Las Vegas Deviated Septum - Ask Dr. Garcia Library - Page 1

NOTICE: Las Vegas Deviated Septum: Ask Dr. Garcia is intended for educational and discussion purposes only. It does not constitute a formal medical evaluation nor consultation. No doctor-patient relationship has been formalized by this communication. If you desire such, please feel free to call and schedule an appointment. Otherwise, please be advised that all information that has been given here should be cleared with your primary care physician before changing or instituting any therapy. Explanation of off-label use of substances may be discussed here in but does not reflect an endorsement nor promotion of such off-label use. All responses regarding Las Vegas Deviated Septum are done personally by Julio Garcia.

Hello, Doctor. I have a bump on my nose and deviated septum. Also, when i push up the tip of my nose it makes some noise. Can this be corrected at the same time, and do you perform that kind of surgery? If you do, will be recovery be longer? Thank you.
Answer: it should be able to be fixed but I do not perform septoplasties any longer, just purely cosmetic rhinoplasties, sorry. JG 11.6.09
I had a deviated septum repaired in early August `08 along with turbinate reduction. It is now Feb`09. I can breathe better now, but I still have bloody crusty things in my nose. I use saline wash constantly, and vaseline inside my nose, but still have a dry, crusty nose. My HMO doctors have said that I have had enough follow-up visits, so I don`t know how long this crustiness is suppose to continue, or is it?...but it is very annoying. Is it a complication that will always be there? What occurred in my surgery that caused this? What else can I try to eliminate this crusty, dry, bloody nose? Thanks for your help.
Answer: should not be happening at this point in time, some of the things that can cause it is a septal perforation or overresection of the turbinates causing excessive intranasal dryness and therefore bleeding and crusting, or a retained suture. I think you are having complications from the surgery and the ENT surgeon needs to see you again as it is certainly not normal to still have those issues. JG 2.24.09
Hi, Dr. Garcia. I had surgery on December 17th. This was my THIRD surgery. I had a deviated septum, and a micro valve collapse in my left side. I couldn`t hardly breathe out of my left nostril. I had to have spreader grafts, and strut grafts I think put in. My surgeon took cartilage from the front of both ears. It is now 3 weeks later and its still really swollen. How long will this take? I tape it at night, and I was wondering if I should just tape it during the day too? Does taping really work? Also, when he went in, because of the scar tissue there is an indentation on the outside of my nose. It`s small, but I have to go in next Thursday for him to laser it. Have you heard of this happening before? Thanks in advance for all of your feedback!
Answer: the swelling will visibly start to show a difference in 4-6 weeks in most cases. I am not sure taping will do mcuh as there is stil swelling internally that cannot be improved with the taping. As to the indentation, it can happen on repeat rhinoplasties, the laser should help though. Best of luck. JG 1.8.09
Dear Dr. Garcia, Is it odd that a facial plastic surgeon does not participate with any insurance considering he mostly does rhinoplasties (which are covered by insurance for deviated septums)? He does surgery at his own office. Anyways, I went to him for a minor nose procedure- just to add cartilage at the bottom of my tip. However, he pointed out all these problems with my nose he thought needed to be corrected. He thought my nose looked unnatural so now I feel I should do more to make my nose look more natural (from prior nose surgery). Since I`m a student, he said he didn`t think I had the money to pay for surgery. He charges double what most surgeons charge so I said not right now I don`t. Then he said he wouldn`t bother talking to me about surgery then or I can come back when I was ready. I needed an explanation of what corrections he wanted to do to my nose (how he wanted to correct my nose). I sent an email with that question since he did not answer it at the office. He didn`t respond to my email so I called his office to see if he received it. I was transferred to him and he said he didn`t think he could be my doctor- to find another doctor because I have too many problems. Well, I only came in with one minor problem, but he pointed out all these other problems I didn`t bring up. During my consultation, he raved how patients travel out of state to have his nose surgeries. He said he was the best and now he is telling me to see another doctor with more experience. He wanted to know the name of my prior surgeon so I gave it. He didn`t know who he he was, but I wonder if he called him. My prior surgeon thought all the things I saw wrong with my twisted nose were all in my head, but I think he just didn`t feel like correcting it. Then this new surgeon confrims everything I saw wrong. However, I was not going there to have those things corrected. Actually, I was hoping he would say my nose looked fine. Again, it was just to add a little cartilage at bottom of tip. I kept questioning the new doctor if he could do the corrections he thought I needed since my prior surgeon didn`t bother since he said I have hard scar tissue. Then he said these other surgeons weren`t as skilled as him. My prior surgeon also corrected a deviated septum, which this nose surgeon said was still deviated. Sorry for the long question (just want to tgive you all the detials). What the heck is goign on with this doctor?
