Richard Westreich, MD
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Richard W.Westreich MD. FACS
Facial Plastic, Reconstructive, & Nasal Surgery/ENT
Selected to 'Best Doctors 2014' by New York magazine's
Phone: 212.595.1922
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Gallery Before and After Photos
Reconstructive Surgery

Functional Nasal Surgery

Crooked Nose Repair

Patients often request cosmetic corrections to the nose at the same time as septoplasty surgery. Nasal obstruction is a common problem that can significantly affect a patient’s quality of life. The goal of surgery for nasal congestion is to make the nasal passages more open. Since Rhinoplasty often involves making the nose smaller, a balance between these goals must be achieved. As a board certified facial plastic surgeon, Dr. Westreich has extensive experience in both functional and cosmetic nasal surgery and is uniquely qualified to perform this simultaneous correction. This procedure is often more difficult in deviated or crooked noses.

The goals of functional nasal surgery 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.

Dr. Westreich believes that a thorough understanding of how the nose works is critical to surgical success. The symptom of nasal obstruction must be comprehensively evaluated, keeping the patient’s ethnicity and nasal architecture in mind, as all noses do not breathe through the same pathways. One such factor is the inferior turbinates; these are paired structures of bone and tissue that hang from the side of the nose bilaterally that 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 reconstructive and cosmetic nasal surgery, Dr. Westreich will evaluate you for both medical and surgical treatment options.

Deviated Septum (Septoplasty)

Septoplasty is an operation to correct the nasal septum, a midline structure made up of cartilage near the tip of the nose and the bone farther back. The nasal septum is essentially the foundation of the entire nose, separating the right and left sides of the nose and helping to regulate nasal airflow. It is normally vertically situated, but becomes deviated when cartilage or bone is crooked, fractured, or bent, which often causes nasal obstruction. Severe deviation can result in both sides of the nose being obstructed. Developmental abnormalities and traumatic injury are common causes of a deviated septum. Previous nasal surgery can also result in nasal obstruction.

The deviated (or crooked) septum can be addressed in surgery. Correction of the deviated nose requires additional skills beyond those required for standard cosmetic rhinoplasty. Many structures including the nasal bones, the nasal septum, the nasal tip, the inferior turbinates, and the overall shape of the face must be evaluated. Facial asymmetry also plays a critical role in developmentally deviated noses. Traumatically deviated noses often have different anatomic elements requiring correction. Failure to correct one or more of these critical structures is the most common cause of surgical failure in the deviated nose. Dr. Westreich will conduct a thorough evaluation of your nose to design a comprehensive surgical plan for successful functional and aesthetic correction.

Foundation Rhinoplasty is a technique developed by Dr. Westreich specifically designed for deviated nose correction. However this technique can also be used in non-deviated Rhinoplasty in order to ensure stable and long term results. When undergoing correction of the deviated nose, you may also choose to have aesthetic enhancements to the nose, chin or other areas of the face.

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