Rhinoplasty is generally done to change the look of the nose, while septoplasty is done to help correct a nasal obstruction or breathing problems from a deviated (crooked) septum. The septum is the “wall” separating the two sides of the nose. Rhinoplasty surgeries often include work on the nasal septum. Rhinoplasty and septoplasty are used to address different patient concerns but are often performed together.

Septoplasty (Deviated Septum Surgery): An Overview

Septoplasty can be done alone to correct the deviation and breathing problem. The surgery corrects the anatomical problem, but septoplasty alone will not correct or reshape a crooked nose. Correction of the deviated septum involves an internal incision called a hemitransfixion incision.

This allows the surgeon to reshape or remove the intranasal septum to open up the breathing passages. In some cases, some insurance companies may cover septoplasty.  The data on deviated septums and septoplasties is quite inconsistent.

This is largely because septums can be deviated minimally to significantly and septoplasties can be incomplete to extensive. In addition, the nasal airway is quite complicated in that airflow depends upon the patency of both the internal and external valves as well as the condition of the nasal lining and turbinates.

Multiple anatomical structures including the septum contribute to these entities, hence a comprehensive evaluation and understanding is required on the part of the surgeon in order to determine if simply a septoplasty is required or if more complex structural grafting will be necessary to improve breathing.

You may benefit from a septoplasty if you suffer from:

  • Difficulty breathing through your nose due to a crooked or deformed septum blocking part of the nasal cavity.
  • Breathing through your mouth all or most of the time.
  • Interrupted sleep due to nasal obstruction.
  • Constant nasal congestion due to a crooked septum obstructing the nasal airways.
  • Recurring sinusitis (infection) due to a deviated septum.
  • Repeated nosebleeds (epistaxis).

Other reasons for these symptoms rather than (or in addition to) a structural problem like a deviated septum:

  • Inflammation of the nasal lining due to allergy.
  • Additional nasal structures may be a problem in addition to the septum. Nasal bones, the upper lateral and/or lower lateral cartilages, turbinates, etc. may also be part of the obstruction or breathing problem.
  • Vestibular obstruction or collapse can cause obstruction and can come about from a previous rhinoplasty or nasal trauma. Weakened nasal cartilages, scar tissue, over-resected dorsal structures can all. (A revision rhinoplasty, possibly involving a spreader, lateral crural strut, columellar strut, batten grafting, etc. may be needed to correct this.)
  • Noncancerous growths in the lining of the nose, called nasal polyps.
  • Enlarged turbinates (structures in the “sidewall” of the inside of the nose that humidify and cleanse the air as it passes through your nose).
  • Collapsed nasal bridge.
  • Drooping nasal tip due to aging or prior rhinoplasty.

An expert rhinoplasty and septoplasty surgeon can determine your specific problems by talking with you and examining your nose.

Your surgeon can then plan the proper surgical or other treatment to correct problems with the structure and/or appearance of your nose.

Rhinoplasty: An Overview

Rhinoplasty changes the nasal framework, reshaping the nose for aesthetic and/or reconstructive purposes. This may involve work on the septum if a change to the septum is needed to create the desired new look or straightening/grafting is required preserve proper breathing or aesthetics.

This may be referred to as functional rhinoplasty and it might include changes to other structures such as  the turbinates instead of (or in addition to) the septum. Major repair to both restore the look and the function of the nose primarily or after prior surgery and/or traumatic injury is referred to as septorhinoplasty.

Septorhinoplasty can correct the following problems:

  • Bridge, too wide or too narrow.
  • Collapsed bridge (collapsed dorsum, saddle deformity).
  • Tip abnormalities.
  • Bump in the bridge of the nose.
  • Droopy tip.
  • Beaked nose.
  • Crooked nose.
  • Bulbous nose.
  • Nostrils too large or upturned.
  • Ski jump nose (over-resected dorsum combined with over-projected/upturned tip).
  • Nose too flat with little projection.
  • Nose too large in relation to face.
  • Unhappy with the look of the nose.
  • Asymmetry.
  • And more.

Septoplasty and Rhinoplasty: Which Procedure is Right for Me?

Your nasal surgery may involve a combination of procedures and each patient/surgery is unique. A dedicated plastic surgeon will plan your specific surgery so that there is the highest likelihood that your nose looks great – and functions well, no matter what the procedure is technically called.

Your surgery will address your specific anatomical issues and your goals for the physical appearance of your nose, whether you want it to look different or not. If your main concern is to change the appearance, any structural problems discovered will also be corrected. Since these procedures are inherently complex, be sure to choose an experienced plastic surgeon with reconstructive experience.

When you meet with your surgeon, he or she can determine if you need both rhinoplasty and septoplasty or just one of these procedures. You will be asked to explain what bothers you about the way your nose looks or functions.

Talk about any sinus, congestion or breathing symptoms affecting your life. Tell your surgeon what troubles you about the look of your nose. Be specific if you can. Describe whether it is the tip, the bridge, the nostrils or the overall structure that is too small, too thin, too broad, too bumpy or too large.

If you’re not certain what is disturbing you about your nose, an expert surgeon with a keen aesthetic sensibility can help you isolate and express the type of changes that seem most reasonable.

Confused about rhinoplasty and septoplasty? To learn which surgery or combination of procedures is best for you, talk to an expert rhinoplasty and septoplasty surgeon – at Cohen/Winters Aesthetic & Reconstructive Surgeons in Bergen County.

Your consultation with your plastic surgeon is free of charge. For us, surgery is a calling and we are happy to help!

revision rhinoplasty NJ

Dr. Winters

About Dr. Winters

Dr. Winters specializes in primary, revision, reconstructive, functional and teenage rhinoplasty surgeries. Dr. Winters is a fellow of the American College of Surgeons and maintains active memberships in the American Society of Plastic Surgeons, the American Society for Reconstructive Microsurgery and others.