Answer: I think the old one does not feel confident he can help the small problem and the new one is an arrogant idiot, find someone else. JG 10.2.08
Is it possible for a rhinoplasty to cause a twisted tip (tip pushed to one side)? My tip seemed straight or not twisted prior to surgery. If surgery can cause a twisted tip, how does it cause it? Does a twisted tip have to do with a deviated septum (which I got corrected)? How can a twisted tip be corrected? A surgeon added cartilage on th epushed in side, but the tip still has that twisted/pushed in one side look.
Answer: it can happen when cartilage is removed and the remaining cartilage is too weak and it then twists, or it can be from stitches placed in the cartilage to try to obtain a certian shape and the sutures are tighter on side side than the other, also if grafts were placed they can shift and give a twisted appearance. It is most common though to have a twisted tip if the septum is deviated. If one has a twisted tip due to the septum being deviated adnd the septum is nor corrected, it can be difficult to straighten the tip. Twisted tips, the majority of the time, require repeat surgery if it persists for months after the intial surgery. Best of luck. JG 9.29.08
I had a rhinoplasty done by a plastic surgeon who does body and face. However, I went to plastic surgeon who only does rhinoplasties- mostly correction surgeries. Anyways, I saw this facisl plastic surgeon to see about addig a little tissue to the tip of my nose. A simple procedure. However, before I mentioned I was there for nose surgery, the plastic surgeon knew I was there for a rhinoplasty. He does other skin beauty procedures. He told me all the things wrong with m,y rhinoplasty without me saying a word. Actually, the doctor who did my rhinoplasty said my scar tissue is too hard to make more corrections. In contrast, the facial plastic surgeon said he was used to working on hard scar tissue. Are doctors who specialize in rhinoplasties able to work more skillfully with hard scar tissue? The doctor who did my surgery said he would not be able to chiel it neatly since it was hard scar tissue. Will my nose collapse if I have too many nose surgeries? Does correcting a deviated septum cause scar tissue to show on nose? Past nose surgeries involved removing lots of scar tissue on my nose- it was scar tissue removal instead of rhinoplasty. I want my nose to look natural and it nother me the facial plastic surgeon said my nose looked unnatural. It is probably true, but my question is my nose will get more scarred ot is hard scar tissue can be sculpted (the tip area)? He said my tip looks bulbous.
Answer: well, I am afriad not, they might encounter it more often and might employ more dramatic techniques to get a desired result, but they do not have special magic for scar tissue. The nose collapsing is due to loss of structure so as long as they leave the supporting cartilage it should not collapse. Septum surgery should not affect the cartilage on the outer parts of the nose typically. It is impossible to tell whether what you desire is acheivable, but I will say that a bulbous tip can be commonly caused by scar tissue and thick nasal skin and that might not be changed with more surgery. Best of luck. JG 9.29.08
Hello. I had a septoplasty almost 5 weeks ago to fix a pretty severe deviated septum. 5 weeks later I still can`t breathe any better and I looked inside my nose with a flashlight and it looks just the same as before the surgery. The right side is almost swollen shut. How long does it take to unswell so I can breathe? Should I be concerned that it somehow deviated again?
