I have mild sleep apnea and really big tonsils and a deviated septum is a rhinoplasty safe? (photos)

My ENT suggests that fixing my deviated septum can help my breathing as well as removing my tonsils. I don't use a Cpap. How will anesthia work?

Doctor Answers 4

I have mild sleep apnea and really big tonsils and a deviated septum is a rhinoplasty safe?

Yes, a rhinoplasty is safe and if done properly should help with your sleep apnea and associated snoring that you may likely also be dealing with. See a board certified plastic surgeon and ask to look at photos of patients with similar pre-surgical situations. Good luck.

Providence Plastic Surgeon
4.9 out of 5 stars 63 reviews

Nasal surgery

Hello and thank you for your question.  This is safe as long as you obtain medical clearance.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Obstructive sleep apnea and rhinoplasty...things to know

Obstructive sleep apnea is a spectrum of obstruction which happens at night time.  Obstruction of the nasal passages can contribute, but is usually not the cause of, obstructive sleep apnea. Correcting the nasal obstruction with a septoplasty, turbinoplasty, and possibly a rhinoplasty (in some cases) will improve the nasal breathing, and might help out with the snoring and or sleep apnea.If you are still electing to improve the appearance of your nose, the rhinoplasty will not be covered by  insurance.  Regardless of insurance coverage, the rhinoplasty can be performed at the same time as the other procedures.  

Surgery to improve sleep apnea is usually quite safe. The more mild the sleep apnea, the less chance of anesthesia problems.  You should make sure that you have and experienced surgeon as well as anesthesia team. If indeed your sleep apnea is primarily due to your large tonsils, removing them well immediately improve your sleep apnea, so your recovery should be relatively uneventful from that point of view.  If you are looking to have the tonsil and nasal work done at the same time, I would seek out a facial plastic surgeon ( who is also board certified in ENT) so you can have a work done by one surgeon. Otherwise, you will need to coordinate the surgery with 2 separate surgeons, or have separate operations at different times.

Best wishes, MKB

Michael Bowman, MD
Roanoke Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Nasal surgery in patient with mild sleep apnea

Hello.  Thank you for your question.  Obstructive sleep apnea is typically related to airway obstruction in the throat (pharynx) that occurs when the muscles around the pharynx relax during sleep and allow collapse of the soft tissues of the pharynx when lying supine.  This can occur at various levels in the pharynx, and a thorough analysis of the airway is required to determine where the obstruction is occurring, in order to determine the best plan for treatment.  If your sleep apnea is mild and your tonsils are very large, then a tonsillectomy may significantly improve the airway obstruction that you are experiencing during sleep.  With regards to your nose, nasal surgery alone is typically not considered a treatment for sleep apnea.  However, if you have difficulty breathing through your nose and there is significant obstruction of your nasal airway from a deviated nasal septum or enlargement of the turbinates, then performing a septoplasty and turbinate reduction, with or without rhinoplasty, can certainly improve nasal breathing and potentially enhance the improvement in your breathing during sleep that you get from tonsillectomy.  With regards to anesthesia, these procedures are performed under general anesthesia.  Since your sleep apnea is mild, it should not significantly increase your anesthesia risk.  I hope this information is helpful.  I wish you the best with your surgery and recovery.

Michael Boggess, MD
Nashville Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.