Rhinoplasty, septoplasty or septorhinoplasty: which nose surgery do you need?

The choice depends on what you want to change: the appearance of the nose, your breathing, or both.

• Rhinoplasty reshapes the outside of the nose: the bridge, the tip, the width or the nostrils.
• Septoplasty straightens the septum, the wall of cartilage and bone that divides the nose inside, to make breathing easier. The outer shape usually stays the same.
• Septorhinoplasty combines the two: the surgeon corrects the septum and reshapes the nose in one operation.

Many people who come for a cosmetic change also have a deviated septum, and many people with blocked breathing are unhappy with a crooked nose. That is why the combined operation is common.

Rhinoplasty is surgery on the bone and cartilage that give the nose its shape. It can remove a hump, narrow a wide bridge, refine or lift the tip, straighten a crooked nose or make the nostrils more even. The aim is a nose that fits the proportions of the face and still looks natural.

The surgeon works either through incisions inside the nostrils (closed approach) or adds a small cut across the columella, the strip of skin between the nostrils (open approach). The operation is usually done under general anaesthesia. Rhinoplasty is generally performed once the face has finished growing, typically from about 18 years of age.

Rhinoplasty can also help breathing if the narrow or collapsed outer structures of the nose are part of the problem, but if the cause is a bent septum, septum work is needed as well.

The septum is rarely perfectly straight, and a small deviation causes no trouble. When it is bent enough to narrow one or both nasal passages, it can cause:

• difficulty breathing through the nose, often worse on one side;
• mouth breathing and a dry mouth, especially at night;
• snoring and poor sleep;
• repeated sinus problems or nosebleeds in some people.

Septorhinoplasty is chosen when a patient has both a breathing problem caused by the septum and a wish or need to change the shape of the nose. It is also common after a nasal injury, when the nose is crooked outside and the septum is bent inside.

Doing both in one operation has clear advantages: one anaesthetic, one recovery period and a result in which shape and breathing are planned together. The septum also supports the tip and the bridge, so correcting it often helps the new shape stay stable. In addition, cartilage removed from the septum can sometimes be used as a graft to support the tip.

The operation takes longer than rhinoplasty or septoplasty alone, and planning is more complex. You can read how it is done at City Medical Centre on our rhinoplasty page.

Rhinoplasty usually suits adults who are bothered by the shape of the nose and have realistic expectations. Septoplasty suits people whose main complaint is blocked breathing confirmed by an examination. Septorhinoplasty suits those who have both, including many patients after a nasal injury.

Surgery is usually postponed or not advised in the case of:

City Medical Centre works with international patients and performs closed, open and revision rhinoplasty as well as septorhinoplasty. Septoplasty on its own is not among the operations we list: the information about it above is general, and the suitable option is chosen at the consultation. The first consultation is free and can be held online: send photos of your face from the front, side and below, describe what you would like to change and whether you have trouble breathing. The surgeon suggests the right operation and names the cost, which is then fixed in the contract.

A personal coordinator stays with you from the first message to the end of recovery and answers questions by WhatsApp. More details are on the rhinoplasty page.

• MedlinePlus — Septoplasty
• MedlinePlus — Rhinoplasty
• American Society of Plastic Surgeons — Rhinoplasty