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Nose Surgery for Breathing Problems

I have breathing problems and snoring because I have kind of a flat nose and was told that rhinoplasty surgery can correct this.  But I am afraid that if I have surgery it is going to make me look a lot different.

Doctor Answers (25)

Functional Rhinoplasty

+3

Functional rhinoplasty is a term that I use to describe a rhinoplasty performed specifically to improve nasal breathing. In many cases, this can be combined with an aesthetic rhinoplasty. In fact, every aesthetic rhinoplasty should be approached with function in mind, and every functional rhinoplasty should be approached with aesthetics in mind.

The short answer to your question is yes, we can improve the nasal airway while maintaining nasal aesthetics. However, much of this will depend on your anatomy. While many think such matters are as simple as doing a ‘septoplasty’, often the issues are more complicated. Seeing an experienced rhinoplasty surgeon will help ensure you get a complete evaluation.

One question to be answered by your physician is: Is there a nasal anatomical issue that affects you nasal airway that is associated with the external structure of the nose?

One example of this is severe anterior septal deviation, for which I have devised a technique called Anterior Septal Reconstruction. In this procedure, the septum is reconstructed via an external rhinoplasty approach and nasal form is preserved.

A second example: narrowing of the midvault area, or ‘internal valve narrowing’. This is tougher to diagnose, but an experienced facial plastic surgeon or otolaryngologist can reliably diagnose this. This can occur after removal of a ‘bump’ on the top of the nose. The classic way to correct this is a ‘spreader graft’ on the affected side(s). This may subtly widen the middle portion of the nose. Other procedures exist to correct this as well.

A third example is called ‘external valve collapse’ and this is sometimes visible as a nostril collapsing. Unfortunately, this can also can happen after aggressive rhinoplasty. I have been asked to correct a number of such cases, and there are a variety of techniques available for this.

Finally, you should be honest with yourself and your surgeon about what your priorities are. If you want minimal to no change, say so. If your breathing is so bad that you would tolerate some more changes, say so.

Here’s little about my philosophy. My goals with any rhinoplasty are:

  • To perform a safe, effective procedure
  • To create a natural, harmonious appearance to the face
  • To maintain or improve the ability to breathe through the nose

I have published numerous articles and chapters on the techniques and outcomes of aesthetic and functional rhinoplasty, and have been asked to lecture nationally and internationally on this topic.

Obviously, rhinoplasty is something I care much about. I spend considerable time with my patients discussing the issues of aesthetics and nasal function, and I think modern rhinoplasty should take both functional and aesthetic considerations into account. Make sure your surgeon understands these issues as well.


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

Airway surgery

+2

Your surgery can most certainly be done without changing your look. In fact, the airway structures are often removed or repaired without changing the patient's appearance. This is mostly because those structures are deeper or require significant manipulation to chagne the look of the nose. This of course is assuming a properly done surgery. Be sure your plastic surgeon does plenty of these surgeries before signing up.

Best Wishes.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 62 reviews

Rhinoplasty for Breathing Problems

+1

Rhinoplasty will likely change the shape of your nose. The key to a successful outcome is your communication with your facial and nasal plastic surgeon. Make sure that your physician and his/her team performs a full internal and external nasal evaluation, and that all of your options and concerns are discussed in details prior to surgery.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Nose surgery without changing your loooks

+1

Nose surgery can be done to improve your breathing without changing your looks. This type of surgery is primarily done by either ENT(ear nose and throat) surgeons or Facial Plastic surgeons trained in ENT as well. The myth that if you do a Septoplasty( fixing the septum) may change the outside of your nose is false.

Good Luck

Carlos Wolf, MD
Miami Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

Airway surgery without changing the shape of the nose

+1

In most instances of nasal obstruction, the problem is due to a deviated septum and turbinate enlargement. Rarely, the location of septum deviation is very high or very far in front of the nose. In these situation, extra steps must be taken during the surgery to ensure the nasal shape is not altered.

Maurice M. Khosh, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Correcting nasal breathing problems without altering the external appearance

+1

Surgery can be done to improve your breathing without altering the shape of your nose if that is your desire. Most breathing problems are the result of septal deviations or enlarged turbinates or some combination thereof. Altering the outside of your nose generally will not improve nasal airway function unless the tip is hanging over the nostrils, there is pinching along the sides of your nose or collapse of your nasal valve. If those issues are not present, you should not need to have the outside of your nose changed to improve your breathing function. As far as snoring, nasal surgery itself has very limited benefit except that snoring may be indirectly improved if you improve breathing through your nose. Snoring itself is caused by the vibration of the soft palate and uvula which are in the back of your mouth. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Most breathing problems can be fixed without changing look

+1

In most cases, correction of the septum and turbinates inside the nose will be enough to fix nasal breathing problems. These treatments do not change the external shape of the nose. In some cases, the outer shape of the nose must be altered in order to fully correct the nasal obstruction (crooked nose, broken nose, or pinched nose).  All depends on your anatomy!

David W. Kim, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Nasal breathing and Functional Rhinoplasty

+1

You can absolutely improve your nasal breathing without changing the outside appearance of your nose. 

In most cases, you can straighten your septum if crooked and reduce the size of your turbinates (the tissues in your nose that make you feel congested) without any external changes.  Also, if you have a narrowing of your nasal valve (the narrowest point of your entire airway) then a nasal valve repair can also be performed at the same time to maximize your nasal airway. 

These procedures can also help with recurrent sinus infections, snoring, and recurrent nosebleeds.  These procedures are generally covered by your insurance plan and are not considered cosmetic. 

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

Functional nose surgery

+1

Improvement in the ability of the nose to breathe can absolutely be performed without changing the appearance. However, in some instances, raising the tip of the nose or widening the nose may help improve your breathing.

Consulting with a facial plastic surgeon / ENT doctor experienced in functional nasal surgery will allow them to examine your nose, inside and out. They will then be able to tell you what will be necessary to improve your ability to breathe through your nose.

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

Nose surgery can improve breathing without cosmetic changes

+1

There is rarely any need to make cosmetic changes if a patient has only a breathing obstruction. Such a problem is usually caused by a deviated nasal septum or enlarged structures called turbinates. It is entirely possible to do surgery on these structures without changing the external appearance of the nose.

Howard T. Bellin, MD (retired)
Manhattan Plastic Surgeon
2.5 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.