Answer: I can take 6-8 weeks in some cases. I would give it to the end of the second month and then see your surgeon. JG 9.20.08
Hi Dr Garcia, I have recently had revision rhinoplasty 3 weeks ago to fix a deviated septum and v shaped indentation formed after removing a slight bump during my primary rhinoplasty. My plastic surgeon advised he had to use 4 grafts with some tissue taken from the front of my ear. A lot of swelling has come down and overall i am pleased with my nose as it is a lot straighter although I do know that cartilage has memory and it may bend again. I do however have a red mark on my nose which is not going away and a raised section on the top of the bridge of my nose which follows down the left side of my nose which is clearly visible as from one side angle it appears I now have a hooked nose. I have done a little research on the internet and feel it may be cartilage graft extrusion or scar formation. I am situated far from my surgeon and phoned to advise of my concerns to which I was informed it is early days. Is there a chance it could be swelling and will reduce in size or will it remain?? I suffered depression from my first rhinoplasty and am now feeling very anxious about this result. I don`t want a perfect nose just a nose similar to my original nose without bumps. Also I have suffered a loss of pigmentation from my primary rhinoplasty is that permanent damage?
Answer: I think with revision rhinoplasties that the swelling is more likely the culprit, I think scar formation can happen but it usually takes at least 6 weeks to even start forming, patience at this time is indicated. I think that the pigment loss from the first one if stil there is likely to be permanent I am afraid. JG 8.22.08
Hi there I had surgery for deviated septum and turbinate reduction in Feb 2008, I saw my consultant this week who advised the reason for seeing no benefit in breathing is that I may suffered a minor collapse of my nose and that I should consider rhinoplasty to fix this. 1: is this common after septoplasty to require some rhinoplasty surgery and if so wuold this be minor surgery 2: my nose is still tender after having the initial surgery (4mths now) is this normal - my surgeon said no all swelling should have gone by now. Appreciate your advice. thk u Lou
Answer: it is not common and it is not a minor revision to resuspend or graft the nose to help with breathing due to collapse. Tenderness can persist in some patients for up to one year. Best of luck. JG 7.5.08
Hi, I had nose surgery three weeks ago (deviated septum and rhinoplasty) and I now have an issue with my left eye. It is filling up with water and tears are running down my face. Is this a common occurance post surgery? It is very uncomfortable and I can`t see as well in that eye as a result of the water. Any suggestions?
Answer: many times due to swelling at the location where the tear duct empties into your nose that can happen, but it is temporary. JG 6.3.08
About 14 months ago I had Radiesse injected in my nose to correct deformities from a botched nose job (the surgery was for deviated septum and cosmetic as well). The plastic surgeon who administered the Radiesse did an excellent job. I never thought my nose would look that good ever again, so I was very happy with the results. I went back to see him in March and he did a follow-up. The result was not good. I went back a week later and he injected a little more in another area to try and counteract what happened from the week before (he didn`t inject in the same place on the 2nd visit). It appeared to help slightly but now it seems all the good he did over a year ago is gone and the look is regressing. Actually when I went in March for the follow up I was satisfied with what I had, but felt I could have used a touch up. I have scar tissue in my nose and I`m wondering if it reacted negatively with that? It didn`t before however, so I don`t know. I am supposed to go back the end of April, but now am almost afraid to. I know he knows what he`s doing as he is very well respected and a good surgeon. I just don`t understand what happened. Any thoughts?
Answer: injections into the nose can be very tricky due to the scar tissue from the surgery, I think the material can be hard to get to stay in one place and having a good result one time is no guarantee it will go as well the next time, I think small touch ups are a reasonable thing to consider though to get it smoother. JG 4.3.08
Dr. Garcia, I`m thinking about getting a rhinoplasty and in addition fix my deviated septum. This is a longshot since your practice is in NV, but have you heard of a NYC plastig surgeon by the name of Dr. George Beraka?
