Possible rhinoplasty add on to scheduled septoplasty?

Thank you for uploading these photos. You should absolutely get a rhinoplasty since you're already going in for the anesthesia and recovery time associated with the septoplasty. Depending on your goals, I recommend component dorsal hump reduction, tip refinement, and a columellar strut graft. The last part is neat since we use the cartilage we already removed for the septoplasty, to make the nose actually look better. If just getting the septoplasty, we throw that piece out.

It is possible that the surgeon doing your septoplasty is an airway surgeon and not necessarily the ideal person to make cosmetic changes. If that’s the case just have them do only the airway work. Or find a surgeon who dies both cosmetic and functional work

It's not something you "add on" to a septoplasty, to be done by the person already selected to do your septoplasty. You can't just go to any plastic surgeon to have a rhinoplasty, because most get very poor training in that operation. You search for a rhinoplasty surgeon separately from how you search for someone to do a septoplasty, although you may find that your current surgeon is already the right one! I'm just saying, don't assume that because you scheduled your septoplasty with her, she can get you the aesthetic nose you want. Now, having said all that, what I notice is that your nose is strong in its forward projection away from your face. You might want to have the bump on the bridge removed, and the tip brought back closer to your face. Then, those two changes tend to make a nose *look* longer, as if the tip had actually dropped, so we usually think about elevating the tip a small amount so the nose doesn't look too long after surgery, especially on the 3/4 views.



How *much* to elevate the tip, or deproject the nose, or lower the bump, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

Rhinoplasty is the most difficult procedure to perform in the entire field of cosmetic surgery and is much more difficult than a septoplasty. Look for a double board-certified ENT/ facial plastic surgeon who can perform both the cosmetic rhinoplasty and functional septoplasty simultaneously under one anesthesia. Study your perspective surgeon's before and after rhinoplasty photo Gallery to make sure that it is extensive with natural results that you like

Rhinoplasty surgery is fairly complex and the ability to deliver consistent quality. Rhinoplasty results is more difficult than most people realize. Because of the complexity, rhinoplasty surgery should be done by providers who have a proven track record with this procedure. I generally recommend patients go through a formal provider, evaluation vetting process before choosing a surgeon to do a rhinoplasty. This generally involves interviewing multiple providers before selecting a provider and then having thorough in person consultations to first and foremost confirm, the provider has to skill an experience to deliver the results you’re hoping for. Secondly, to have a clear understanding of what changes you’re seeking to make sure the surgeon Understands and confirms they can deliver those results. I generally recommend patient start to process by scheduling five in person, consultations with providers in their community, who have a proven track record for rhinoplasty surgery. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar facial characteristics to your own. An experience surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Highly experienced surgeons should have access to hundreds or preferably thousands of before and after pictures. If the rhinoplasty surgery is not done well, it can leave you this and revision or secondary rhinoplasty. Surgery is much much more difficult to manage than primary procedures. Without having gone through the proper vetting process of first selecting, a rhinoplasty surgeon , you are now in a position where you have to confirm that the surgeon you’ve chosen, has the skill and experience to do this procedure well enough to leave you pleased with the outcome. From a technical perspective, it is highly appropriate to do rhinoplasty surgery in conjunction with a septoplasty. In many ways, it is preferable to do the procedures together.
The only issue is provider selection, and confirming that your provider has sufficient skill and experience doing Aesthetic rhinoplasty surgery.
Last minute decisions, regarding surgeries that will affect your appearance, for the rest of your life are advised. If you’re interested in having a rhinoplasty, then begin the process of discussing this with your current provider, and possibly vetting for other providers to make sure you have the right surgeon.
Rhinoplasty surgery is not a single procedure, but rather involves many different operations to treat different parts of the nose. The nose is usually subdivided into different units, and there are different procedures for each subunits of the nose.
Your provider may potentially do an excellent job, but you need to confirm they have the skill and experience before simply signing up for something that can have potentially negative consequences.
Best,
Matt Hagstrom, MD