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“I like my nose, but it’s crooked, and I can’t breathe well. I don’t want to change the shape that much. Do I need a full Rhinplasty?”

The Foundation rhinoplasty technique, which is used for crooked or deviated noses, is also helpful in retaining more of what a patient looked like before surgery. It can be used as a stand-alone procedure or to set the foundation for a more comprehensive aesthetic rhinoplasty. Advanced septoplasty techniques help to support the nose from the ground up, adding predictability to the results over time, as well as improving breathing and nasal function. “A crooked nose doesn’t breathe straight.” Patients are given options for their surgical experience, such as polish procedures designed at creating symmetry and straightening alone, partial rhinoplasty where tip changes or profile changes alone are done a la carte, as well as more comprehensive procedures involving the whole nose.

Results are still dramatic but more natural and refined. Options allow patients to customize their experience within the confines of medical possibilities. Patients feel like they still have their preoperative identity and sense of self but were able to correct and focus on the issue(s) that were most important to them.

Concepts of a Natural Looking Rhinoplasty

Dr. Westreich

Getting Started

The first step in pursuing foundation rhinoplasty is to set up a confidential consultation at Dr. Westreich’s welcoming, comfortable office in New York City. There, he will examine your nasal anatomy, take down a detailed medical history, and begin to create your customized cosmetic plan for aesthetic or functional improvement. If he deems it necessary, the doctor may suggest additional procedures, such as facial implants or dermal fillers, to address your visual concerns at a deeper level.

Dr. Westreich loves to answer questions, and will take an uncommon amount of time in the preoperative phase of the procedure in order to ensure your wishes and desires are understood. The use of before and after photography, along with computer imaging and advanced measuring capabilities, helps each client to arrive at more specific expectations and creates a scenario where both doctor and patient are on the same page from start to finish.

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Foundation Rhinoplasty Before & After

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Deviated Septum Surgery NYC More About Crooked Nose Repair

The goal of functional nasal surgery, also called crooked nose repair, is to create even and adequate passages on both sides of the nose. If the external nose is crooked and not fixed, then the likelihood of surgically creating a straight septum with balanced air passages is low. Dr. Westreich believes that creating a uniform and straight nose, both internally and externally, is the best way to meet the functional and aesthetic goals when performing septoplasty and rhinoplasty surgery.

A thorough understanding of how the nose works is critical to surgical success. The symptom of nasal obstruction, also called a deviated septum, must be comprehensively evaluated, keeping the patient’s ethnicity and nasal architecture in mind, as all noses do not breathe through the same internal pathways. We must first understand what a “normal” septum looks like. The right and left nasal passageways are separated by the septal wall, a vertical structure made up of cartilage.

Ideally, the septal wall is straight and aligned, evenly separating the right and left nostrils and optimizing airflow. A deviated septum means that the patient’s septal wall is misaligned. This causes an asymmetry of the cartilage that supports the nasal cavity so that one nostril becomes more blocked than the other. This can cause a moderate to severe disruption in airflow. A deviated septum is a cause of concern when it significantly impairs breathing, is accompanied by frequent headaches, trouble sleeping, and recurring sinus infections.

What is a Rhinoplasty?

Dr. Westreich

Causes of a Deviated Septum

A deviated septum can be present at birth, can result from growth during adolescence, or from trauma to the nose. In either case, it is in the patient’s best interest to seek medical attention, as a deviated septum can be both unhealthy and uncomfortable.

Also, because symptoms from a deviated septum can become worse over time, Dr. Westreich always recommends patients consider deviated septum repair in the earlier stages of the condition when possible.

Other Factors

One key factor that can impact the proper function of the nose is the inferior turbinates. These are paired structures of bone and tissue that hang from the side of the nose bilaterally. The inferior turbinates can become engorged with blood. These turbinates swell and obstruct your nose when you get a cold or if you have allergies. Reducing their size can be critical to improving your breathing. Many other conditions, such as allergic or irritant rhinitis, chronic sinusitis, and other illnesses, can contribute to breathing problems. As a specialist in ENT, reconstructive, and cosmetic nasal surgery, Dr. Westreich will evaluate you for both medical and surgical treatment options.

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Symptoms of a Deviated Septum

The most apparent and disruptive symptom of a deviated septum is difficulty while breathing. This restricted breathing can manifest as an extra effort for inhalation of air and loud snoring at night. Patients who suffer from a deviated septum typically feel permanently congested and often report frequent sinus infections, nosebleeds, and headaches. Pain concentrated around the nose, postnasal drip, sleep apnea, and congestion that is more prevalent in a single nostril are other common symptoms of a deviated septum. If you are experiencing any individual symptom or a combination thereof at a higher-than-average rate, schedule a consultation with Dr. Westreich at his New York City office to have a professional evaluation of your condition.

