Is it ok to have Rhinoplasty after Septoplasty? If so how long to wait?

I
generally have patients wait at least 6 months to correct
the outside of the nose, if they had a previous Septoplasty. This should be done in
the hands of a Board Certified Plastic Surgeon or Otolaryngologist with expertise in Rhinoplasty.

  I would have both procedures done at the same time so that you can have one recovery.Kenneth Hughes, MDLos Angeles, CA

Many patients opt in to do both a rhinoplasty and
septoplasty surgery at the same time. By doing them both in a single operation,
you will only have to prep for surgery, be placed under anesthesia, and undergo
the recovery period a single time. However, if you are unable to afford having
both surgeries done simultaneously and would rather space out the procedures, I
would recommend waiting about 8 months before considering a second nose
surgery. In this way, the majority of recovery has progressed and you can start
making arrangements to take time off for the second recovery that will be
necessary after your rhinoplasty.

Dear DaxeUK;What I glean from your question: you assume that
the correction of the deviated septum and cosmetic rhinoplasty can't be done simultaneously. That's
incorrect.Frankly, the optimal time to
do the rhinoplasty is along with the septoplasty, unless there's some very unusual
circumstances, which would be detected at consultation. Why have two procedures when you can have
both combined at the same session?

The breathing portion of the operation, which generally means improving the
septum and possibly even trimming the turbinates, typically is a benefit of insurance. But a pure cosmetic change of the nose is
not covered. So what must be considered: if your nose has shifted because of the architectural abnormality, it's going
to be important for the surgeon to literally examine all parts of the nose to
determine what needs to be done. That represent the optimal opportunity to
have both the desired cosmetic changes as well as the functional reconstructive
changes.



You need to start with some good research.Finding
a good cosmetic plastic surgeon starts with a computer search of surgeons in
your (or distant) areas. Best results come from super-specialists (a medical,
not an advertising term) who do the procedure you want at least weekly and have
done it for at least a decade.



Once
you narrow in on the website of a surgeon who looks good to you, focus on the
before and after pictures, looking for patients who have had the procedure you
want. There should be dozens and dozens of such photos.



Many
good, plain language cosmetic plastic surgery books are on Amazon.com or
Barnes&Noble.com.

As
you read, write down questions that can be asked later in consultation with a
surgeon. We have two such books – Secrets of a Beverly Hills Cosmetic
Surgeon and The Essential Cosmetic Surgery Companion designed to
help with all the nuts and bolts of cosmetic plastic surgery consultations and provide
questions about both the before and after surgery experiences.The
more before surgery consultations you go on, the more you’ll learn about your
procedure. Prepare a list of questions beforehand and take notes as the surgeon
talks. In the best practices, no interruptions should take place. And, you
should be spending more time with the surgeon than with the office
administrative staff. You should not feel rushed or that you are on a
consultation conveyer belt. Take a friend or relative along as two brains
are always better than one in gaining information and understanding. If you
hear a medical term you don’t understand, ask the surgeon to explain it in
plain English. Ask yourself two key questions: “Is this
surgeon teaching or selling?” And, can I put my life and my face into
this particular doctor’s hands? Can I trust him?”

But before that do your cosmetic surgery homework. Here's the low-down on that:The homework time you spend will be more than worth it. You want to do cosmetic
facial surgery right – the first time. The most critical element of the process
is surgeon selection. Ideally, you want a board-certified surgeon, in either
plastic surgery or head & neck surgery and fellowship trained, who is highly
focused on the procedue(s) you want and who performs those procedures at least
weekly. Make sure he or she has been in practice for a minimum of ten years.



Websites are the key to understanding the practice. You should see at
least dozens of before and after pictures, showing the changes in the procedure you
want. The most helpful sites have a variety of graphics, including photos of
how you might look one or five or ten days after surgery. Look for detailed
explanations of all procedures. The site should answer nearly every question
you have. Generally, the top practices have the thickest, richest
and most informative websites. The dedicated doctor spends some serious time building
an educational website for your benefit.



Here is another hint: Ask the practice if you can speak with one or more
patients who have had the same procedure(s) you want. See their before
and after photos if possible. You learn most from walking in the shoes of those
who have made the journey before.



Best wishes,
Robert
Kotler, MD, FACS Beverly Hills, California

Ideally, your septum would be repaired and cosmetic rhinoplasty performed at the same time. You really want to have as few nasal procedures as possible. In most cases, insurance will cover the functional part of a septorhinoplasty while the cosmetic portion can be performed at the same time for an additional out of pocket charge. This can minimize your cost and downtime. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Dear daxeUKyou are describing a septal deviation that contributes to your external nose deviation. These are not separate procedures but should be completed together if you hope to improve both breathing and appearance . To get the best result --And since this is not an emergency, I'd suggest waiting until you can afford to do both septoplasty and rhinoplasty together Best wishes 

Often rhinoplasty and septoplasty are a combined procedure. This is very important in cases of nasal septal trauma reconstruction. Often, septal cartilage is necessary to reconstruct the deviated portions of the external nose. If too much septal cartilage is removed during the septoplasty and the septoplasty was done prior to the external rhinoplasty, then ear cartilage or rib cartilage may be necessary to reconstruct the nose. I would highly recommend discussing this with your surgeon prior to making a decision regarding your surgery.

Frequently, rhinoplasty and septoplasty can be performed on the same day. Your insurance coverage may be one reason to separate the two surgeries. Consult with your surgeon as he or she knows the scope of the surgery and the specifics about you.

It is possible to have a rhinoplasty after a septoplasty, but it's better to have them performed together under one anesthetic by a very experienced nasal surgeon who can deal with the functional and cosmetic surgery simultaneously. If both procedures were performed at the same time, there will be one anesthetic with one recovery period. In addition, the septum is already  opened up in case cartilage  harvesting/grafting is required. Patients must pay for the cosmetic portion of the rhinoplasty, while the septoplasty is billed to the patient's medical insurance, once medical necessity has been documented. For more information and many examples, please see the link and video below

If you are thinking of having a rhinoplasty, and you need a septoplasty, it really makes the most sense both from the surgeon's and the patient's standpoint to do them simultaneously.  You should be able to find someone who is capable of doing both for you.  Consult with a rhinoplasty specialist and they will guide you on the risks/benefits for you.Hope this helps and good luck to you!Best,Dr. Most