Planning for septoplasty and not sure if it's worthwhile including rhinoplasty. What is the additional risk and complexity?

I have a severely deviated septum that I plan to get corrected soon. I've spoken to an ENT who recommended septoplasty and 'turbinate reduction.' But trying to decide if adding some cosmetic work is worthwhile. I have a somewhat 'hanging columella' (just based on what I've read on this site). How hard is that to change? I'm aware of the insurance implications but would adding rhinoplasty like this make a septoplasty more complex or add significantly to recovery time?

Doctor Answers 5

septoplasty and rhinoplasty procedure

A septoplasty and a rhinoplasty procedure  are two completely separate procedures, however both can be performed at the same time. Medical necessity must be documented for the septoplasty in order to bill that to a patient's medical insurance. It's best to have that pre-authorized  ahead of time. A rhinoplasty is performed for cosmetic purposes and must be paid for by the patient. Both procedures can be performed together. Rhinoplasty can accomplish reducing the hanging columella. For more information  and many examples, please see the link and the video below

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Adding rhinoplasty to septoplasty surgery

Adding rhinoplasty to septoplasty surgery has variable increased in complexity and recovery time. If it's just a "hanging columella", then possible cast not required, so recovery is more similar to septoplasty alone. However, patients with a bump or deviated noses who have rhinoplasty then are more likely to have some more external swelling and bruising. Typically, plastic surgeons will recommend combining septoplasty and rhinoplasty for many reasons. If you haven't already, then speak with your ENT or rhinoplasty surgeon to review options.Best,Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 77 reviews

Cosmetic rhinoplasty and septoplasty

If you have aesthetic concerns about your nose and are planning to undergo a septoplasty for breathing difficulty, I would strongly recommend consulting with a board-certified facial plastic surgeon to discuss your aesthetic goals. We often combine a septoplasty to address nasal obstruction with a cosmetic rhinoplasty and it makes the most sense to do both at the same time. If your septum is severely deviated, you may actually require an "open" or external rhinoplasty approach to adequately correct the septal deviation. If you undergo a septoplasty alone (without the rhinoplasty approach) and you have a severe deviation, it may not be possible to fully correct the septum. Additionally, by having a cosmetic rhinoplasty at the same time as your septoplasty, you will likely have sufficient cartilage to use for grafting or reshaping your nose if needed. On the other hand, if you undergo a septoplasty now and decide to have a cosmetic rhinoplasty in the future, you may not have enough cartilage to use, and would likely require additional cartilage from your ear or rib cage at that time. Take the time now to think through all of these options and be sure to consult with an experienced rhinoplasty surgeon so you can make the best informed decision. Good luck!

Sachin S. Pawar, MD
Milwaukee Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Septoplasty and Rhinoplasty

Septoplasty in conjunction with Rhinoplasty is very commonly performed.  In fact, I tell my patients that if they have a desire for cosmetic changes to the nose then the perfect time to do it is when we are going to do a septoplasty to help them breathe better.  The benefit is that the physician can use the harvested cartilage from the septum to help with the rhinoplasty if needed.  However, doing a rhinoplasty is vastly different that a septoplasty and you need to make sure that the physician is capable and trained in rhinoplasty surgery and it isn't just something they want to add on to your planned septoplasty.  The hanging columella is variable (depending on how much it's hanging), but a competent well trained rhinoplasty specialist should be able to help you with that.

Douglas K. Henstrom, MD
Iowa City Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Rhinoplasty with septoplasty

It is very common to have rhinoplasty in conjunction with septoplasty and have a successful and beautiful outcome. The mistake is in assuming that "adding a little cosmetic work" is simple and can be done by anyone. Firstly it should be something you really want not an afterthought. Once its done you can't easily reverse it. Secondly you need to choose a surgeon that regularly does rhinoplasty and not someone who primarily does septums and turbinates and will dabble a bit with some cosmetic work for you. They are different skill sets and not all surgeons have both. That's the best way for you to be sure it will come out the way you want functionally and aesthetically.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.7 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.