January 13, 2022

Treatment sharpens sense of smell for ‘professional nose’

Surgery at Vanderbilt helped 25-year-old Meredith Watson pursue her dream of becoming a professional nose — someone specially trained in combining ingredients to create fragrances.


by Jill Clendening

For most of us, a congested nose is an annoyance, but for 25-year-old Meredith Watson, not having clear nasal passages hindered her dream of becoming a professional nose — someone specially trained in combining ingredients to create fragrances.

Thanks to the treatment she received at VUMC, Meredith Watson is able to pursue a career as a ‘professional nose.’
Thanks to the treatment she received at VUMC, Meredith Watson is able to pursue a career as a ‘professional nose.’

“It wasn’t until pretty embarrassingly late in life that I learned it’s not normal to only be able to breathe with one nostril most of the time,” she laughed. “I thought everyone just dealt with this, and no one was talking about it.”

Watson was working as a research analyst in the Vanderbilt Music Cognition Lab in the Otolaryngology department at Vanderbilt University Medical Center when she decided she wanted to pursue a career using a sense other than hearing — the sense of smell. During her earlier studies to earn a bachelor’s degree in brain and cognitive science, all things olfactory had intrigued her.

Not letting her faulty nose hold her back, she applied to ISIPCA Paris, a noted educational institute focused on perfume, cosmetics and flavoring. She was invited to sit for an intense, four-hour Olfactory Intelligence Exam in New York City. She earned admission, and in 2020 she began her studies in Paris.

Then, the pandemic hit. Everyone at ISIPCA Paris became hypervigilant in taking precautions to prevent the spread of COVID-19 — especially since one of the symptoms and potential long-term effects is a loss of the sense of smell.

“As someone whose future career and livelihood is dependent on their sense of smell being intact, facing a pandemic that can affect that in a major way, and possibly for a very long time, has been quite scary,” Watson said.

After successfully navigating her first year of study, Watson was ready to fix her sniffer. She returned to Vanderbilt and met with John Seibert, MD, service chief of General Otolaryngology/Head and Neck Surgery.

She’d already been screened for allergies at the Vanderbilt Asthma, Sinus and Allergy Program; Seibert said she was “basically allergic to Middle Tennessee.” But antihistamines and other medications only gave her limited relief.

Seibert did an endoscopic exam during which a thin tube with a camera and light was inserted up Watson’s nose. It showed she had a deviated septum, meaning the thin wall between the two nasal passages was displaced to one side. A nasal bone spur was not helping the situation.

She also had somewhat prominent turbinates (bony structures inside the nose covered with erectile tissue that regulate and humidify inhaled air).

“An analogy I often tell patients is that inside your nose there are the roads and there is the traffic,” Seibert said. “A problem with the ‘roads’ would be something like a deviation of the septum or enlarged turbinates. Nose traffic is inflammation, allergies, an upper respiratory tract infection. I always say let’s fix the traffic first. If that doesn’t work, then we’ve got to adjust the roads. Meredith had already tried fixing the traffic.”

Olfactory structures are located high inside the nose, so Watson felt confident her sense of smell wouldn’t be negatively impacted by Seibert’s repairing the lower structure of her nose, but what Seibert couldn’t tell her was if her sense of smell would change in any way.

He corrected her septum by performing a septoplasty and did what he calls a “liposuction of the turbinates,” a submucosal resection to reduce the size of the lower turbinates.

A week following surgery, Seibert removed the splints and packing that stabilized Watson’s nose as it healed.

“I didn’t think I would notice the change in my breathing so immediately, but after Dr. Seibert got the packing out, and I took a deep breath, I literally could feel air in parts of my nose where I’d never felt it before,” Watson said. “I truly didn’t know that you could feel air at the back of your nose. It was wild. Later, when I was cleaning my kitchen, I could truly smell the spray I was using. I was surprised at how emotional that made me. I started crying because I could really smell again.”

Watson has a case full of little flasks of scents she studies — according to airport scales, 31 pounds’ worth. She got each one out to refamiliarize her nose with their nuances.

And the improvements to her nasal passages have already paid off. When she returned to Paris to continue her studies, her olfactory talent led to an offer of a dream job at IFF (International Fragrances and Flavors) as a scent design management trainee. In this role, she’ll serve as an artistic director of fragrance projects.

“This is the type of job I was aiming to get after I finished the program, so I’m honored to have been offered this opportunity two years before my graduation!”

As for Seibert, he routinely does surgeries to remove polyps, correct a wayward septum or unblock sinuses, but for him this was a first: clearing out the roads of a nose so an individual could have a clear path to her future as a professional nose.