How can I fix my crooked septum post rhinoplasty-11 years?

Question

Hi. I got surgery to fix a deviated septum ~11 years ago (age 16) with some cosmetic work to get rid of a hump and lift the tip very slightly. Can't tell if it's just in my head or if it's actually getting worse as time goes by. It seems to lean to one side & I have a very pronounced "good side." The most problematic part is the cartilage/where my nostrils are. What is the minimum I could do to fix this? Is a 2nd rhinoplasty required? Could it just be an issue with the cartilage & a simple fix?

Aaron Stone, MD · Answer

Your photos show an asymmetric tip with the left tip cartilage shifted upward and forward relative to the right tip cartilage. It is hard to see from the photo if the septum is deviated and if so to what degree. That will require a speculum exam for evaluation. Unfortunately your right maxilla is retruded so there is no quick/simple fix and it is not clear from the photos alone what the minimal work required would be. An open rhinoplasty is the most reliable way to realign and make the tip cartilages more symmetric. However, if the bone base on which the nose sits is tipped just working on the tip would appear futile. If this is a progressive problem and you have been losing bone on the right you will need imaging studies before any surgery.I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery especially with the limited view photos you submitted.My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

Gerald Minniti, MD, FACS · Answer

Hello,You should be seen by a few surgeons expert in revision rhinoplasty to evaluate you nose and discuss your options.  A revision rhinoplasty/septoplasty can potentially improve the appearance of your nose. Best of luck!

Toby Mayer, MD · Answer

Revision septoplasty for crooked septum? I would need to examine your nose to see if a minor adjustment is needed on the part of the septum in your nostril is needed or a full septoplasty if your septum is deviated inside the nose.

Mohsen Tavoussi, MD, DO · Answer

I believe a face to face consultation would be best to discuss your concerns. Majority of the deviated noses result from deviated septum both before and after surgery. Revision must address this problem. Good luck

Jordan Rihani, MD · Answer

Hello Seasan, thank you for your question. Over time, there are various changes that may occur following a rhinoplasty or even naturally in our noses. I would consider an in person evaluation with a surgeon experienced in rhinoplasty, to see the degree and cause of the obstruction and to discuss your options.

How can I fix my crooked septum post rhinoplasty-11 years?

Answers (8)