Does a non-ENT plastic surgeon have the training to perform turbinate reduction?

Question

I'm hoping to combine a rhinoplasty with a septoplasty and turbinate reduction. Do plastic surgeons that aren't otolaryngologists get enough training in the latter procedure for it to be performed safely and appropriately? I know of course that ability varies by surgeon and their experience level, but I'm wondering whether plastic surgery residencies even provide training in turbinate reductions? Is it safer if I want to combine the procedure to only consider ENT plastic surgeons?

Rady Rahban, MD, FACS · Answer

The answer is Yes and it depends.  Turbinate reductions is a relatively straight forward procedure and Yes a plastic surgeons should be more than capable to perform the procedure.  That being said you can simply ask your surgeon and they will let you know their comfort levelGood Luck

Ronald J. Edelson, MD · Answer

I reform turbinate reductions quite routinely and find them very helpful in creating a good airway after rhinoplasty.  It is a straightforward procedure and routine performed by both ENT surgeons as well as plastic surgeons.  I think you should focus on finding a surgeon with whom you are comfortable regardless of which specialty the surgeon is trained in.  Experience if really the most important factor.

Scott C. Sattler, MD, FACS · Answer

Rhinoplasty is both a functional and cosmetic surgical procedure. Your surgeon will examine your nasal airway and determine of turbinate reduction will improve nasal airflow. The relationship between the nasal septum and turbinates is an important determinant of airflow in the external nasal valve.

Shervin Naderi, MD, FACS · Answer

Hi.  That is a great question.  All three specialists listed above: Plastics, Facial Plastics, & ENT are all technically trained, qualified and Board Certified to perform rhinoplasty, septoplasty & turbinate reductions.  Who is best comes down to where they trained, how good their "hands" are and how much of these procedures they do on a day to day basis.  Just because you are an ENT it does not mean you are the best at a septoplasty or turbinate reduction but just because you are a plastic surgeon does not mean you are the best at a nosejob.  Michael Jackson's surgeon was a prominent Plastic Surgeon and I see poorly performed septoplasties by some ENT surgeons.  But by enlarge an ENT will be best at internal nasal work: i.e. septoplasty and turbinates.  The fact is many ENT surgeons do more nose jobs than the average plastic surgeon.  But there are some great Plastic Surgeons who truly focus on the nose and know it inside out and can do a great job.  Surgeons like Rollin Daniel or Spencer Cochran or Bahman Guyuron (check name spellings) are Plastic Surgeons who focus on the nose and know it inside and out.  Yet these plastic surgeons are rare.  The average plastic surgeon simply does not get enough nose training (cosmetically or functionally) and does not do that many per year to learn and fine tune their technique.  I hope Dr. Corbin's answer to your question here was a typo because you asked about Turbinates and he replied to you about Tonsils.  Most plastic surgeons do know the difference between a turbinate and a tonsil but by enlarge they just dont get the kind of training and exposure to noses that they get to body procedures.  Add to it the fact some surgeons by nature are cocky and arrogant and do not admit any poor outcome and will never improve due to that.  Septorhinoplasty is a humbling operation and no matter how many you do per year you cannot get them all perfect.  I am the first to admit that not all of my noses turn out amazing but all of them improve and some turn out near perfect.  Its just the nature of Rhinoplasty. Just honest facts. Facial Plastics is a unique specialty that combines ENT and Plastic Surgery and many of these surgeons have the unique ability to do a good job for the nose inside and out.

William Portuese, MD · Answer

A rhinoplasty, a septoplasty, and turbinate reduction can all be performed simultaneously under one anesthesia with one recovery period.  Look for a surgeon with extensive experience in rhinoplasty, and that Surgeon should be well adept at septoplasty and turbinate reduction.  It is important not to overdo the turbinates, since an empty nose syndrome can occur.  Look for a surgeon who is board-certified in facial plastic surgery or plastic surgery, and has a large rhinoplasty photo gallery.  In addition, looked at their ratings, reviews, and testimonials.  For more information about functional and cosmetic nasal surgery including many before and after results, please see the video and the link below

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and most plastic surgery residencies teach their residents how to do tonsillectomies safely. That said ask your surgeon his experience and familiarity with the procedure.Dr. Corbin

Jon A. Perlman, MD (retired) · Answer

Thanks for your question. Anyone with years of experience performing septorhinoplasty is also well-equipped to deal with hypertrophic or enlarged turbinates. Make sure that you are confident in your selection of a plastic surgeon or facial plastic surgeon based on reputation, rapport and a review of before-and-after photographs. Good luck and best wishes.

Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, California

Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, California

Fred Suess, MD (retired) · Answer

Most Plastic Surgeons have had septal and turbinate reduction surgery experience in their training. Where the plastic surgeon has had ENT training is usually not and issue.

Michael Elam, MD (retired) · Answer

Dear 0username0, A septorhinoplasty is a combined procedure with the "septo" portion addressing the function of the nose and the "rhinoplasty" portion addressing the aesthetics. In the majority of these patients turbinate reduction is required to ensure proper air flow. It is very important when performing turbinate reduction that they are not over resected leading to open nose syndrome. A surgeon who spends a large portion of their practice performing nasal surgery should be adept at performing this combined procedure. The speciality of the surgeon themselves is not as important as their expertise. Personally I always address breathing function even if the patient has no prior history of breathing difficulties due to the fact that once the nose is reduced the patient could then have symptoms they did not have before. I would suggest  since you are on realself now that this is a great place to start your search for a  specialist. Find some expert surgeons and read their reviews if a large portion of their reviews are regarding nasal surgery then the surgeon likely denotes a large portion of their practice to this speciality. Once you have narrowed down some expert  surgeons then set some consultation appointments. During the consultation the surgeon will perform an intra-nasal examination to determine the degree of deviation of the septum as well as discussing the turbinate reduction. Also digital imaging may be available where the surgeon can show you the proposed aesthetic result. Then review the surgeons before and after photographs especially noses similar to your own so you can ensure the surgeon provides natural looking septorhinoplasty results. Once you have determined the desired nose then the surgeon will discuss at length the techniques that will be used to attain your desired nose and fix the functional concerns. After these steps you should be very informed and you will find a surgeon and office staff that you feel comfortable with and then you can make an informed decision. You can also discuss post operative recovery at this time and your concerns with opioid medications you discussed in an earlier question.  See some examples of septorhinoplasty results in the link below and the video above. Best regards, Michael V. Elam, M.D.

Does a non-ENT plastic surgeon have the training to perform turbinate reduction?

Answers (9)

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