Getting Rhinoplasty After Septoplasty?

I broke my nasal bones in 3 different places and cracked my septum. My nose was never totally straight to begin with, but the results of the Septoplasty surgery are terrible.

My doctor would not do Rhinoplasty and Septoplasty at the same time as he said it would have difficulty healing. My nose is more crooked then before and my right nostril is twice the size of my left.

Will I need Rhinoplasty to fix this? Can it be straightened, and how long do I have to wait after the septoplasty to have Rhinoplasty? My nose almost looks deformed.

Doctor Answers 14

Septorhinoplasty is commonly performed together

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A septorhinoplasty is commonly performed together. They can be performed separately. Since the patient has already had a septoplasty, one should probably wait two to three months prior to embarking on a rhinoplasty surgery to let full healing take effect regarding the internal portion of the nose. Nostril size can be slightly adjusted through Weir excisions of the alar base, also known as an alarplasty.

Do rhinoplasty with a revision septoplasty

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Hi, it's not clear as to why the septoplasty and rhinoplasty were not done initially, however it sounds like you will need revision at some point in the future. I would advise you to see a surgeon who is experienced in both primary and secondary (revision) rhinoplasty. Most surgeons will ask you to wait 6-12 months after your initial procedure to allow the swelling to come down prior to performing any additional surgery. Good luck.

Missing information

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I am not sury why the septum and rhinoplasty couldn't be done concurrently- must be the nuance of the injury.

You will likely need a rhinoplasty at some point. I would guess that you will need to wait abuout a year before an attempt should be made. In the hands of an experienced rhinoplasty surgeon, you should have a great result.


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You will likely need a rhinoplasty

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 Without pictures it is hard to give you specific advice.  However, it sounds like eventually you will need a cosmetic rhinoplasty.  However, if you recently had surgery on your nose, it is best to wait several months to a year before considering any revision surgery.  Good luck.

See a revision rhinoplasty specialist.

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 It is very unusual not to do both at the same time. The nose can be revised, but you should see a revision rhinoplasty specialist with a great deal of experience to repair your nose--you want the next operation to be your last.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Rhinoplasty may be necessary

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Sounds like you have had fairly significant nasal trauma with this and in the past as well. It sounds like your septum may have slipped off it's perch (the maxillary crest and the nasal spine.) When this happens there is a big discrepancy in nostril size. That can be corrected with a septoplasty addressing the dislocation of the septum. If additional contour improvement in your bridge or tip is desired you would most likely require a reconstructive septorhinoplasty.

Rhinoplasty and septoplasty as related to a crooked/straight nose

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As previously mentioned the septum is the central internal structure (wall) that divides the left from the right side of the nose.

Your external nose can be crooked and your septum straight or vice versa.

Straightening the septum does not necessarily straighten the nose but it is typically performed to improve breathing or help decrease nasal congenstion/obstruction associated with sinusitis.

Generally rhinoplasty and septoplasty are perfomred concurrently. One exception is severe collapse of the septum in which possible vascular or structural support of the nose may be compromised.

Nasal Fracture, Septoplasty, Rhinoplasty

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Nasal reconstruction after nasal trauma routinely involves the septum (septoplasty) and the outer structures of the nose (rhinoplasty). Personally, I virtually never recommend seperating these two parts if both require attention. Nasal structures are closely interrelated: For best outcome, septum and external nose are addressed in conjunction. In addition, cartilage grafting is commonly necessary for fracture repair and this cartilage can be harvested from the septum. Septoplasty commonly involves removal of some cartilage which can then be "put to work".

It sounds to me that you will require further nasal reconstructive surgery with cartilage grafting. After septoplasty, these grafts may have to be taken from the ear.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 51 reviews

Rhinoplasty after Septoplasty

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Following a closed reduction of a nasal fracture with or without a septoplasty, it is common for the nose to have residual deformity or breathing problems. The medical literature reports that the need for a subsequent rhinoplasty to correct these problems can be as high as 50%.

Rhinoplasty and septoplasty are frequently performed together. The term septorhinoplasty denotes a surgical procedure to correct both the form and function of the nose and is often performed after nasal trauma.

For a post-traumatic nasal deformity in which the nose remains crooked, a rhinoplasty with osteotomies (surgical breaking of the nasal bones) combined with other techniques such as spreader grafts is almost always required. The timing since a previous septoplasty is less important as the time since the most recent nasal fracture as it is important for the swelling that resulted from your trauma to have gone down.

If the cartilage from your septum has been removed or is severely damaged, it is likely that cartilage grafts would be needed for your rhinoplasty to straighten, strengthen and rebuild your nasal framework. Cartilage cano be taken from another area such as the ear or rib. Thus, for severe post-traumatic nasal deformities, seek a surgeon that specializes in rhinoplasty for your definitive correction.

Treatment(s) for a broken nose

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A rhinoplasty is a combined operation consisting of multiple proceedures done at one time on the external and internal parts of the nose to restore nasal function and,in many cases,appearance. A septoplasty is an internal proceedure to straighten or remove parts of a deformed septum which are interfering with nasal function. A septoplasty cannot correct the asymmetry resulting from broken and displaced nasal bones.

In my experience over 30 years nasal trauma like you describe is best handled in a single proceedure (rhinoplasty) where ALL the elements of nasal archetecture are reconstructed to restore function and appearence.

Barry H. Dolich, MD (Retired)
Bronx Plastic Surgeon

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.