Septoplasty and rhinoplasty are 2 completely separate procedures
A septoplasty is performed in the back of the nose when there is twisted bone and cartilage blocking airflow in the back of the nose. A septoplasty will not change the shape of the nose, and is only done for medical necessity which must be documented at the time of the examination and consultation. A rhinoplasty is performed for cosmetic purposes to make changes to the shape of the nose, which can include cartilage grafts, cartilage removal, suture techniques, dorsal hump removal, and reduction of a hanging columella. For more information and diagrams showing the differences between cosmetic rhinoplasty, and functional septoplasty, please see the video and the link below
Functional and cosmetic rhinoplasty: best surgeon to select?
ABPS board-certified plastic surgeons or ENT facial plastic surgeons have the greatest experience in performing such procedures. Amongst all surgeons some will have greater experience and confidence than others so choose your surgeon carefully regardless of background training. At your consultation you should be shown examples of patients with similar problems to develop a sense of confidence in your treating plastic surgeon. Good luck and best wishes.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California
Rhinoplasty and septoplasty are often performed together in the same setting. This makes a great deal of sense for a number of reasons which your surgeon can review with you. Most experienced rhinoplasty surgeons do also perform septoplasty although ENT-trained facial plastic surgeons tend to have more experience with correction septal and breathing issues.
Find Facial Plastic Surgeon or Rhinoplasty specialist
Without any photos, it is difficult to assess the severity of your nasal issues. Based on the problems you listed, you may have some very complex cosmetic and functional problems with your nose. My advice is to seek evaluation by a facial plastic surgeon as they also have ENT training. By your description, you may have saddle nose deformity which would require rather extensive reconstruction of the nose. Regarding a deviated columella, this can be caused by deviation of the septum or displacement of the lower cartilages (called the medial crura) that line the inner aspect of the nostril. To adequately fix the deviated columella and all the problems you listed, you will likely need an open rhinoplasty which places a small incision near the base of the columella. Do your research and make sure your surgeon is well versed in reconstructive rhinoplasties!
Best choice for septorhino?
Thanks for your question. In general, a facial plastic surgeon with an ENT background is more likely to focus on rhinoplasty than a general plastic surgeon. However, there are a TON of really good rhinoplasty surgeons who have a general plastic surgery background. It's really a matter of doing your research into individual surgeons instead of one group over another. A deviated columella usually is the result of a deviated caudal septum. The fix depends on how much is deviated, and by how much. If it's only a little bit off and only a small amount is deviated, you can just shave off the deviated area. If it's way off and a lot of the septum is involved, you sometimes need to replace it with a straight part from the back. That is a much bigger deal, but straightforward enough for a surgeon who does a lot of rhinoplasties. Here's an example from my practice.Good luck!
ENT vs. plastic surgery
Hi Lisa, either a board-certified Plastic Surgeon or ENT surgeon should be able to help with the problems described. Not all ENT or plastic surgeons perform rhinoplasty however, so it is best to do your research before selecting someone. In regards to a deviated columella, this can be fixed or improved using very standard rhinoplasty surgical techniques. Good luck and all the best.