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Septoplasty versus Rhinoplasty: What is the Difference?

A general Otolaryngologist (ENT) is the usually the first person a patient sees when they have difficulty breathing through their nose in Cincinnati, Ohio. There are multiple causes of nasal obstruction. A deviated nasal septum is one possible cause. Repair of a deviated septum can often improve nasal obstruction. However, the cause of nasal obstruction may involve not only the septum but also the cartilage and bones that give the external shape to the nose. It is in those cases that the patient is usually referred to a sub-specialized, fellowship-trained facial plastic and reconstructive surgeon.

The Septum is a “Wall” Composed of Cartilage and Bone

The septum is a “wall” composed of cartilage and bone that separates the left and right nasal cavities. The septum starts at the front of the nose and ends at the back of the nose into a common opening called the nasopharynx, which sits above and is continuous with the throat.

The front of the septum is primarily cartilage. This quadrangular cartilage supports the nasal bridge and tip. The back of the septum is composed of multiple bones that have fused together and which extend from the skull base to what is referred to as the “floor” of the nose.

The Severity and Location of Deviation Contributes to the Severity of Nasal Obstruction

A septum that causes nasal obstruction is usually deviated or curved from the midline. The deviated portion of the septum can be composed of cartilage, bone, or both. A septal deviation can occur due to trauma, or it can be the result of genetics.

A septum can be deviated to one or both sides (i.e., S-shaped septum). The more severe the deviation to one side, the more likely it is to cause nasal obstruction.

A septum can be deviated low, towards the nasal floor, or high, towards the nasal bridge. The lower the deviation is in the nose, the more likely it is to cause nasal obstruction.

A Septoplasty Procedure Can Improve Nasal Obstruction Secondary to a Deviated Septum

A septoplasty utilizes an incisions inside the nostril to remove the deviated portion of the septum (cartilage and/or bone). Some cartilage is left behind at the nasal bridge and tip. This cartilage functions as a strut to minimize the risk of deformation of the nasal bridge and/or tip.

A Rhinoplasty Can Address More Complex Causes of Nasal Obstruction

In contrast, a rhinoplasty involves the manipulation of the complex of cartilage and bone that contributes to the external appearance of the nose. A rhinoplasty can be performed with all of the incisions inside the nostril in some, select cases. However, a rhinoplasty is performed utilizing a small incision at the base of the nose in most cases. The procedure can be performed to improve nasal breathing if these external components are narrowed and contributing to the nasal obstruction. A rhinoplasty can also be performed to improve the appearance of the nose.

A Rhinoplasty and Septoplasty Can be Performed Together

A septoplasty is often performed with a rhinoplasty not only to improve breathing but also to supply cartilage for grafting for rhinoplasty. Cartilage removed from the septum can be used as a supportive and shaping graft to improve nasal obstruction and/or the appearance of the nose.

Trust Your Face to a Facial Plastic Surgeon

It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck.

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