‘Nose job’ usually goes beyond cosmetics

Posted by on Oct 3, 2012

Erin Wright is a rhinologist at the University of Alberta Hospital’s Alberta Sinus Centre in Edmonton.


Q: What is a deviated septum? Is it just a cover for getting a nose job?

A: Your nose is partitioned into two equal sides, normally, by a structure of bones and cartilage called the nasal septum. A high percentage of people – I wouldn’t argue with 80 per cent – don’t have two equal sides.

One nostril larger than the other would be a manifestation that the front part of the septum might be deviated a bit. But that doesn’t necessarily mean it’s a problem.

Some people have a deviated septum because of some trauma at birth.

Some people can suffer a broken nose while they’re growing up, which can cause a bend in the septum.

It might not look like much from the outside, in terms of a nasal fracture, but the septum, which is like a shock absorber, could have buckled.

When we see people who were referred in for nasal obstruction, we try to figure out if a bend in the septum is a functional problem. Does it limit air flow through one side of the nose or the other?

Symptoms of a deviated septum that are problematic are blockage of the nose, congestion and general stuffiness, but again there are many potential causes – allergies, for example – for swelling of the nasal tissues.

If the person has a good history for allergies, I’ll send them to an allergist to get checked out and I would probably treat the inflammation with medicines like intranasal steroids.

If the septum is just bent way over, completely obstructing one side of the nose, nasal spray is not going to solve the problem.

If I think the septum truly is contributing to that person’s symptoms – if it’s clearly affecting their quality of life, their ability to sleep or eat properly – we’d likely offer them corrective surgery.

Typically, the surgery is done under general anesthetic. You make an incision inside the nose and lift up the mucus membrane that lines the bone and cartilage so that you can strategically trim or modify the cartilage or bone to get it to sit back as close to the mid-line as possible. Generally, you’re trying to improve air flow through the area that is most problematic.

Sutures or other strategies like stenting hold things in place as they’re healing.

Surgery almost never alters the outside appearance of the nose.

There are instances where the septum is markedly buckled, and when it’s suddenly straightened, the nose might actually look straighter. But the cosmetic aspect is not typically altered. That would be unusual.

Sometimes, a person may decide if they’re having corrective surgery for a deviated septum they might as well have the cosmetic surgery they’ve been thinking about as well. But that, too, is rare.