Answer: sorry but I have not, sorry. JG 1.28.08
Dear Dr Garcia, I had a nasal cartlidge graft about 5 weeks ago because my septum was collapsing and i had large holes in it causing a deviated septum ,breathing difficulties and deformaties to the nose.The surgeon said he would put some cartlidge from my ear on both sides of my nose some on the tip and some in the septum to strengthen it. now the swelling has gone down i have a lump of cartlidge on one side i think he put the larger amount on the wrong side as i had a big dent in the left side and my nose was and still is leaning to the right with a bump on the right side also it now seems longer than before because of the extra cartlidge at the tip. Do you think that it might be possible to straighten it and shorten it with what i have told you or do you think there is a big chance of my nose collapsing.
Answer: I think you need to see your surgeon and discuss when it is possible to reposition it, best of luck. JG 1.14.08
Dr. Garcia, I had a deviated septum fixed back in August I still have trouble breathing and still find that I still have a lot of the same pain at the bridge of my nose is that normal because it kind of really still hurts. They did find a cyst that they removed and that took some of the pain away. Do you suggest I go back and have it looked at by another doctor? Also I would like to speak to someone about a filler I broke it as a teen and now it has a grove and looks crooked..what should I ask for and how much does that run?
Answer: a filler migth be an option, the syringes usually go for about $500, and I do think you need to see a surgeon about the breathing problems if they are still there, best of luck. JG 12.12.07
Dr. Garcia, THanks for taking questions. I have had 3 surgeries on my nose. I have a deviated septum still and the last surgeon destroyed some of the skin on my nose, so I have very very thin skin on the bridge. I know that I need to have a 4th surgery and most doctors have talked about putting fascia there to thicken my skin. I am a male and would like to know of a great revision rhinoplasty specialist in the Southern California area. I know Dr. Daniel only operates on women. Could you recommend someone in the area that you think could do a great job. Definitely want your opinion. Thanks.
Answer: Ron Gruber but he is up in northern California, or maybe Steve Hoefflin in Santa Monica. JG 11.6.07
Dr. Garcia, although it has been a little while since I have been on your site I have always appreciated your straight forward, honest and at times satirical wit in your replies to all those questions. You have also given me some invaluable professional advice in the past that really did help, thanks for that. I am seeking your expertise again and I have enclosed some background information (so I hope you can bare with me) I am considering having a 3rd revision rhinoplasty, primary was over 25 years ago, although I was not happy with the result I did not bother to have my 1st revision till over four years ago. With the 1st reviosn my nose started out nice and straight, however over a period of months my nose developed an obvious dent particularly on the right side. The 2nd revision was done January of this year by a different doctor who claimed the problem was due to a deviated septum. Since this procedure my nose over several months has developed an an obvious dent again. The middle vault section has also separated which gives the appearance of an inverted v and unfortunately the gap and dent seems to be getting bigger as time goes by. The tip of my nose also seems slightly lose and tends to move when I lean my head in either direction. My doctor back home feels he can fix my `little` problem with a small piece of cartlidge from my own nose which he claims is a minor procedure and he can do this under local anesthesia. However before I go through this minor ordeal I have decided to get a trusted second professional opinion basically to assess if this is a viable option for my particular problem, discuss alternative options, or whether I should call it a day. I really have a fear of having the over done `Michael Jackson` look (sorry Michael). I also tend to have dark circles around my eyes and with age (menopausal middle aged woman) seem to becoming more prominent. As I recall, you were working on some cream that may help with dark circles so I very interested in purchasing that as well as other treatments you think would be beneficial. (I already use your dmae eye and face creams). We are planning a family holiday, which includes Las Vegas and L.A. in late January/early February 08 for a few weeks, so with regards to the above information do you take appointments for people who just need a second professional opinion? If you do, great, who do I speak to or email to set up an appointment? If you are too busy, no worries, could you recommend someone either in Las Vegas or L.A. during that time. Thanks
Answer: might want to see Rollin Daniels MD in New Port Beach,Ca. he is a great revision rhinoplasty surgeon, sounds like you need what are called spreader grafts. As to the creams, I am getting there, I made it too strong and people were getting irritated so I am slowly decreasing it to see what will be effective, all the best. JG 11.6.07
I am 41 year old woman, I have unsurfaced cheeks due to pimples, which I ended up with large and deep scars. Plhich astic surgeon recomended me for facelift with dermabrasion. Recently had a deviated nasal septum my ENT surgeon asked me to do the surgery, and I will grab this chance to do my nose job. Now my question is which operation should be done first facelift with dermabrasion or deviated septum with nose job, or both together? Please help me to set up my mind I am confused. Thanks, Daisy
Answer: nose surgery first. JG 11.2.07
I had a nose job fixing a deviated septum about a year and a half ago. About six months after the surgery, the swelling had gone down and i was happy with the way it looked. Over the past year though, the tip has expanded, getting thicker (scar tissue growing?) What could i do to make it go back to the way it was? If getting a revision surgery is the best way to grow, and the growing scar tissue was scraped out, would this just cause more to grow? Thank you.
