Should I get a septoplasty during my revision rhinoplasty? (Photos)

Question

Hello Doctors, I had a primary rhinoplasty in 2020, which addressed a dorsal hump but didn’t fully resolve my concerns. My nasal tip remains bulbous and droopy, so I’m planning to undergo a revision rhinoplasty. During a recent CT scan of my head (done for unrelated reasons), I discovered how deviated my septum is (see pictures). This aligns with my ongoing symptoms: nasal resistance and loud breathing. I don’t believe the septum was addressed during my rhinoplasty, breathing didn’t improve or worsen post-op. Given these factors, I’m wondering: 1. Would it be advisable to combine a septoplasty with the revision rhinoplasty? 2. Could a septoplasty improve, or could it worsen some of the external asymmetry of my nose? 3. Should I thus prioritize finding a surgeon experienced in both functional and cosmetic revision rhinoplasty? I truly appreciate your time and insights. Thank you in advance.

Alejandro Nogueira, MD · Answer

Yes, your septum is creating an impigement of one nasal fossa, however this should be treated ONLY if the patient has symptoms due to it, if this is the case (I assume so) then yes, a septoplasty is correctly indicated at the same time of the revision rhinoplasty; however... this is not easy thing, the surgeon has to be very brilliant and experienced.

However, the septoplasty plays no role in your tip or nose deviation, these issued have to be addressed by the revision rhinoplasty planning.

However, the septoplasty plays no role in your tip or nose deviation, these issued have to be addressed by the revision rhinoplasty planning.

Eric M. Joseph, MD · Answer

You were dissatisfied with the appearance of your nose, and if you have difficulty breathing through the left side due to a deviated nasal septum, there is no reason not to correct you deviated nasal septum at the time of revision rhinoplasty. I hope this helps, and I wish you well moving forward. Sincerely, Dr Joseph

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can see from your photos If you have a deviation problem, of course, we recommend you to have a septorhinoplasty operation, there is no harm in being together, but it is important that your doctor who will perform the operation is a specialist in the field of ear, nose and throat so that you do not have problems in terms of breathing problems in the future.
 Best Regards!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a revision rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. A septoplasty should be performed at the same time to help improve breathing. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

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