Do I need a Rhinoplasty?

Question

A toddler threw an iphone at my face years ago, and after finally seeing an ENT, he said that I needed to have a septoplasty. I had a septoplasty a couple months ago, and while my breathing is slightly better, my nose is uneven. The right side protrudes while the left side slants in. There is also something that feels like bone blocking the airway on the left side. When I stick my finger up it, I always hit this bone. Do I need a septoplasty or can it be fixed without surgery?

Miguel Mascaro, MD · Answer

Gaby, great question, and very common at that.  A septoplasty will address the nasal septum along the middle and help you with your breathing, while a rhinoplasty deals with the nasal valve, the bony structures, as well as the appearance of the nose.  In some cases, a functional rhinoplasty (one that is intended to improve breathing after trauma, for example) includes maneuvers such as bony repositioning, spreader grafting, etc which will address the way you look as well.  It sounds like the procedure that you had done was performed mostly to address your breathing, and not the appearance of your nose from the outside.  If you continue to have troubles breathing, then you may require a functional rhinoplasty along with a cosmetic component to straighten it out and get your nose looking great again.  That being said, without any pictures or exam, its tough to say.  I hope some of this information helps.  Best of luck!

Garrett H. Bennett, MD · Answer

Your septoplasty may have partially improved your breathing, but, if your nose is twisted and the bones have collapsed from a fracture then that may be obstructing your breathing as well. You have internal and external valves inside your nose that sound like they may be compromised as well. If you have a functional breathing issue from a fracture, your insurance should help.

William Portuese, MD · Answer

A rhinoplasty is performed for cosmetic purposes to straighten a broken nose from trauma. A septoplasty is performed on the inside of the nose to improve airflow. A septoplasty will not change the shape, only improve breathing for medical necessity.  A rhinoplasty and a septoplasty are two completely separate procedures, however both can be performed at same time. To straighten a crooked nose requires osteotomies placed in the nasal bones, and cartilage grafting techniques, such as a spreader graft.  For many examples of crooked nose rhinoplasty results, please see the link and the video below

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