Yes and No - you may have breathing problems

Immediately after rhinoplasty, packing (in some cases), swelling, and mucous/bloody fluid will definitely make you feel like there is a clothespin on your nose. After a week or two, as the swelling resolves, the great majority of patients can breathe as well or even better than they did before the surgery.

Many surgeons ignore the nasal septum when performing cosmetic rhinoplasty. When the nose is reduced, it is essential that the septum is also reduced. If not, a previously straight and non-problematic nasal septum will buckle and deviate, causing breathing problems. If the nasal septum is deviated to begin with, then it must be corrected. The only time that the septum can be left alone is if the nose is not to be reduced, and if it is relatively straight to begin with.

Another cause of post-op breathing problems is when too much lower lateral nasal cartilage is removed in the attempt to reshape the tip of the nose. Lastly, the lateral internal walls of the nose have structures called inferior turbinates. They can be reduced permanently in a non-invasive in-office 15 minute procedure called Somnoplasty.

Please remember to choose your rhinoplastic surgeon most carefully to avoid these and other problems.

Be well and good luck.
Michael A. Persky, MD, FACS

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The short answer is no.

The typical rhinoplasty done in the 1980’s or even 1990’s relied heavily on reduction of prominent cartilage and bone to achieve a more refined look. Knowledge of the long-term effects of such techniques was spotty and, so, many unfortunate patients were left with the trademark ‘operated’ appearance of a pinched, droopy, or distorted tip, and scooped-out nasal bridge. These occurred because the newly-weakened structural elements of the nose could no longer provide the necessary support, often leading to breathing trouble.

The forces of healing are dynamic and often operate for several years before these outcomes are evident. So, a postoperative result may look great immediately after surgery, yet evolve into a dismal failure over time. Likewise, collapse of the nose’s structural supports will compromise the basic function of the nose, namely breathing.

Modern thoughts on rhinoplasty take a much more conservationist approach. As much as possible, reshaping and contouring are achieved with suture and graft techniques that will usually leave the nose ‘stronger’ than it was preoperatively.

While many surgeons think of nasal breathing more as an afterthought, those who have an interest and experience in rhinoplasty will assign as much importance to nasal function as to aesthetics. The result, at Profiles Beverly Hills, is that once short-term swelling is resolved, your breathing should be as good or better than before and the changes to your nose should remain ‘stable’ for a lifetime.

Breathing problems should be one of the main parts of a preoperative exam prior to rhinoplasty. If indicated, the breathing obstruction should be treated during the surgery.

In the immediate postoperative period with rhinoplasty, there will be some swelling that may make breathing difficult with the dressings. Patients are often advised to breathe through their mouths for the first few days. 

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