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A deviated septum can restrict proper airflow and make it increasingly difficult to breathe. Though there are some non-surgical treatments that can alleviate some symptoms, nothing is as effective or long-lasting as an actual surgery. A septoplasty, essentially a surgery to repair the inside of a crooked nose, can improve a patient’s overall health.

During your septoplasty in NYC, Dr. Westreich will make a small incision on the inside of the nose through which he can remove the extra cartilage and/or bone that is confining the flow of air. The procedure is typically complete in less than two hours, and the patient is placed under general anesthesia to maximize comfort. It is common for patients to seek a simultaneous rhinoplasty, or nose job, alongside their deviated nose surgery. In this way, patients are able to bundle complementary procedures and reduce cost and recovery times while improving both their physical health and the appearance of their nose.

Choosing the right surgeon to conduct the procedure is one of the most important decisions in the entire process. As a general rule of thumb, if a patient wants both functional and cosmetic corrections, it is recommended that patients seek a single surgeon who is also board-certified in otolaryngology, otherwise known as Ear Nose and Throat (ENT). Dr. Westreich is double board certified in facial plastic surgery and otolaryngology, meaning he has extensive knowledge of the facial anatomy and commonly works on both the functional and aesthetic properties of the nose. Not only is he one of the most qualified surgeons practicing Septoplasty in New York City, but he also treats each patient on an individual basis and takes pride in cultivating personal, lasting patient-doctor relations.

Septoplasty by Dr. Westreich Patient Testimonial

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Risks and Complications of Surgery

Even when all the proper care and precautions are in order, septoplasty does carry some risk. Excessive bleeding, scarring, resulting infection or perforation of the nose, and the loss of sensitivity to smell are rare but serious complications. Still, it is important to stress that the benefits of a deviated nose surgery far outweigh the likelihood of complications. Dr. Westreich works hard to minimize the possibility of risk, so you can rest assured that you are in good hands every step of the way.

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Types of Rhinoplasty

Open Rhinoplasty

This typically leaves a nearly invisible scar on the columella (the skin between the nostrils) and is commonly used as an approach for Rhinoplasty. The same exact surgery can be performed through both open and closed approaches. Due to his expertise in using the closed approach, the Open Rhinoplasty approach is used only for specific technical reasons in Dr. Westreich’s practice.

Closed Rhinoplasty

During a closed rhinoplasty procedure, the surgeon performs the surgery through the nostrils without visible incisions. Through the nostrils, the surgeon can modify the cartilage and bones, add grafts and sutures, and have a full view of the nasal anatomy. Dr. Westreich prefers using a Closed rhinoplasty approach for several reasons:

  • Patients often heal quicker compared to open rhinoplasty.
  • The tip-profile relationship is easier to establish and predict using a closed approach.
  • The blood supply to the nasal skin is preserved using the closed approach, which can result in less scarring and thinning of the skin over time.

Non-Surgical Rhinoplasty

Results obtained from non-surgical rhinoplasty last between six months and two years. The procedure requires only topical anesthesia and 15-30 minutes to complete. Patients with prior nasal surgery should be aware of an increased risk of vascular blockage using non-surgical Rhinoplasty. Certain areas of the nose also carry a higher risk of complications with filler injection.

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Patients with purely internal surgery will not have significant swelling on the outside of the nose. Those patients requiring a more extensive procedure will experience mild sensitivity and swelling after surgery. However, after the first 2-3 weeks, the swelling is generally only noticeable to you and your rhinoplasty surgeon and not to others. For most patients, the full results of the procedure become mostly visible after 1-2 months but final results can take 12-18 months in some patients.

Dr. Westreich uses Exparel, a special injection given at the end of each procedure in which the bones are manipulated. This powerful pain reliever lasts for three days, which is longer than the time that rhinoplasty patients usually feel the most pain. By using Exparel, Dr. Westreich has noticed that his patients recover faster, allowing them to go home sooner on the day of their surgery.

Exparel also means that patients need fewer strong painkillers in the recovery room, which reduces the chances of feeling sick after surgery. Patients experience less pain after the operation, so they don't need as many strong painkillers during their recovery. This not only lowers the risk of feeling sick or getting constipated from traditional pain relief methods but also helps patients feel better as they recover.

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