Can a deviated septum and asymmetry be fixed while maintaining a natural result? (Photos)

Question

Hello. I have a "very minor" (according to ct) deviated septum and bone spur. Despite being described as a minor deviation on scans, my left 3/4 profile looks drastically different than my right 3/4 profile. Is it possible to correct this without drastically altering the overall nose appearance? Would just septoplasty be best, or would septo/rhinoplasty be ideal? I don't hate my nose overall, but I wish it looked more similar on each side and was slightly straighter from front view.

William Portuese, MD · Answer

Septoplasty is performed in the back of the nose to improve airflow dynamics through the nose, and does not alter the shape of it from the external appearance. A rhinoplasty can be performed to improve the look of the nose. The three-quarter profile that you're referring to usually is related to one side being convex and the other one being concave, which gives a differential look from both sides. Adding a cartilage graft to the concave side is usually performed with a spreader graft harvested from the inside the nose. The convex side can be shaved down if necessary. Both a rhinoplasty and a septoplasty can be performed if needed. Rhinoplasty is a very difficult procedure, so choose your specialist wisely based on extensive experience.

Randal Haworth, MD, FACS · Answer

A “minor” septal deviation on CT can still drive visible asymmetry if the cartilaginous vault and tip complex are twisted. Functional septoplasty and cosmetic refinement are often planned together precisely because straightening airflow structures affects the outer shape.

Natural results depend on conservative reshaping, preserving (or reconstructing) support, and respecting skin thickness—not on removing every irregularity. Asymmetry can be improved; perfect mirror symmetry is rarely honest marketing.

Photos and a CT note are starting points only. An exam that includes internal inspection and a clear functional-cosmetic plan with a facial plastic surgeon is what determines whether you can breathe better without looking “operated.”

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a rhinoplasty. A 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. It is possible to address the deviated septum at the same time. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. 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. FACS
Harvard-trained board certified plastic surgeon

Best wishes and good luck.

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

Gary M. Horndeski, MD · Answer

The deviated septum can be corrected by itself or you can combine it with a rhinoplasty.  You have slight tip asymmetry.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

Hi, your nose generally looks good and proportional. Mild changes that you are concerned with are hard to notice on these photos. It would be in your best interest to have a consultation with a board certified plastic surgeon, expert in rhinoplasty. Good luck.

Can a deviated septum and asymmetry be fixed while maintaining a natural result? (Photos)

Answers (5)

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