Considering rhinoplasty and septoplasty, but getting mixed info on if septoplasty is needed. How can I know for sure?

I have had multiple consultations with ENT's and facial plastic surgeons to get my deviated septum fixed as well as to have rhinoplasty. Most of my consultations have been with double board certified doctors in plastic surgery and otolaryngology. I find that I'm getting different info from different doctors. Some say I have a deviated septum with enlarged turbinates, others say my septum is fine, but do need to get turbinates reduces. How do I know who to trust or which is correct? Thank you.

Doctor Answers 6

Septoplasty is often needed with rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Septoplasty is often needed with rhinoplasty for several reasons, but it's not required in all cases. A common reason to have septoplasty with rhinoplasty and turbinate reduction is to improve nasal breathing and congestion. Another reason to perform septoplasty is to obtain cartilage for grafting during rhinoplasty.Ultimately, the decision on what to do in nasal surgery depends on factors such (1) physical anatomy, (2) your preference, (3) your surgeon's recommendations. There isn't one best answer for all patients, and opinions will vary among the best rhinoplasty surgeons.Best,Dr. Chaboki

Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The most important question is if your nasal breathing is being effected by the deviated septum or not. If you can breathe well then you do not need the septoplasty. RegardsDr. J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Rhinoplasty, septoplasty, and turbinate surgery.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
A thorough examination of the internal portion of the nose is required to make a determination about a deviated septum and turbinate hypertrophy. If patients have significant nasal obstruction, these two issues are the most common areas that cause nasal obstruction.  Both turbinate surgery and a septoplasty are  performed to improve airflow through the nose, once patients have failed medical management. A rhinoplasty is performed for cosmetic purposes. Both cosmetic rhinoplasty and functional breathing surgery can both be performed at  the same time when necessary. For more information discussing the differences between the two procedures, please see the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Need for septoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Septoplasty is usually indicated if there are symptoms of nasal obstruction and the septum is deviated.  Septoplasty is also needed when the outward appearance of the nose is deviated without nasal obstruction. It is common that a rhinoplasty and septoplasty are performed at the same time.  The sized of the turbinates can vary by day and is related to weather or allergies.  This may lead to the variability in recommendations.  If the turbinates are so large that they are touching the septum, they will cause obstruction of the nasal passage.  In that situation it is best to reduce the turbinates in addition to performing the septoplasty. 

Jennifer Parker Porter, MD, FACS
Bethesda Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Its a mute point of you are having a rhinoplasty performed as well since a septoplasty is usually performed in order to obtain cartilage to graft on your tip for the rhinoplasty.  Also, if you are having breathing difficutlies, might as well do the septoplasty with the turbinectomy to ensure your breathing is improved.  Best wishes, Dr. T. 

Rhinoplasty/Septoplasty Considerations

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I am sorry you have received conflicting answers about your concerns. This may reflect different impressions by qualified doctors about how your nose looks internally. Sometimes the nose can actually look different inside on different days depending on factors such as allergy activity, humidity, or whether you have a cold or not. The septum can be minimally deviated and really bother some people, but not another person with the same degree of deviation. Turbinates can enlarge and then look normal a few hours later. The bottom line is really f these findings cause you consistent nasal congestion or not. If your breathing is good all the time then these are not significant factors. You must decide during a consultation if the doctor's goals are in line with your own. If not, find a surgeon who has a plan and vision that agrees with yours.

Ira D. Papel, MD
Baltimore Facial Plastic Surgeon
4.9 out of 5 stars 36 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.