Rhinoplasty Forum and Chat Support Forum and Message Board for Patient's Questions and Answers Rhinoplasty (Nose Surgery) Smell Taste and Voice

Explore what others have to say about Rhinoplasty Plastic Surgery of the Nose with answers by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

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Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Rhinoplasty Nasal Surgery Important Information

Question: Re: singer nose

I am an unsigned singer working on an album for a record compnay that's interested in me. If I have nose surgery, will it change the sound of my voice? And if so, how much? The bridge of my nose is wide as the bottom part. I would also like to have minor sculpting done on the tip as it is asymetrical. What do you think?

Q

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

The nose CAN play a factor in our sound. Nasal obstruction causes a nasal sounding voice. The internal size of the nose may have a slight effect on the resonance. If the surgery opens a closed nose, there is a big change. If the nasal valves are altered, some control may need to be changed. Patients who demonstrate such changes are those who lose the entire nose. I have never heard a difference in a non - airway modifying rhinoplasty. Without an in office examination and evaluation, I would not be able to comment about your specific case. Most rhinoplasty surgery should have little effect. However, I do not know of any plastic surgeon will guarantee nasal surgery will not change the sound of singer's voice.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

I definitely agree with you on having the right motive. I've always felt that I could benefit from rhinoplasty. I know this is probably an issue with almost every plastic surgeon but I assure you, I have a healthy perspective. I shall do my research then I'll call your office to set up an appointment. Thank you for your reply.

Q


Question: Re: taste/smell septoplasty

Dear Doctor Bermant

I am going to have a submucosal resection, is it possible that I loose totaly or partialy the sense of smell or taste.I am worried about this because I am a professional wine tester since many years and obviously it will be desastrous to loose or diminish this senses What is your opinion, please ?C

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

The operation may enhance your sensation of smell but there are risks for a temporary and rarely a permanent alteration of both smell and taste.

Smell comes from molecules carried by the air currents coming into contact with certain regions of the nose (and mouth) that have receptors (nerve endings) for that purpose. Taste id from the molecules brought to those receptors areas concentrated in the mouth but also can be from stimulation of the odor receptors in the nose. Trying to divide taste and odor borders more on the philosophic and those trying to define what may not need separation.

Septoplasty complications can present problems with many factors involved with these sensations.

Swelling after surgery often impairs access of the molecules to the nerve endings. If the odor molecules cannot get to the nerve endings, odors can be lost. Most swelling resolves over several days but further reduction occurs over weeks. In most cases septoplasty is done to enhance the air passage through the nose. Therefore in most cases, smell and the world of odors are opened for that patient. If the eddy currents were doing a great job of getting the molecules to the receptors before surgery and surgery changes this for the worse, then smell can be lessened.

Nerves can be injured. Theoretically the sensory nerves for smell can be injured. I have seen such cases in major crainiofacial surgery and facial trauma, not septorhinoplasty. The nerves that supply the top of the palate can be injured in septoplasty. This unusual complication comes from that nerve running either in the floor of the nose or the palate bone. This injury is much more common in fractures of the midface and palate but can be a complication of aggressive septal surgery.

I have heard many patients tell me their smelling was enhanced by the surgery. I warn my patients that there are real risks of such complications, but that they are rare. Will your surgery enhance your senses or harm them? How long will there be if any at all a loss or change of smell? I do not have the answer. You should discuss such issues with your doctor. Only your doctor has examined you and knows the surgical plan. There are risks but then there are also risks crossing the street. Can you imagine someone being required to go over such risks and benefits?

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Re taste smell septo plasty

dear Dr Bermant

Thank you very much for for your message I do not understand the following sentence : "If the _eddy currents_ were doing a great job of getting the molecules to the receptors before surgery and surgery changes this for the worse, then smell can be lessened." Please would you be so frienly to clarify what you mean by that ?

Much obliged for your earliest reply

C

Dr. Bermant answers:

The air travels up the nose and twists and turns just like a flow of water down a creek. Instead of rocks and pebbles, we have the twists and turns of the walls and the turbinates disrupting the even flow. An eddy current is the swirling of the flow. Such swirling can be used to ensure more contact with the nasal lining to pick up moisture to humidify the air as it passes through the nose. It also provides a better sampling of the air for the smell receptors.

Michael Bermant, MD


Hi,
I am a 36 y.o. male who has for many years realised that the internal structure of my nose is bent which has resulted in reduced air-flow in my left nostril. This has only slightly affected me over the years although it may be contributing to the occassional bout of snoring.

Of more concern to me over the last few years has been the realisation that I have a reduced sense of smell. Specifically, the sense is periodic in that sometimes I can smell (it is best just after exercise or a hot shower) but usually I can't smell much except for very strong odours. I also believe that my sensitivity changes as well (although it is difficult for me to quantify the sensation). This is unfortunate since my appreciation of food and drink has increased over the last decade and I place great importance on this sensation.

Upon a visit to a recommended ENT specialist, I was diagnosed with a deviated septum. The subsequent CT examination report states: "There is quite gross mucosal thickening in both maxillary antra and both ostiomeatal complexes are completely occluded. Mucosal thickening is present throughout the ethmoid aircells, with only a few cells remaining patent. There is mucosal thickening in both frontal sinuses which mainly affects the bases, and there is mucosal thickening within both sphenoid sinuses."

"The nasal septum is slightly deviated towards the left. There is mucosal thickeneng overlying the right sided turbinates. Some attenuation of the left inferior turbinate is noted. No definite nasal polyps are seen. The nasal passages and postnasal space are patent." "Impression: Quite marked chronic pan sinusitis. Deviation of the nasal spetum to the left anteriorly." The ENT recommends Nasal Septoplasty using Functional Endoscopic Sinus Surgery (FESS). I have spent some time reading the comments on your bulletin board but most emphasis seems to be on using this surgical procedure to aid breathing difficulty. Since my primary concern is one of sensorydeprivation, what is the likelihood that thisoperation will improve my sense of smell. Sincerely, G

Dr. Bermant replies:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

A deviated septum can cause a mechanical obstruction. If there is mechanical nasal obstruction and that obstruction has limited air flow to working receptors for smell, opening the passages CAN improve smell. There are just too many factors at play here. Odor molecules must be delivered to just the right place. There are many factors beyond just a deviated septum that can limit this access. Those sensors must be working. There are many problems where these receptors just are not able to do their job.

Now assuming everything is working, opening up the passages must also result in eddy flow of the air particles to get to the receptors.

Such discussions are best done after an examination and evaluation.

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