Is it more risky to perform a septoplasty on a nose that had a previous septorhinoplasty done?

Question

Hi all - looking for some help here. I have a complex medical history with my nose. I had a septorhinoplasty in 2013 (to correct an earlier deviation. In 2016 and 2017, I sustained separate nasal fractures due to sports accidents. Each time, I had a fracture reduction. I sustained a heavy hit to the nose, with blood coming from it. This caused a deviated septum and breathing trouble. Is there a danger in a corrective septoplasty now given that some septum was removed in the original procedure?

Thomas Spalla, MD · Answer

I have performed revision septoplasties and revision rhinoplasties many times over the past decade. They are always more challenging due to scarring (tissue planes are distorted), potentially less blood-flow to regions, and, as you commented, missing pieces. Some septoplasty surgeries can result in a significantly less cartilage and bone with which to work. These tissues are often helpful in rebuilding and straightening a septum. When they are not present, and are required, we surgeons need to look elsewhere for structural support. Occasionally, ear cartilage can be used, but the septum usually needs more support and rib grafts are often necessary.
If your airflow is disrupted and your septum is crooked, you may need to undertake a revision. Just consult with an experienced nasal surgeon with whom you feel comfortable to ensure you feel good about your decision moving forward as there may be some bumps in the road (hopefully not).

David M. Kowalczyk, MD, MBA, FACS · Answer

Hello! Great questions. You sound like you have a complex history regarding your nose. You'd want to meet with a surgeon who performs structure repair to the nose as your septum likely can't be fixed in the traditional way without potentially creating instability. An open structure, septorhinoplasty can be used to straighten any remaining septum and create stability to your nose. Seek consultation with a number of surgeons to determine which approach may be best. Hope this helps!

Is it more risky to perform a septoplasty on a nose that had a previous septorhinoplasty done?

Answers (2)

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