Septoplasty vs. Rhinoplasty: What's The Difference?

Septoplasty and rhinoplasty are the two major ways to surgically alter one’s nose. And though the two sound similar and deal with the same basic territory, there are major differences in each procedure. A rhinoplasty addresses cosmetic issues with the nose, such as bridge height, a bulbous or droopy nose tip, or nostril issues, explains Edward Kwak, MD, a double board certified facial plastic and reconstructive surgeon in New York City. A septoplasty, meanwhile, corrects the nasal cartilage for improved breathing.

In even simpler terms: “A septoplasty is considered a functional surgery because it makes your nose function better, while a rhinoplasty is considered a cosmetic surgery because it can make you look better,” says Roxanne Grawe, MD, a board certified plastic and reconstructive surgeon at ROXY Plastic Surgery Center in Powell, Ohio. Though disparate, the two procedures are often performed at the same time, depending a patient's needs.

Ahead, we’ll further explain the similarities and differences between rhinoplasty and septoplasty surgery.

What Is Rhinoplasty?

The most well-known form of nasal surgery, rhinoplasty (a.k.a. nose job) is a surgical procedure that alters the external shape of the nose. Rhinoplasty is “always associated with external contour irregularities,” says Lee Ann Klausner, MD, a double board certified facial plastic and reconstructive surgeon in NYC. An accident or breakage caused by trauma to the nose or simply aesthetic preference about how a patient wants their nose to look, may be cause for a rhinoplasty. There’s also a procedure known as a ‘revision rhinoplasty,’ which is a secondary surgery that corrects a previous, unsatisfactory attempt. Since rhinoplasty is a cosmetic procedure, it will most likely not be covered by health insurance.

Rhinoplasty Recovery & Results

The outcome of a rhinoplasty will depend on your vision for a new nose, Dr. Grawe says. “A rhinoplasty can make your tip more defined, remove a dorsal hump, make your nose smaller or shorter or narrower or tilted differently,” she says. “All your desires should be discussed with your surgeon ahead of time, so you are on the same page prior to surgery.”

On surgery day, you’ll likely be admitted for an outpatient procedure and be able to return home after surgery. The procedure often requires general anesthesia, Dr. Grawe notes. As she explains, there are two types of rhinoplasty — closed rhinoplasty, which “requires incisions only on the inside of the nose,” and open rhinoplasty, which necessitates a small incision at the bottom of the nose. “The decision between the two has to do with your surgeon’s preference and what needs to be changed with the nose,” she says.

Depending on the goals of the procedure, the surgeon may break your nose, which will leave you with bruises below the eyes after surgery. You’ll be sent home with a splint on the outside of your nose that will be removed about five to seven days later.

For six months after surgery, Dr. Kwak advises his patients to avoid strenuous activities, even vigorous nose blowing. You’ll also have to refrain from activities like smoking and drinking, wearing makeup, tannings, facials, working out, and traveling until medically cleared. “Generally, patients look fantastic at the one-month mark (or earlier), although swelling and asymmetries are to be expected until approximately the one year mark,” he says.

What Is Septoplasty?

In contrast to rhinoplasty (which can address any number of external nasal issues), septoplasty hones in on the central nasal cartilage — the portion of the nose that separates your nostrils. As Dr. Grawe explains, the septum is like the walls of the house, providing stability to your nose and also allowing for streamlined air movement through the nose.

For those dealing with breathing or functional concerns, “a septoplasty opens up airways for improved breathing,” Dr. Kwak says. “This helps patients who suffer from a long list of nasal problems, including nosebleeds, sinus infections, snoring, and migraines.” Since septoplasty is usually considered a medically necessary procedure (read: not cosmetic surgery), it may be covered by insurance.

Septoplasty Recovery & Results

Like rhinoplasty, septoplasty is typically an outpatient procedure. During the surgery, “the cartilage in your nose will be straightened and supported with suture techniques and sometimes cartilage grafting,” Dr. Grawe explains. Depending on your specific needs, “you will have a small incision inside your nose or on the columella (the bottom of your nose),” she adds. Often, the surgeon will end the surgery by placing an internal nasal splint, which helps decrease swelling. Many providers allow patients to go home the same day.

After surgery, you can expect “very little” discomfort, Dr. Grawe shares, but there will likely be some swelling around the nose and cheeks. Your breathing should improve within two weeks of the procedure. Since septoplasty often involves straightening the septum, it may, in turn, straighten the nose itself. It should be noted that this is a side effect — not the goal — of this surgery.

Which Procedure Is Best for You?

As with any reconstructive or cosmetic surgery, the most important factor in a successful procedure is proper communication with a board certified provider. Once a surgeon understands your reasons for seeking nasal surgery and your goals for a modified nose, they can recommend the best course of action (or even share if non-surgical options, like liquid rhinoplasty, could suit your needs). In the meantime, all you need to do to help decide which procedure — septoplasty or rhinoplasty — is right for you: take a deep breath.