Is getting two surgeries done at the same time recommended? I would like to get Orthognacthic and Rhinoplasty surgery done.

Question

I have seem some people getting these both done at the same time. My question is, is this generally okay to do so? Lastly how can I find doctors who specialize in both fields?

Nima Shemirani, MD · Answer

Dear Zakme,Thank you for your question.  I agree with the other doctors that you would likely need to coordinate 2 surgeons to perform the 2 procedures due to specialties.  My only worry is that you are operating on 2 parts of the airway at the same time (nose and mouth).  Swelling might be unpredictable and could make breathing difficult.  After a rhinoplasty, you are often swollen and plugged inside the nose that you have to breathe through your mouth.  With the additional mouth swelling, it can lead to tongue swelling as well so your airway may be compromised.  You will also have significant facial swelling from both procedures, so I would take that into consideration.If you decide to separate the procedures, I would perform the orthognathic surgery first because we use the chin and lips as guides when performing rhinoplasty in an artistic fashion.Best,Dr. Nima

Faisal A. Quereshy, MD, FACS · Answer

Awesome question:  Simultaneous rhinoplasty with jaw reshaping surgery can be done, but with some cautions.  When dealing with upper jaw surgery, the majority of the swelling can distort the nasal / nose contours, so minimal nasal changes can be done, but the patient needs to be aware that after swelling resolves, additional touch ups may be needed.  And this is really due to the closeness of the swelling in and around the nasal tip and upper cheek regions that can impact the final outcome.
When lower jaw surgery is performed, we have successfully offered rhinoplasty without any risk and great results offering ONE surgery visit.  No problem in this instance.
The best surgeons are those that are board certified in both maxillofacial reconstructive surgery and facial cosmetic surgery, with a full understanding of the jaw and bite issues, along with the facial soft tissue esthetic demands that can be addressed.
I hope this helps:)
Dr. Q.

William Portuese, MD · Answer

Orthognathic surgery is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay and should be performed first, especially if the upper jaw is being performed as well. A rhinoplasty is performed under general anesthesia as an outpatient surgical procedure. Both procedures should not should not be performed together. Alternatively, a chin implant can augment chin forward to help facial balance and proportions. For many examples of  chin implants performed in combination with a rhinoplasty, please see link and the video below

Jeffrey Jumaily, MD · Answer

getting two procedures done at the same time is fine. Those particular surgeries are not recommended to be done at the same time for two reasons 1) oral surgeons who do orthognathic surgeries are usually not experts at rhinoplasty. 2) orthognathic surgery can have changes on the projection of the nose. so you really want the ortho done first then do the nose after it's all settles. Best wishes

Regina Rodman, MD · Answer

While I frequently do surgeries with my partners at the same time, I would not recommend these two at the same time.  I do only facial plastics and my partners do body contouring plastics and many patients have these at the same time.  This works well because the patients save on OR time and anesthesia, and have only one recovery. 
I do both orthognathic and rhinoplasty surgery, and am probably one of the few surgeons who is craniofacial and facial plastics trained.  I would not recommend pairing these two procedures.  The reason is that most patients need to stay in a splint with their mouth wired shut after jaw surgery.  After rhinoplasty the nose is packed with splints and generally gets blocked with crusts and blood clots.  It is very hard to breathe through the nose after rhinoplasty.  While a patient can breathe through the mouth with jaws wired, it can be very uncomfortable, and it will be worse without nasal breathing.  It's too much at once.  Further, if you are planning upper jaw surgery, the position of the nose can change and this is not a good foundation for a rhinoplasty. 
I would do jaw surgery first, then rhinoplasty 6 months later.
Best of luck
Dr Rodman

Michael Elam, MD (retired) · Answer

Dear Zakme, Most surgeons who specialize in rhinoplasty may not specialize in both procedures. Chin augmentation and rhinoplasty are combined often together it depends on what you need done. Seek some consultations with experts in both fields. Best regards, Michael V. Elam, M.D.

David Alessi, MD - Account Suspended · Answer

There is usually no problem getting both done together.  It does depend on exactly what needs to be done with the orthognathic surgery.  We do our combined surgeries with a Maxillofacial surgeon expert in all areas of orthognathic surgery.  We prefer to stay specialized in rhinoplasties.  Best wishes.

Richard W. Fleming, MD (retired) · Answer

It is unlikely you will find a surgeon experienced with both of these procedures but you can have two surgeons coordinate their work so everything is done during the same operation.

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