Septum deviation still prominent after septoplasty & rhinoplasty, revision options? (Photo)

Question

4 months post op. Septum was Superiorly deviated to the right and caudal on the left into the nostril, columella shifted to the left, nasal stenosis on the left. Dr. told me she would not be able to get nostrils symmetrical, but that there would be some improvement. I am worried because I don't feel like the nostrils and columella look any better. She said there is Irritation/edema over left medial vestibule at caudal septal repair. Will I see further improvement? If not, revision options?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a a revision in order to improve nostril symmetry and correct the septal deviation.  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.
Harvard-trained plastic surgeon

Andrew Miller, MD · Answer

It is too early to really consider doing anything further on your nose. However, it does appear that the septum is deviated to the left anteriorly, which contributes to the difference in the nostrils. Often times, it takes more than some people think to get the end of the septum to stay in the midline position, and sometimes it's not possible. You should go see a rhinoplasty specialist with your op note to show exactly what was done to see if it's worth it to try more.

Gianfranco Frojo, MD · Answer

Even though it is very early in the post-rhinoplasty recovery....I do think that there is some rather obvious septal deviation to the left causing obstruction of the left nostril (external nasal valve). I would seek a second opinion if you are not on the same page as your plastic surgeon. It is absolutely critical to find an American Board of Plastic Surgery board certified plastic surgeon with experience in rhinoplasty, one preferably with an accredited Aesthetic fellowship endorsed by the Aesthetic Society.

Eric M. Joseph, MD · Answer

Based on your singular photo, you appear to have the bottom of your septum deviated to the left and this may be causing your tip to veer to the right. Are you having difficulty breathing through the left side of your nose?
4 months post-operative is early and your healing, and the base of the nose tends to hold on to swelling for the longest. If you feel like your surgeon is not giving you adequate answers to your questions, please consider procuring a copy of your operative report, before photos, and visit with another reputable rhinoplasty specialist for clarity. I hope this is helpful. Sincerely, Dr Joseph

Septum deviation still prominent after septoplasty & rhinoplasty, revision options? (Photo)

Answers (4)

Answer: You may indeed have a persistently deviated nasal septum to the left.

Answer: You may indeed have a persistently deviated nasal septum to the left.

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Septum deviation still prominent after septoplasty & rhinoplasty, revision options? (Photo)

Answers (4)

Answer: You may indeed have a persistently deviated nasal septum to the left.

Answer: You may indeed have a persistently deviated nasal septum to the left.

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.