Answer: revision surgery might not help, could try small injections of kenalog or 5FU into the tip. JG 10.17.07
Hi Dr Garcia thank you for your time. I had botox a month or so ago and my cheeks dropped I got a chimpanzee look. I also noticed I lost a lot of fat in my face recently, (49 yrs old) My dr. suggested Sub Q to fill out cheeks but after reading about the procedure realised it was quite invasive so enquired about Radiesse. On appointment she decided to inject Radiesse into the area below my eyebags (think it is the tear trough), my nasobial folds and marionette lines all without a local - ouch! My left side is ok (apart from small needle bruise) but my right side is very bruised - have a huge bruise on my chin and one on my cheek. I still note I have the chimpanzee look with the tear trough and my right nasobial fold has changed my smile. Is it possible all will settle as time goes on? I have a deviated septum and the pain where she injected in this area was a lot more and is still tender. Is it still early days for me to be worrying as I have read some people get quite a lot of problems with Radiesse and realise it can be permanent? Should I have gone with the Sub Q? Thanks again. LC
Answer: it should settle down in time when the carrier in the Radiesse dissolves, but it migth take a month or more. I think Radiese is not a good replacement versus Restylane SubQ. JG 6.26.07
Hi Dr. Garcia, My husband has a deviated septum, and has unknowingly lived with it for years. Because he was experiencing a lot of problems(coughing, gagging), especially after eating certain types of foods, he went to an ENT. They suggested a surgery that was fairly invasive and after being through 2 recent knee surgeries, he was not up for it. Now, about a year later, the knee surgeries are behind him, but he still does not want to have surgery. Mainly because he is worried about the potential for brain injury, the uncomfortable recovery period and the possibilty that it will not work(his dad`s surgery did not take). He was told that there was a procedure involving balloons that has not yet been put into practice, and I was wondering if you can elaborate on the most minimally invasive, safe and effective procedures available today for deviated septums? Thank you
Answer: I have not been impressed with the amount if improvement with the balloon surgery. As to the septum, you are correct, it does not always stay straight, and the septum is not causing the gagging and coughing, tough call, but as long as he is willing to live with it he can continue to do so. JG 3.7.07
Hi Dr. Garcia, I will try to keep this as short as possible- bear with me! My left nostril has been bleeding for close to a month. Sometimes it`s like a real nose bleed and other times, it`s when I blow my nose, there`s blood (not old blood either). If I go too long without blowing my nose, I get all stuffed up on the left side. I am having a very hard time breathing out of this side whether or not I blow my nose. It`s happened very suddenly. It`s even getting painful when I breathe b/c the inside is so raw. My regular M.D. said I have a popped blood vessel and to treat it with saline spray and bacitracin. She also asked me if I ever broke my nose b/c I have a deviated septum. I never broke it, but it was once banged pretty hard and then swollen thereafter for about a week. Can breathing problems due to deviated septums have such a sudden onset? Is rhinoplasty the ultimate cure for such a thing? Please give me your advice! I`m desperate to breahe! Lauren N.Y.
