We know the ins and outs of rhinoplasty, or a nose job, but septorhinoplasty is a procedure we don’t hear about as much. However, according to SPATE, videos about the surgical procedure have been viewed more than 543.7 million times on TikTok, and it’s a common request for people of all ages. Here, we get the inside scoop from three leading facial plastic surgeons on what it is, how it’s different from a traditional rhinoplasty, and more.
What is septorhinoplasty?
“A septorhinoplasty is a surgery that addresses concerns with both the septum and the overall shape of the nose,” explains Kirkland, WA facial plastic surgeon Daniel J. Liebertz, MD. “It straightens the nasal septum, which is a sheet of cartilage that divides the nose into the left and right nasal passages and is commonly deviated, or crooked, to one side or the other. Septorhinoplasty is the combination of two separate procedures, a septoplasty and a rhinoplasty, through the same incisions.”
New York facial plastic surgeon Lee Ann M. Klausner, MD says the ideal candidate for this procedure is someone who may complain of symptoms of nasal obstruction from one or both nasal passages, resulting in breathing issues. “Sometimes, when the septum bends to the right or left nasal passage, people will notice they don’t breathe well from one nasal passage or from both,” she explains. “Sometimes a crooked septum might be causing the patient to experience recurrent sinus infections. Other candidates are individuals who have a crooked nose from birth or acquired from nasal trauma.” With a nasal injury, the septum can become deviated and block the airway and breathing, adds Palo Alto, CA facial plastic surgeon Jill L. Hessler, MD. If only the internal part of the nose is being operated on for this purpose, the procedure is a septoplasty.
What is the difference between septorhinoplasty and rhinoplasty?
Think of septorhinoplasty as a functional and aesthetic surgery, and rhinoplasty as solely aesthetic. “Septorhinoplasty changes the shape or contour of the nose and septum, whereas rhinoplasty changes the shape of the nose only,” Dr. Klausner explains. Dr. Hessler adds that if a deviation in the septum isn’t present, then a rhinoplasty alone can achieve the change in appearance. “This surgery takes less time and can be less expensive.”
During a rhinoplasty, Dr. Liebertz explains that “small pieces of septal cartilage are commonly removed for grafting without the need for completion of a full septoplasty. Some surgeons may take insurance for the septoplasty portion of the surgery; however, most private insurance carriers will not cover rhinoplasties.”
Why would a surgeon perform one over the other?
It really depends on the patient’s concerns and the surgeon’s abilities, Dr. Hessler says. “If there is a breathing problem or an external deviation of the nose, then often the septum needs to be addressed in addition to the external appearance of the nose,” she explains. “Seek the expertise of a fellowship-trained and experienced facial plastic surgeon or plastic surgeon who performs a lot of rhinoplasties. Facial plastic surgeons spend five years of training exclusively on the face, including in-depth surgery on the nasal passageways and sinuses, so they are aptly able to address most any deviation.”
When is the best time to have this surgery?
This depends on many factors, including the patient’s lifestyle, health status and age (nose surgeries are very popular with the younger set, after the nose stops growing in the mid-to-late teens). “Many students—high school and college—choose to repair their deviated septum or have their rhinoplasty over their summer break,” says Dr. Hessler. “It allows them time to heal and not miss school. It also helps draw less attention to the fact that they had surgery.”
What is the recovery like for a septorhinoplasty?
“The recovery is similar to a standalone rhinoplasty: Patients can expect noticeable external swelling and some bruising for the first two weeks; however, because more work was done internally to improve the septum, they may also experience stuffiness, dryness or congestion during this time,” says Dr. Liebertz. “I recommend liberal use of nasal saline sprays and intranasal Aquaphor for at least the first few weeks while the septoplasty is healing.”