The question of whether rhinoplasty can fix a deviated septum is common for individuals seeking to improve both the look and function of their nose. A deviated septum is a condition where the thin wall of cartilage and bone (the septum) separating the nasal passages is crooked, restricting airflow and causing breathing difficulties. Rhinoplasty, often called a “nose job,” is a surgical procedure designed primarily to reshape the external nose for aesthetic reasons. Fixing a deviated septum requires a related procedure, called septoplasty, and the two surgeries are frequently performed together in a combined operation known as septorhinoplasty.
Understanding Functional vs. Cosmetic Nasal Surgery
Nasal surgery is categorized based on its primary goal: internal function or external appearance. Septoplasty is performed specifically to correct a deviated septum. This procedure focuses on the internal structure, aiming to straighten the cartilage and bone to improve nasal airflow and breathing.
Rhinoplasty, in contrast, is an aesthetic procedure that involves modifying the bone and cartilage to change the size, shape, or proportions of the external nose. Its primary purpose is to enhance facial balance and refine appearance. Rhinoplasty alone does not typically fix a significant septal deviation, though minor septal corrections might be necessary to support aesthetic changes to the external framework.
The distinction is important because septoplasty is usually considered medically necessary for breathing problems and may be covered by insurance. Rhinoplasty, being cosmetic, is generally not covered.
Combining Aesthetics and Function in One Operation
The definitive answer to fixing a deviated septum while also achieving aesthetic goals is the combined procedure, septorhinoplasty. This single operation simultaneously addresses the functional issues of the septum and the cosmetic concerns of the external nose. Many patients seeking aesthetic changes also have an underlying breathing problem, making the combined approach highly beneficial.
A deviated septum can sometimes cause the nose to appear externally crooked or twisted. Correcting the midline septal foundation is often necessary to provide stable support for the newly reshaped external nasal structure. Combining the procedures ensures that functional improvement and aesthetic refinement work in harmony to create a balanced and well-supported nose.
How Septorhinoplasty Corrects the Septum and Reshapes the Nose
Septorhinoplasty is a comprehensive surgery requiring careful planning to address internal structures and external contours. The procedure uses either a closed approach (incisions hidden inside the nose) or an open approach (a small incision across the columella). The open approach is often preferred for complex cases because it provides better visualization and access to the nasal framework.
The functional part involves accessing the nasal septum by lifting the mucosal lining away from the cartilage and bone. The surgeon removes or reshapes the deviated portions, ensuring sufficient cartilage remains to maintain structural support, specifically the L-strut. Removed septal cartilage is frequently preserved for use as grafts to reinforce or reshape other parts of the nose, which is a key advantage of the combined procedure.
The aesthetic portion follows, utilizing techniques like adjusting the nasal bones through controlled fractures (osteotomies) to narrow the bridge or correct a deviation. Cartilage grafts, often sourced from the newly straightened septum, are meticulously placed to refine the nasal tip, augment the bridge, or provide structural support. The entire procedure typically lasts between one and two hours, depending on the complexity of the corrections.
The Recovery Process and Long-Term Outcomes
The recovery from septorhinoplasty begins immediately, with patients typically experiencing swelling, bruising, and congestion. External splints and sutures are usually removed within the first week (five to seven days post-surgery). Internal splints or dissolvable packing may also be used to support the newly straightened septum and manage bleeding.
Most patients can return to work and light activities within 10 to 14 days, though strenuous exercise must be avoided for four to six weeks to prevent injury and excessive swelling. Around the one-month mark, internal swelling subsides enough for patients to notice a substantial improvement in breathing.
While functional results are apparent relatively quickly, the long-term aesthetic outcome takes much longer to fully materialize. The majority of visible swelling resolves within the first six months, but subtle residual swelling, particularly in the nasal tip, can take between 12 and 18 months to completely dissipate. The long-term benefits include permanently improved nasal function and a final, refined aesthetic appearance.