After Rhinoplasty is It Common to Have Breathing Problems?

I am considering Rhinoplasty, but I've heard that it often causes trouble breathing afterwards. Is this true?

Doctor Answers 29

Rhinoplasty Should Produce A Nose That Looks Good & Functions Well

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With the advances in rhinoplasty techniques over the past several decades, the goal of any rhinoplasty should be to produce a nose that looks good and functions well. When performed correctly, one should not have to be sacrificed for the sake of the other.

The key is to find an experience rhinoplasty specialist -- a surgeon who devotes a significant percentage of his or her practice to rhinoplasty. There are a handful of surgeons in the US who perform rhinoplasty exclusively.

Dallas Facial Plastic Surgeon
4.7 out of 5 stars 149 reviews

The goal of rhinoplasty surgery should be first to...

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The goal of rhinoplasty surgery should be first to maintain function and second to achieve improved aesthetics. While there are complications of surgery which can produce difficulty breathing, such as a perforated septum or nasal collapse, in general, a well trained and experienced rhinoplasty surgeon should be able to achieve a good cosmetic result in a functioning nose. The presurgical assessment is important to determine if you have any breathing difficulties which may be worsened after surgery. In addition, the surgeon may not be able to achieve all of the cosmetic goals that you want because of functional concerns. Again, speaking with a qualified surgeon is always critical to achieving the best result.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Nasal obstruction is not a common occurrence after rhinoplasty surgery.

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Every patient considering rhinoplasty is different, and may require special considerations. Many patients with functional and cosmetic concerns have both addressed at the time of nasal surgery. Anatomical understanding of the nasal valves (internal and external) may enable your surgeon to maintain or improve your nasal airway at the time of rhinoplasty. Hope this helps. Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Nasal Congestion & Breathing After Rhinoplasty Facial Surgery

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Nasal congestion may either be immediate or chronic with rhinoplasty / nose job surgery. Most nasal congestion after rhinoplasty surgery is due to normal postoperative swelling. A majority of this internal, as well as external, swelling resolves within a couple weeks. However, it may take a couple months for the final swelling to resolve. Normal crusting inside the nose also keep the breathing down after surgery. It's important to follow the postoperative care instructions of your surgeon.

Long-term nasal congestion after nose job / rhinoplasty surgery is more of a concern, and due to many, many conditions, some of which may not be due to the original surgery. Fortunately, it is uncommon to have long-term nasal breathing difficulty after rhinoplasty. Allergies, nasal polyps, dust exposure, and sinus problems all cause nasal congestion. These nasal breathing problems can be evaluated by an otolaryngologist and treated accordingly.

Turbinate hypertrophy and deviated septum are common potential causes. These conditions are also usually easily treatable.

Lastly, scarring or major alteration in the structure of the nose after rhinoplasty surgery can contribute to breathing problems. Fortunately, this is usually the least common cause of breathing issues following surgery.

Plastic surgery is a balance of potential risks and benefits. Only after a comprehensive evaluation can a nasal surgeon help determine the most appropriate options for you. Best of luck.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

The goal of rhinoplasty is to improve the aesthetic...

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The goal of rhinoplasty is to improve the aesthetic appearance but also to maintain function.  However, sometimes during the early post-operative period some patients complain of difficulty with breathing.  This is usually due to swelling which improves in the first few weeks after surgery.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breathing problems after rhinoplasty

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Due to the considerable amount of swelling after rhinoplasty, patients experience restriction of airflow through the nose in varying degrees. The restriction on airflow from a rhinoplasty subsides within the first couple of weeks after the surgery. Complete obstruction out of the nose is common if a septoplasty is performed or any turbinate surgery is performed at the same time as a rhinoplasty. Once the swelling from a rhinoplasty and/or a septoplasty has resolved there should be normal.  For many examples of rhinoplasty, please see the link below to our photo Gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Although always a concern , this does not seem to be a...

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Although always a concern , this does not seem to be a common problem. I performed hundreds of rhinoplasties, and most of them are designed to reduce size of the nose. Patients are usually not bothered by the change of the nasal airway.

However, if one has breathing problems before nasal surgery, the nasal airway has to be evaluated and septoplasty/turbinate surgery maybe indicated. This is usually combined with cosmetic surgery of the nose. This portion (functional) of this procedure may be covered by insurance .

Rhinoplasty should not cause breathing problems

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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.

Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Temporary Congestion, Not Permanent Problems

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After surgery, you are correct that swelling and dressings can cause congestion for some time as the nose heals. But rhinoplasty should never cause long-term respiratory problems. In fact, the surgery is often used to improve breathing in the long run. A successful rhinoplasty should leave you with breathing that's the same as or better than it was before surgery. 

Jerold Olson, MD
Tucson Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Swelling Can Make Breathing Difficult, But Only Temporarily

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Tissue swelling can make breathing through the nose impossible, but this issue usually resolves itself as the body heals and the swelling subsides.

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.