How to correct a deviated septum and deviated columella on a primary surgery? (Photo)

Question

Primary surgery candidate with a deviated septum, deviated columella cartilage and nasal spur. Goals: 1. maximize airflow, particularly to the deviated portion. (L strut septoplasty?) 2. Straighten columella cartilage. (columellar extension graft?) 3. Columella tissue obstructing deviated portion edge of nose. (Stitch tissue?) 4. Remove nasal spur.(Surgical excision?) Current ENT can only offer a closed septoplasty. Septorhinoplasty? Is my case that difficult to fix right the first time?

William Portuese, MD · Answer

A septoplasty can remove the bone spur, and straighten the caudal septum for airflow management purposes. A septoplasty is only performed for medical necessity which must be documented at the time of the examination and consultation. A rhinoplasty procedure is performed to straighten the crooked columella, and the crooked nose. Expect to pay for the cosmetic component yourself. For more information about the differences between a rhinoplasty and the septoplasty, please see the link and the video below

Fred J. Bressler, MD, FACS · Answer

You present with nasal airway obstruction from a deviated nasal septum, characterized by a caudal septal deformity to the left, a central septal deviation and left posterior bone spur. The CT scan shows some turbinate enlargement which can be confirmed by physical examination. Your case appear to be straight forward, and if you do not desire any cosmetic changes to the appearance of your nose then you do not require a rhinoplasty or columellar extension graft. A standard, well designed and executed endonasal (closed) septoplasty can correct your nasal obstruction, remove your nasal bone spur and correct your columella to a straight position without vestibular encroachment. A conservative turbinate reduction could also be considered. An experienced ENT, Facial Plastic Surgeon or Plastic Surgeon should be able to help you achieve your goals without major difficulty. Best Regards.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Deviated anterior nasal spine is easy to fix and requires flipping of your nasal septum to the other side of your nasal spine; a small stich is also placed to keep it on the other side of the spine. minimal trimming of the spine may be necessary.

How to correct a deviated septum and deviated columella on a primary surgery? (Photo)

Answers (3)

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.

How to correct a deviated septum and deviated columella on a primary surgery? (Photo)

Answers (3)

Browse related questions

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.