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Deviated Nasal Septum.

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Can you advise whether my septum is deviated from looking at the photograph? I don t breathe particularly well through it, some whistling and heavy breathing, but my main concern is from a cosmetic perspective. My nose is asymmetrical and bothers me. Would septoplasty help restore un even nostrils. Can drug use cause something like this. I did cocaine when I was younger.

Thanks


Category: ENT Specialist

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Category: ENT Specialist
Dr. Sunil Jalan is online now

Expert:  Dr. Sunil Jalan replied 4 Days.

Hello,

Thank you for using Ask a Doctor Service from Doctor Spring.

I can understand your problem, and will try to help you the best possible

your main concern is appearance of nose (cosmetic perspective), same time you want relief from nose block.
By this picture I cannot see septum, so I can’t comment about it, for that you need examination by local ENT specialist. He can do direct examination, if requires he can do endoscopy test (Rigid nasal endoscopy).
For cosmetic appearance also I need two more picture include from front, from side (lateral view). In this picture only minimum caudal deviation to right is seen.
For cosmetic correction surgery is Rhinoplasty and for septum correction is septoplasty. But you may not require both.
If you have persistent nasal obstruction on one side and if same side deviated septum is seen on endoscopy then only septoplasty will help.
if you have any other nasal symptom including nasal discharge or excessive sneezing, please mention about it.

Cosmetic appearance is a very subjective perception, so before taking any decision you should understand about it and you should discuss realistic expectation with you surgeon before surgery.

Hope this helps. Feel free to ask if you have any further queries.


Thank you.


Regards

Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA



Patient replied :

Hi

thanks for your response. I have attached a few more pictures to make clearer the asymmetry the eneven nostrils cause . Can you advise whether this could potentially be due to a deviated septum. Could it be genetic.
I not sure how likely it would be that past cocaine use would alter nostril shape. My septum itself, doesn't appear to have any damage to it at all.

Could the nose simply be asymmetrical genetically?

Thanks


Expert:  Dr. Sunil Jalan replied 3 Days.

Hello,

First I will talk about cosmetic appearance as this is your main concern.
I saw all pictures and honestly as a surgeon I want to tell you that you have a beautiful nose (sharp, no hump on dorsum, no saddle on dorsum, no widening of root of nose, tip is good and nostrils also seems even). I can't make out any obvious difference in nostrils. So I will strongly discourage for any cosmetic surgery, because any surgery has its side effect and if desirable correction range is small then it becomes all the more difficult in cosmetic surgery.

To know about your septum it has to be examined by local ENT doctor, it can't be seen by pictures. Some time caudal dislocation of septum can cause nostil asymmetry which is not there in your case(in caudal dislocation, septum is seen anteriorly through nostril, not seen in your picture).

Nose asymmety has no relationship with genetics or cocaine use, so leave it.
Almost 30 percent of normal population has some deviated nasal septum. Most of them don't have any cosmetic problem and only 5 to 10 percen of these have nasal obstruction due to this. So if somebody even has deviation nasal symptom and doesn't have any symptom or obvious cosmetic problem, they don't require surgery.

Hope this helps. Would be glad to answer any follow-ups.

Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA


Patient replied :

Thank you for your response. Perhaps it is subjective, and i m seeing much worse than others can see, as i m fixating on it. However, I still feel certain that one of my nostrils is rounded and one is a different shape, as the next picture attached shows. If genetics or drug use aren t associated with an asymmetric nose, what is the cause? Would cocaine only effect the septum, not the shape of the nostrils? Is it more likely this difference I see is what I was born with?
And would you say correction would likely be through rhinoplasty not septoplasty?


Expert:  Dr. Sunil Jalan replied 2 Days.

Hello,

I can see very little difference in shape of nostril as you say. Nostril shape is not genetic (gentic means something which transfer from parents). This shape is different for all of us and it changes until we stop growing (for nose and nostril 16 years of age). So now it will not change in shape with time. There is no specific cause for nostril shape.

Surgery for nostril shape will be rhinoplasty not septoplasty.
Still you think twice before any surgery for this minimal correction. Discuss with you cosmetic surgeon that you should not have any external scar, because it may look worse that deformity.

Hope this helps. Feel free to ask if you have any further queries.

Thank you.


Patient replied :

Thank you.

To clarify then, you as a surgeon, would discourage surgery for this kind of correction, as it is not necessary because it is minor? In your above answer you describe the issue as a deformity which worries me.... Do you think most people looking at it wouldn't notice it or does I present as obvious?


Expert:  Dr. Sunil Jalan replied 1 Day.

Hello,
Sorry for using word"deformity'. w=We use this for anything which is not normal or if patient perceive it is not normal. It was a generalised statement that for minimal correction we should avoid scar.
I am very sure that most of people will not find anything wrong in your nose. It is perfect and beautiful.

Take care


Dr. Sunil Jalan
Category: ENT Specialist
Experience: 
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
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