Septoplasty with Bilateral Turbinate Reduction?

Question

Can someone have septoplasty with bilateral turbinate reduction to improve their breathing problems at the same time while improving their look?

Thomas A. Lamperti, MD · Answer

You can certainly combine functional nasal surgery like septoplasty and turbinate reduction with your cosmetic rhinoplasty. If you're considering both it actually makes the most sense to do the septoplasty at the same time as often the septal cartilage can be put to use during the rhinoplasty.

	Improving your septum position and turbinate size can often improve chronic nasal obstruction by improving your nasal airflow.

William Portuese, MD · Answer

It is certainly acceptable to undergo cosmetic rhinoplasty at the same time as surgery to improve breathing such as septoplasty and/or bilateral turbinate reduction. The cosmetic portion of the nose is billed to the patient while the medically related breathing issues are billed to the patient’s health insurance.

Jacob Freiman, MD, FACS · Answer

The answer to your question is absolutely! In fact, If you are thinking of cosmetic or secondary rhinoplasty, you should have them both performed at the same time since otherwise you will have to wait a year between each procedure. You might as well have anesthesia once and go through recovery once. Besides, the septoplasty can aid in formation of a more cosmetically appealing nose by using the cartilage for grafting if necessary.

Robert Kotler, MD, FACS · Answer

Hello;

	Generally, it makes perfect sense to combine the nasal septoplasty and turbinate resection with the cosmetic rhinoplasty.  You have one operation, one anesthetic, and one recovery.  Generally, also, it is more economical to combine procedures.

	There are some caveats which you should know. 

	First, the recovery period may be longer if you add septoplasty and turbinate resection to the rhinoplasty.  It may be necessary to keep some packing in the nose (if the surgeon places packing) for a longer period of time if you have the functional surgery combined with the cosmetic rhinoplasty.  Generally, there is a tendency for more swelling and bruising because you have now had two operations instead of one.  It also takes a bit longer to heal.

	There are some technical considerations that you should discuss with the rhinoplasty surgeon.  Experienced nasal surgeons know that there can be consequences to the cosmetic appearance from performance of the nasal septoplasty. 

	What I mean is that all the structures of the nose are interrelated and, therefore, one must be very cautious to understand the need to preserve certain structural elements, while at the same time altering some structures, particularly to improve the airway.

	I would suggest that you do consult someone who "majors" in both rhinoplasty and the functional nasal surgery to improve the airway.  Turbinate reduction is very important as a component in improving your airflow.

	Be sure to ask your rhinoplasty surgeon if he uses the Kotler Nasal Airway&trade;.  This device allows you to breathe immediately after nose job surgery and throughout the entire immediate postoperative period --whether your nose is packed or not.  It is very helpful, and it is a big favorite among patients today.

	Robert Kotler, MD, FACS
	Facial Plastic Surgeon
	Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
	Author, THE ESSENTIAL COSMETIC SURGERY COMPANION

Shashidhar Kusuma, MD · Answer

Generally speaking the airway should be assessed while evaluating a nose for any reason.  A cosmetic rhinoplasty in cases should be combined with airway surgery to make sure that there are no breathing problems after surgery. At the same time if it is known that there are breathing problems prior to surgery, then it is very important that the surgeon be aware of this problem and correct both the cosmetic and the functional(airway) problems at the same time.

	The turbinates can be reduced with endoscopic techniques to minimize trauma and post operative crusting, dryness etc. The septoplaty  in many cases help the rhinoplasty as the cartilage that is removed during a septoplasty can be utilized to graft the nose while doing a cosmetic rhinoplasty.

	Good Luck.

Peter A. Aldea, MD · Answer

Septoplasty and turbinate reduction is commonly done to improve breathing. It may also be combined with a cosmetic rhinoplasty if a change in nose appearance is desired.

Rondi Kathleen Walker, MD - Account Suspended · Answer

The combination of a septoplasty with a rhinoplasty and turbinate resection is very common.  It is an excellent way to improve your breathing problems.

	The rhinoplasty portion of the procedure addresses your beauty by improving the shape and size of your nose, while the septoplasty and turbinate resection address a deviated septum that can obstruct your breathing.  Resection of your turbinates is beneficial when both a rhinoplasty and septoplasty are performed as it keeps your nasal passages from becoming to narrow.

Richard P. Rand, MD, FACS (retired) · Answer

It is common for an experienced ENT or plastic surgeon to do airway improvement surgeries such as septoplasty and turbinate reduction while performing a cosmetic rhinoplasty. Just make sure you go to the best doctor because especially in this surgery you only get one great shot at the best result.

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