Deviated Septum Nose Surgery - Go to a Plastic Surgeon?

There are numerous ENT, Facial Plastic and Plastic Surgeons who have the training and expertise to address your difficulty breathing after a prior septoplasty or septorhinoplasty. This could simply be a persistent deviation in your septum which narrows your nasal airway on one or both sides. On the other hand, you may have some narrowing of what we call the internal or external valves of your nose. The diagnosis could be easily be made with an examination of the inside and outside of your nose. Be sure to visit a surgeon who specializes in revision nasal surgery, as the level of complexity is greater in these cases. 

In some cases, a septoplasty alone may not be enough to correct nasal obstruction. Nasal obstruction can also be secondary to enlarged turbinates, a narrow or collapsed nasal valve, or other issues. In many patients, more than just a septoplasty is needed to optimize the nasal airway, particularly in patients who have already had septoplasty surgery. In some of these patients, a revision septoplasty, combined with turbinate reduction and repair of nasal valve stenosis is needed to optimize breathing through the nose.
Be sure to see an expert like a facial plastic surgeon who has extensive experience with nasal surgery, including nasal valve stenosis repair, nasal obstruction, and complex rhinoplasty cases.
All the best,

To be honest if you are only correcting the functional aspect of your nose I do not think it makes a huge difference.  Both plastic surgeons as well as ENT's are trained in the area of correction of breathing/airway issues.  I think there is a lot of ego issues in medicine today and competition.  The truth is you should go to whomever you have a good connection to assuming you have checked their credentials and they are indeed board certified in which ever field.  Now if you were planing to address the cosmetic aspects of your nose then the debate over a plastic surgeon vs ENT becomes a bit more sticky but I will save you the pain of the discussion.Hope that helpsDr Rahban

The most important thing is that you seek out a Board Certified Plastic Surgeon or an Otolaryngologist that has both Expertise and Experience in doing both functional and aesthetic rhinoplasty. It does not matter who you go to as long as the person who does the rhinoplasty is very versed in doing septal reconstruction concomitantly.

It appears that you will require a revision septoplasty to repair your deviation.  This can be a complex procedure and one that may require use of ear or rib cartilage.  Your nasal airway obstruction may also be due to valve collapse or turbinate hypertrophy.  Seek and experienced nasal/rhinoplasty surgeon for the best functional result.

Facial Plastic Surgeons, Plastic Surgeons, and Otolaryngologist are all trained  (in theory) to perform Septoplasty.  However, some individuals from each of these groups devote a greater portion of their practice to Nasal surgery.   Secondly, some Surgeons are just more experienced and better skilled than others.  Word of mouth and evaluation of postoperative results will help guide a patient in his/her decision.

An experience nasal surgeon-either a Plastic surgeon or an Otolaryngologist could help you. I find two reasons for continued nasal obstruction after a prior septoplasty-either the first surgeon did not do a good job or there is a dynamic component to the obstruction that the septoplasty did not correct. This means that you may have a weakness in the nostril area or even in the support of the tip that if corrected may offer you improved breathing. You may also have other factors such as allergies or enlarged turbinates contributing. Hope this helps.

Both of these specialists are good choices for deviated septum surgery so long as they perform rhinoplasty and septoplasty weekly as part of their practice.

Choosing a qualified surgeon is the most important decision you can make when deciding to under go nasal surgery.
First and foremost, choose an surgeon who specializes in nasal surgery and who has experience correcting both functional problems (such as a deviated septum) and cosmetic problems.
While most ENT doctors routinely perform a septoplasty to correct a deviated septum, not all ENTs perform rhinoplasty.
Similarly, not all plastic surgeons who are able to address cosmetic problems are as well-versed in the functional aspects of nasal surgery. It is important to find a surgeon who is skilled at both.
Secondly, your surgeon should be Board Certified in either Otolaryngology (ENT) or Plastic & Reconstructive Surgery. Not all "cosmetic surgeons" have undergone the rigorous training in accredited residency programs that allow them to become Board Certified in either of these two specialties.

Often patients seeking a rhinoplasty complain about some breathing problems which are caused by deviated septum. An experienced board certified plastic surgeon should be able to examine your nose and evaluate the problems. During the consultation you should be explained what is causing the nasal airway obstruction in your case. Both procedures rhinoplasty and septoplasty can be done at the same. The septoplasty can be covered by most of insurance plans; the predetermination has to be done prior the coverage.