Rhinoplasty plus Septoplasty? (Photo)

Hi I am certain I have a deviated septum and issues with one of my nostrils as you can see. Can you suggest what type of procedure I might need. I would also like my nose to be smaller, and I have a small bump on the bridge I would like removed. I also have chronic stuffy nose issues on the right side. Do you think I would need a caudal septoplasty plus a rhinoplasty? The side of my face that has the nostril issue photographs much better than the side that doesn't, and is more photogenic, why?

Doctor Answers 11

Rhinoplasty plus Septoplasty?

Rhinoplasty is a procedure to improve the shape of your nose for breathing or appearance.

Septoplasty is a procedure to adjust the middle wall between your left and right nasal passage. This can be done as a separate procedure or as a component of rhinoplasty.

A septorhinoplasty is a combination procedure that addresses the internal and external shape of the nose. Improved breathing and shape can be accomplished in this one surgery. I recommend consulting with a rhinoplasty surgeon (general or facial plastic), so she/he can ask you questions, examine your nose, and perform a photoanalysis. I like to use 3D computer simulation software to get on the same page as my patient. I can then present a surgical plan appropriate for your face to produce a safe and happy outcome. Safety comes first. 

San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Rhinoplasty plus Septoplasty?

The internal and external nasal areas that you described and would like improved can be addressed with a nasal surgery (rhinoplasty) and a septoplasty which are typically done at the same time. A natural appearing nose can be achieved when the procedures are performed by an artistic plastic surgeon with extensive experience in nasal surgery.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on a limited two dimensional photo without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Open rhinoplasty and septoplasty combination surgery

Open rhinoplasty with modification of the internal components of the nose to improve appearance can be combined with septoplasty, which is a functional component of the procedure.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Septorhinoplasty Candidate

Dear dr.kats, It is common for most patients to have a particular side of their face that is the most photogenic. This is why you will see models and actresses take photographs often from the same angle. Mariah will only sit on a particular side of the person interviewing her as that is her believed better side. So that is common. In patients like yourself who most likely have a deviated septum and also have aesthetic concerns then a combined procedure called septorhinoplasty is performed. The "septo" portion addressing the functional aspects and the "rhinoplasty" portion addressing the aesthetic concerns. You are an excellent candidate for septorhinoplasty surgery and in the hands of an expert surgeon you should expect a very nice result. Reducing your dorsal hump and tip projection, refining your tip and addressing the nostril asymmetry will bring better balance to your overall facial aesthetics.  During consultation imaging can be performed to show you the proposed results taking into consideration your desires as well as your nasal anatomy. Once the desired nose is agreed upon the techniques that will be used to attain the desired result will be discussed. You will also have the opportunity to review before and after photographs to ensure the surgeon performs natural looking rhinoplasty procedures. See septorhinoplasty examples in the link below and video above. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Rhinoplasty plus septoplasty

From them limited photographs presented, it does appear that there's a caudal septal deviation which can be straightened. A thorough internal  examination of the nose is required to determine what other issues are causing breathing issues. The rhinoplasty procedure can accomplish shaving down the dorsal hump, making the nose smaller and narrower. For more information about septoplasty and rhinoplasty, many  before and after examples of rhinoplasty, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty and septoplasty

Hi there,

Thank you for your photos and questions.

A rhinoplasty can be done at the same time as the septoplasty to make the changes you are looking for. Removing the bump and making the nose smaller is part of the rhinoplasty. The septoplasty does need to address the caudal septum or it will not be possible to straighten the nostrils. After the surgery, your nose should look better and you should be able to breath better as well.

I am not sure what you are seeing on the 3/4 photos of one side versus the other, but it might be the amount of nostril show? I would recommend discussing that in person during your rhinoplasty consultation.

Hope this information is helpful. Good luck!

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews


Thank you for the questions but an examination is needed as there could be several reasons for obstruction

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Rhinoplasty Plus Septoplasty

These pictures do show that you have a small hump and a deviated septum which could b corrected by a septorhinoplasty. The size of your nose can also be reduced at the same time. While the deviated septum can cause nasal obstruction an examination is necessary to determine what should be done to correct your breathing problems. All of this work is best done at the same time.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews


Hi Dr. Kats,

Thanks for your question. The only way to know the cause of your nasal obstruction would be to examine the nose. You probably have a deviated septum that is at least contributing to the congestion. There are other structural causes as well, such as nasal valve stenosis. To address these issues, you will probably need a septorhinoplasty, which is typically performed to improve breathing as well as to improve the appearance of the nose.  As to your question about being more photogenic on the one side, based on the supplied photos, I'm not sure what is causing that issue. An in person evaluation would help address that concern.

Please let us know if you have any further questions or concerns!!

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon
5.0 out of 5 stars 41 reviews


Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. You may also benefit from a conservative dorsal hump reduction.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.