Hi a rhinoplasty can address both functional and appearance of the nose. 
It is better for you to consult with a facial plastic surgeon who can examine you and discuss the surgical procedure if required and the post op recovery 
process

Gary M. Horndeski, MD · Answer

You most likely had trauma to your nose that caused septal deviation as well as distortion of the external nose. You can see from your photographs your nose is not straight and has contour deformities. You will need an open rhinoplasty and septoplasty.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You are an excellent candidate for rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. You should be able to have an excellent result. Best wishes to you

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have thin nasal skin with a wide tip appearance and a hanging columella. I agree that you have a septal deviation to the left. If you have both functional and cosmetic concerns with your nose, it is best to have both of them taken care of at one operation with a reputable facial plastic surgeon and rhinoplasty specialist. Wishing you well! Sincerely, Dr Joseph

John L. Burns Jr., MD · Answer

There should be no reason for more than one procedure.  These concerns should be articulated to your surgeon but they can all be addressed in a single procedure.

Steven M. Denenberg, MD · Answer

If you want to change the appearance of your nose, you should identify everything about all parts of the nose that you want to change, and approach a rhinoplasty surgeon with your ideas. A septal problem can be corrected at the same time as the rhinoplasty.

If you only have a slight trouble breathing, then don't have *only* a septoplasty, because it won't fix anything. The tip asymmetry is unlikely to be related to the septal irregularity, and it's almost impossible that the tip would improve with a septoplasty.

So your decision is really only whether you want a rhinoplasty, and point out the tip asymmetries that bother you to the surgeon.

If you do decide to have a rhinoplasty, how *much* to make the various changes you might wish, and will they fit your face and will you like them? We figure that out with morphs, well before surgery. Morphs could also help you identify better just 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 really 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 the surgeon has that information and judgment best.)

Finally, 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. Any rhinoplasty requires techniques and skill that most plastic surgeons don't possess with expertise. 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.

Ronald J. Edelson, MD · Answer

That caudal septal deviation is not uncommon. If it bothers you cosmetically it is quite simple to deal with.  If you have breathing problems or want other changes to your nose those and other issues which can be dealt with also

Shabnam Ghazizadeh, MD · Answer

Hi @Loving794819, I recommend a consultation with a rhinoplasty specialist. Caudal deviations can cause external shape deformities and are often associated with other internal deviations or trauma. Best of luck, Dr. Ghazizadeh

William Portuese, MD · Answer

A caudal septal deviation does not cause a prominent rhinion. These are two completely separate issues. A deviated septum is fixed with a septoplasty and is usually billed the patient's medical insurance for medical necessity. Any changes to the outside of the nose is considered cosmetic rhinoplasty, and must be paid for by the patient. Both a septoplasty and a rhinoplasty can be performed in the one anesthesia with one recovery. Digital computer imaging of your nose upon your facial features would also be helpful to understand what can be accomplished With a cosmetic closed rhinoplasty.