Answer: sounds likes one type of surgery will be needed, it might be a place on the turbinates that has a non-healing area that scabs and bleeds. I think you need to see an ENT and have them examine you after they have numbed you up, posssibly they can cauterize it at that time. Best of luck. JG 2.15.07
Good Evening. I had nose surgery in February 2004 to correct a deviated septum, and to also contour the nose for a more appealing look. I was very pleased with the look I received after the surgery, however after several months I couldn`t breath from the left side of my nose. I went in for surgery again just a couple of weeks ago...after my doctor began the surgery (it was explained to me later!) he found that the left side of my nose was shattered. He had to completely rebuild that side of my nose, and ended up using some synthetic materials to help build it up. I`ve felt pretty good since the surgery - lots more pain than last time, but nothing unbearable -- I`m HORRIBLY bruised (my nose) and it`s extremely swollen. Correct me if I`m wrong - I assume this is because of what all he had to do. Over the past couple of days I`ve noticed that I have a spot inside my left nostril-fairly far up inside that feels very, very tender - almost raw. I`ve also noticed that my nose is slightly curved to one side. Is this just because of the swelling going down unevenly, or is it something that should be checked sooner rather than later? Thanks for your help,
Answer: all normal and should all settle down in time, best of luck. JG 11.27.06
Hi Dr. Garcia. I had a rhinoplasty a year and two months ago. He fixed a slightly deviated septum, narrowed the nose, got rid of the hump, shaved off cartilage from the tip to get rid of bulginess and I think gave me an implant at the tip. Bottom line is that I am really happy with the results. It looks really natural to the point that people cant tell. Problem: My breathing isn`t as clear as before and I almost always have a runny nose. Somedays its very light and on some I feel clogged up. Also on occasion, I take out really stringy/rubbery clear mucous which gives me temporary relief(though I cringe when I do so). Ive used ocean spray but I did not feel a difference. Its not as severe as some of the other posts but do you think there is something wrong? or do you think it will it go away in time? What do you suggest?
Answer: might be allergies, I would suggest seeing your ear nose and throat specialist. JG 11.16.06
How are you Doc? Last year I had revison work done on a botched rhinoplasty/deviated septum procedure from 10 yrs previously. My NY doctor did a BEAUTIFUL job straightening the septum and refining the nasal tip. The only thing bothering me is some collapsed cartilage on the left side from the first rhinoplasty that breaks up the line of the bridge and gives the impression that my tip `leans` to the side. My doc suggested Restylane injections and even demonstrated the result by shooting this `dent` full of saline. I loved it! I asked about grafts so it would be permanent but he seemed hesitant because he said it`s not such a big dent anyway and the graft could be incorrectly sized, it could shift, be absorbed, show through or create more scar tissue that could potentially block out the nostril (the septum wall needed extensive repair on the left side and the collapsed cartilage apparently already leaves me little room for breathing properly) Do you believe that grafts are so risky and injectibles are better options in such a case? I`d like the effect to last as long as possible, obviously. All my thanks
Answer: I agree wholeheartedly with your doctor, best of luck. JG 11.13.06
hi dr garcia! i want to get a nose surgery done. i have a deviated septum so my nose turns towards the left of my face. it is not very obvious, but i have noticed this problem in my pictures. also it bends a little from the top. do you think i can get a surgery done to correct this and at the same time not look like i have gotten some procedure done (after recovery period). what will be the recovery period after such a procedure, and also the cost.
Answer: well many insurance companies cover surgery for a deviated septum if there are breathing difficulties, if all that is done is to straighten the septum, I think it will look better but not done, the recovery time before you are 100% is about 3-4 weeks. JG 10.16.06