Can a turbinate reduction improve my breathing after Rhinoplasty?

I had a primary rhinoplasty, April 2014 and have been left with some asymmetry with my nostrils and also complications with my breathing. The first non-surgical treatment performed to improve my breathing were cortisone shots in each nasal cavity but, it provided little improvement. The next alternative my surgeon recommended is a partial removal of my turbinates. Can this procedure be effective in improving my breathing? I also have significant nostril asymmetry.

Doctor Answers 7

Turbinate reduction post rhinoplasty

Thank you for your question

There are a number of causes for difficulty breathing thru your nose. 

       One involves collapse of the internal nasal valve correction here includes placement of a Sheen cartilage spreader graft .

        Another cause is a deviated septum. Treatment includes straightening the septum. 

         It's not uncommon for pt's with a deviated septum to have concomitant enlargement of the inferior turbinates. In this scenario I would fix the septum but would avoid reducing the turbinate. The reason for this is that many of these pt's will see a reduction in the size of their turbinate after surgery . If the turbinate remains large after surgery then you may be a candidate for  an anterior inferior turbinectomy . 

        For more information on noses please see the accompanying video on noses.  I hope you find this useful.


Tampa Plastic Surgeon
4.8 out of 5 stars 57 reviews

Turbinate reduction can help breathing but also can cause more problems if not done correctly

Some surgeons will cut off part of the turbinates to open the nasal airway, especially for obstruction post rhinoplasty. This isn't always the answer. The turbinates are just one component of the nasal airway. I prefer first treating with nasal steroids to try and shrink them medically. Also, if too much is removed then it can cause more problems that can be permanent. Please make sure your surgeon has a background in functional nasal surgery including septoplasty and sinus surgery and has exhausted all non-surgical methods as well as assuring that turbinate elargment is really the issue and not just a blanket treatment.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 109 reviews

Turbinate resection after rhinoplasty

Turbinate resection can be very effective to improve the nasal airway.  Why this wasn't done at the time of your rhinoplasty is confusing.   If you had no breathing issues before surgery then you have to be concerned about another cause for breathing difficulty beside the turbinates.  Knowing that the nostrils are asymmetric suggests that you might be having problems related to what is known as the internal (and/or external) nasal valve.

If nasal decongestant spray such as Afrin or Neosynephrine does not improve breathing then the problem is likely in the valve area and not the turbinates.

Be sure to see a surgeon certified by the American Board of Plastic Surgery for a thorough evaluation.

Turbinate reduction to improve breathing after rhinoplasty

Turbinate reduction is a great procedure to improve issues related to chronic nasal obstruction, but it should only be performed for the proper indications.

A facial plastic surgeon would be able to provide the best overall advice in your situation after an examination and some discussion with you to get a better idea of the history of your symptoms and what has or has not worked best for you so far.  The reason for this is that most facial plastic surgeons have a background in ENT training and board certification in that specialty as well.  A general ENT doctor can provide great advice as well, but if that person does not perform rhinoplasty or has a limited understanding of it his or her ability to advise you on everything might be limited.

There is more to it than just the turbinates.  Since you say your nasal breathing has been worse since having a rhinoplasty one would assume that there have been some structural changes related to that.  In that situation you might need to consider revision rhinoplasty procedures for the greatest improvement, but turbinate reduction alone might be enough to get decent improvement in your nasal obstruction.  It will do nothing to change nostril asymmetry though.

David W. Rodwell III, MD
Charleston Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breathing

Turbinate surgery MIGHT help, but it depends on the specific CAUSE of the sensation of airway obstruction. After rhinoplasty surgery another cause can be narrowing of the internal nasal valve which requires a completely different procedure to correct. You may be able to see if this is contributing to your symptoms by performing a Cottle maneuver - you can Google this simple test and do it yourself.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.4 out of 5 stars 72 reviews

Nasal breathing

There are a number of anatomic variables that can contribute to breathing obstruction. Enlarged turbinates are one reason, and for proper candidates an inferior turbinate reduction can improve breathing. However, without examining you, it's hard to say whether this procedure will provide significant benefit.

You mention that you experienced breathing complications following your primary rhinoplasty. It may be necessary to reverse or correct those problems from surgery in order to fully restore normal breathing. Be sure to consult with an experienced facial plastic surgeon who understands both the cosmetic and functional aspects of the nose. Good luck!

Mark Been, MD
Barrington Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Turbinate surgery

Turbinate reduction can improve breathing if an enlarged turbinate is the cause of your nasal airway obstruction. Sometimes the tissue overlying the turbinate is boggy and engorged because of allergies and this can improve with afrin administration. This test can be done in the office. If it is given and the breathing does not improve, it suggests the turbinate could be enlarged because of the bony component of the turbinate or that the airway is obstructed for another reason like a deviated septum, bony spur or nasal airway narrowing from the upper lateral cartilage. An examination with a board certified plastic surgeon can help answer this question. Best of luck, MMT

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.