Asymmetrical nose dome & deviated septum. What are my options? (Photo)

Question

Mid 30’s. Never had surgery to my nose. Nose tip assymetry of left dome; more firm & larger than the right side. Bump can be seen from right profile. I have issues breathing out of my right side when stuffed up, my nose veers a little to the right, & I couldn’t fit the covid swab all the way back on this side. Possible deviated septum? I’d like to correct the septum & the assymetry to the tip. I’m in Surrey, BC. What are the options & estimated cost range please?

Gary M. Horndeski, MD · Answer

A rhinoplasty/septoplasty could be performed to correct this.  The procedure takes 2 hours to perform under general anesthesia and cost $7,000.

Best Wishes,

Gary Horndeski, M.D.

Eric M. Joseph, MD · Answer

Your up close photos show the asymmetry, however, this is something that would require rhinoplasty surgery to address, in all likelihood. This should be reserved for severe dissatisfaction with the appearance of your nose. I hope this helps. Sincerely, Dr Joseph

Caner Kacmaz, MD · Answer

Hi! This is Arzu from Dr. Caner Kacmaz Clinic. The deviation and the shape of your nose can be correct with rhinoplasty. For more information do not hasitate to contact with us
Kinf regards

Andrew Miller, MD · Answer

Based on your photos, you are a great candidate for rhinoplasty. The fullness of the bridge and tip can be reduced some, and the inside can be done at the same time. Be sure to see an expert rhinoplasty surgeon that can do computer imaging at the same time.

Oakley Smith, MD, FRCSC · Answer

Hi , septorhinoplasty correct the septum (function) of the nose then the surgeon carries on with the rhinoplasty to enhance the shape of the nose.It is better for you to consult with a facial plastic surgeon who can examine you and discuss the surgical procedure and the post op recovery 
process.

Jacob Tower, MD · Answer

Hello, hope you are well. The only way to diagnose a deviated septum is with direct visual examination, but it sounds highly likely based on your description. Septorhinoplasty can be performed to correct the septal deviation and tip asymmetry. You can contact the offices of plastic surgeons directly to get a sense of costs for the procedure.
Best,Dr. Tower

Ferit Bayakir, MD · Answer

Hello. Tomography or examination is required for septum deviation. Also, not every deviasypn requires surgery. Tipplasty procedure is necessary for the external image. If deviation requires surgery, it can be done together.

William Portuese, MD · Answer

The asymmetry of your nasal tip is related to normal facial asymmetry. The amount of asymmetry in your tip is not worth the risk of trying to adjust that so slight of an asymmetry. There is no perfect nose, since there's a left half and the right half of the nose and they're both different.  A  deviated septum is repaired with a procedure called a septoplasty. A rhinoplasty can accomplish shaving down the dorsal hump. For many examples in our current price list,  see the link below.

Onur Gilleard, MBBS, FRCS(Plast) · Answer

Hi. Your main option would be a septo-rhinoplasty. It’s hard to tell from the photos though exactly what needs to be done. The asymmetry on the photos seems relatively minor and especially regarding dome asymmetry this may not be improved with surgery. Even if the cartilages are made more symmetrical the soft tissue needs to conform to the new structure and scar tissue build up can be a bit unpredictable. If your main concern is a dorsal hump (not really visible in the photo) and breathing then septo rhino can help. If it is mainly the dome asymmetry then I think it’s a bit of a risk having surgery just to target this . Costs range but start at about 8k in London

Mats Hagstrom, MD (license on probation) · Answer

Luckily, you have plenty of options so I suggest to your advantage.
For those interested in rhinoplasty surgery I suggest you begin the process by looking for plastic surgeons in your community who seem to have a lot of experience with this procedure. Try to get a list of at least five providers. Next begin scheduling in person, consultations with the providers on your list.
It’s a good idea to look at a lot of before and after pictures. You can start the process by getting a good set of facial pictures of yourself. Look at how plastic surgeons take before and after pictures to get an idea. Having pictures of your own nose and face Helpful when reviewing before and after pictures. 
Look for others, who have similar facial and nasal features to your own, and keep copies of results you find appealing.
During consultations, make sure you meet with the surgeon who’s going to do your procedure and are not being seen by a commission sales person a.k.a. patient care coordinator.
During turn off, location, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patient who had similar nasal characteristics of your own. An experienced plastic surgeon that should have no difficulty showing you the before and after pictures of at least 50 previous cases.
Being shown a handful of pre-selected images, representing the best results of a provider’s career, pictures don’t look like yours is insufficient to get a clear understanding of what average results look like in the hands of each provider or what your results are likely to look like. The provider how often they perform rhinoplasty surgery and how many rhinoplasty surgery they’ve done in their career.
Generally speaking, a plastic surgeon shouldn’t have before and after pictures for at least 1/3 of the number of cases they claim to have done. This means a plastic surgeon who claims to have done 1000 rhinoplasty surgeries should have between 300 and 400 complete sets of before and after pictures if not more.
Rhinoplasty is not a single procedure. It is an umbrella of many different operations, all focused on changing the appearance of the nose. Surgery related to the septum is referred to as septoplasty.
Sept all related issues, especially related to breathing difficulties are generally covered by medical insurance so it’s not uncommon for people to have rhinoplasty septoplasty combined surgery that is in part, covered by medical insurance, and in part covered by the patient. 
Bring pictures of your own face with you to use while reviewing the before and after pictures during the consultation. Take care phone number during each consultation, especially regarding the quantity and quality of before and after pictures.
Make a careful list of each of the specific procedures. The surgeon is recommending to be included in the rhinoplasty surgery. You need to understand each of the different sub components. Rhinoplasty procedures may include dorsal reduction, tip lifting, tip definition, tip projection, creating a supra tip break, in fracturing etc. etc. 
Continue having consultations until you feel comfortable. You found the right provider for your needs. Rhinoplasty surgery is complex and getting consistent quality of times including making accurate assessments is not always straightforward or easy. This is definitely a procedure that choosing the right provider makes a big difference.
Look for plastic surgeons, who have a lot of rhinoplasty experience or preferably specialize in the procedure exclusively.
There’s no correct number of consultations needed to find the best provider. The more consultations you scheduled and we’re likely you are to find the best provider for your needs.
The biggest mistake patients make is scheduling one consultation and then scheduling surgery.
Being board-certified and plastic surgery with years of experience, and an overall good reputation does not mean somebody has mastered any one single procedure, especially not rhinoplasty surgery.
When, in doubt, slow down and schedule more consultations.
Best,
Mats Hagstrom, MD

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