Combined Rhinoplasty

Most noses that need aesthetic surgery also have a functional problem, and most noses that block also look slightly crooked. The septum, the bones and the tip cartilages form a single structure, so it makes sense to treat them together. A combined rhinoplasty, known in surgical terms as septorhinoplasty, does exactly that: the shape is refined and the airway is repaired in one operation.

Dr. Teker is an ENT surgeon before he is a rhinoplasty surgeon, and this is the way he approaches every nose. Functional problems are looked for even in patients who came only for their profile, because a beautiful nose that cannot breathe is not a result he will put his name to.

Three things that block a nose

• The septum. The central wall bends and narrows one passage. Straightening it is the core of the functional part of the operation, and the straight cartilage removed becomes graft material.
• The turbinates. The shelves on the side walls swell with allergy and irritation. Reducing them gives more room without harming their role in warming and humidifying air.
• The valves. The narrowest point of the airway, where the septum meets the upper side cartilages. When it is too narrow or collapses on inspiration, spreader grafts hold it open. Lowering a hump without protecting this area is a common cause of breathing problems after rhinoplasty elsewhere.

One operation, one plan

The aesthetic plan is made exactly as it would be for a rhinoplasty alone, on standardised photographs, with each change explained. The functional plan comes from endoscopic examination and, if needed, a CT scan. In surgery, Dr. Teker works from the inside out: the septum first, then the valves and turbinates, then the bridge and tip. Cartilage taken from the septum supports the tip and widens the valves, so the two halves of the operation help each other.

Recovery

Expect the same course as after rhinoplasty: a splint on the bridge for a week, a stuffy nose while the internal swelling settles, bruising that fades within ten days. Soft silicone splints support the septum for the first week and are removed with the external splint. Breathing improves steadily over the first six weeks and is usually better than the patient remembers it ever being. The shape refines over a year.

Who is it for

Anyone considering rhinoplasty who also breathes poorly, anyone with a crooked nose, and anyone who has been told their septum is deviated but also dislikes the look of their nose. If your only concern is breathing, a septoplasty alone is enough, and Dr. Teker will say so.