Rhino-septoplasty - Do I need to correct the whole nose deviation or only the little deviation of caudal septum? (Photos)

Correction of deviated septum is not always easy and completely predictable procedure. Only after deformity is completely defined after surgical exposure, an experienced surgeon will make decision what is the best way to correct and fix it to prevent recurrence. In your case it is very likely that a combination of septoplasty and rhinoplasty to address function and external nose dis-balance would be my suggestion. Good luck.

To correct the crooked caudal septum I would just trim back the cartilage that is sticking out of the nostril. No grafts needed. Although I think you would benefit from a full rhinoplasty if you just want the lower septum trimmed that would be quite simple to do although many surgeons make it more complicated than it needs to be. The diagram you show makes it too complicated. I trim back the lower septum in almost every rhinoplasty a perform and it can be done with way the closed technique

Hello and thank you for your question. Although an exam in person is ideal, from your photographs alone it appears that you can benefit from a subtle dorsal hump reduction, correction of your deviated septum, and possible tip refinement.

To address your question about the deviated septum specifically, I typically improve septal deviation by:
(1) Exposing the entire septum from the cephalic end to the caudal end (top to bottom) because this allows me to (a) expose the boney septum as well, and straighten it directly, (b) debride any deviated bone or excise any bone spurs that could be impinging on the airway, and (c) score any deviated segment of the cartilaginous septum to help straighten it.
(2) Septal reset (along the base of the caudal septum), as indicated in your diagrams.
(3) Extended spreader grafts, locked into a columellar strut; please note that this maneuver not only maintains the straightness of the septum (and nose) but also maintains the tip at length, thereby risking the risk of nasal tip droop.

Any further modification of your nasal cartilage can be done with trimming, stitching or additional grafting. Of note, if you have any breathing difficulty, a septoplasty or other maneuvers may benefit you as well, and insurance can cover this to reduce the price of your surgery overall☝️

For more information on rhinoplasty, please refer to my link below.

Good luck and please let me know if I can help.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon in Boston & Miami

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. The Entire nose should be corrected and not just the caudal deviation part.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

A caudal septoplasty alone should improve your breathing. If there is any doubt then a nasal endoscopy can be done in the office to make sure the deeper (inner) septum is ok. In fact caudal septoplasty alone can be done under local anesthesia.
Regards
Dr Janjua