Does Deviated Septum Surgery Change Nose Shape

Deviation of the nasal septum into one side causes an asymmetrical appearance in the nose because the left nostril is smaller than the right. Most people who have this problem can breathe through their noses just fine, but it’s still something that bothers them when they’re around other people or watching television. People with this condition are usually very self-conscious about it, and sometimes even suffer from social anxiety related to having what others consider “ugly” or “funny looking” noses.
The main cause for the asymmetry is that the nasal septum (the cartilage that divides the two nostrils) has shifted toward one side. This shift doesn’t affect how well you breathe, so you don’t really need surgery to correct it. If your nasal septum is only slightly off center, then you simply need a nasal decongestant spray like Rhinocort Aqua or Afrin Nasal Spray to temporarily narrow both sides of the nose until the symptoms subside enough to go back to normal breathing. In some rare instances, however, the shift might be significant enough that it actually affects how well you breathe.
A person whose septum is significantly off center will probably want to talk to his doctor about getting surgery to fix the problem. The type of surgery depends on whether the septum itself is already underdeveloped or if there is also structural damage to the bones surrounding it. If the latter is true, then surgery may be needed to straighten the curved bone at the top of the nose known as the vomer bone. A surgeon can do this by making small incisions along either side of the nose and pulling down the upper lip and cheekbone to create what looks like extra space between these structures. He’ll use wire sutures to keep them pulled apart. Surgeons call this operation a V-osteotomy.
Septoplasties are another common surgical procedure used to treat a deviated nasal septum. During a typical septoplasty, the surgeon makes small cuts along the columella — the long piece of skin at the tip of the nose that connects the end of the nose to the skull — and removes extra tissue. Next, he uses scissors to cut away any excess cartilage on the columella and the roof of the nose that could block airways. Then he flattens out the lining of the lower part of the nose called the soft palate, which helps make room for more oxygenated blood to reach the brain. Finally, he closes up the cuts using stitches or staples. Sometimes, a plastic surgeon will take off additional fatty tissue in front of the ear during a septoplasty, although this isn’t always necessary.

While all of this sounds pretty straightforward, it can be difficult to judge exactly how much of each step needs to be done, especially since the size of the patient’s nose varies greatly. One problem is that many doctors base their decisions regarding how much tissue to remove solely on measurements taken with tape measures rather than physical examination. Another issue is that patients often complain afterward that their noses look different after the surgery than before. Some surgeons claim to be able to predict the outcome based on preoperative CT scans of the face; however, others say this kind of technology is too inaccurate to be useful.
One way to avoid complications is to work with a board certified plastic surgeon who is experienced in dealing with complex nasal issues. Your doctor should know how to evaluate the anatomy of the nasal septum and surrounding structures and help determine the best course of treatment without causing unexpected changes to the nose’s appearance. After determining the extent of the deviation, your doctor should perform a thorough evaluation of your overall health and discuss potential risks associated with your specific case. For example, a person who smokes cigarettes or takes certain medications may require special attention during recovery.
Another complicating factor is that the position of the septum can vary considerably among individuals. It may be shifted forward or backward relative to the rest of the facial skeleton. Since the nasal septum is made of cartilage, it tends to move around quite easily. As such, the position of the septum can differ dramatically from day to day, even over short periods of time. When the septum shifts forward, it means that there is less room available for the nostrils to open fully. To compensate for this, the surgeon may decide to reduce the length of the columella, which would mean that the ends of the nostrils would be closer together. On the other hand, a septum that moves backward creates more room for the nostrils to expand laterally.
If the nasal septum is located behind the middle portion of the nose, then the surgeon will typically make adjustments to the bones surrounding the septum. These adjustments include modifications to the shape of the vomer bone, the bone at the top of the nose, as well as the conchae — tiny pieces of cartilage that sit on the undersides of the nostrils. The conchae function as little cushions that protect the delicate tissues underneath from injury. They can become flattened and deformed due to pressure caused by improperly fitting glasses or contact lenses. By reshaping the vomer bone and adjusting its insertion into the hard palate, the surgeon can restore the relationship between the vomer bone and the teeth, allowing the bone to snap back upright again.

Depending on the severity of the deviations, the final result of a septoplasty can range from subtle differences to full transformations of the entire nose. While some patients may look better immediately following the procedure, the real test comes months later when they try wearing new eyeglasses or contacts. Only after the healing process is complete can we truly assess the improvement. Of course, if you’ve been feeling self-conscious about your nose ever since childhood, you’ll probably be glad to see any improvements regardless of how slight they may seem.
To learn more about nose shapes and related topics, browse the links on the next page.
Asymmetric faces are considered attractive by some cultures but unattractive by others. Anthropologists believe that the reason for this is that humans tend to prefer symmetry, with a few notable exceptions.

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