ENT Doctor Capable of Combining Sinus Surgery with Rhinoplasty?

Many ENT doctors do not perform rhinoplasty. However, an ENT doctor who is also board-certified in facial plastic surgery is capable of performing endoscopic sinus surgery with rhinoplasty. All facial plastic surgeons original background is in ear, nose, and throat surgery and should be well versed in endoscopic sinus surgery techniques. Find a surgeon who has vast experience in both cosmetic rhinoplasty as well as the functional rhinoplasty. The most challenging part of this operation is finesse of the rhinoplasty, so make sure you like a surgeon’s before and after photos. Typically, a rhinoplasty surgeon who has performed thousands of rhinoplasties is likely to have performed thousands of endoscopic sinus surgeries as well. We perform this combination quite frequently in our practice. There is no other reconstruction in the nose that has to be done during the procedure.  

A simple answer is "yes' the two surgeries can be performed at once.  However, I would first analyze your need for sinus surgery, because I am more in line with Dr. Joseph's thinking.  If you truly have hypoplastic sinuses, the sinus surgery required tends to be more involved with drilling of bone etc.  The recovery from this type of surgery is also more complicated.  Secondly, do you really need sinus surgery?  In my opinion, sinus surgery should be more a procedure of last resort than an answer to garden variety sinusitis.  Lastly, does your Doctor do a lot of Rhinoplasty?  Making a choice on Rhinoplasty surgeon should be more involved than combining two procedures for the sake of convenience.  Rhinoplasty is the most complicated of aesthetic procedures and requires a high degree of skill and experience. 

Endoscopic sinus surgery is one of the ENT procedures I still perform with regularity. This may be performed at the same time as Rhinoplasty Surgery. I have a few comments based on your question:

Make sure you truly need sinus surgery. I have never operated on "hypoplastic sinus cavities". Your sinus cavities are very close to your eyes and your brain, so large cavities are safer to operate on. If your nose and sinuses are filled with polyps that are obstructing your breathing, then you may need to have this addressed. The report of your sinus CT scan should describe abnormalities other than hypoplastic sinus cavities which I consider a normal anatomic variant.

The only negative of combining the 2 procedures is operating time. The sinus surgery would be performed first, and that takes around 2 hours or longer depending on your condition. Rhinoplasty surgery typically takes me between 1.5-2 hours. Also, if you have infection in your sinuses, I would not suggest performing both at the same time.

Lastly, make sure your ENT does lots of nose jobs. Ask to see many photos before proceeding.

I hope this is helpful for you.