Blocked nose all the time after revision rhinoplasty, can this be fixed with another surgery?

The first issue to address is your chronic nasal decongestant spray use as this causes rebound nasal congestion and makes it so your nose is continually blocked (rhinitis medicamentosa). You may potentially have an underlying structural cause for your blockage, but first you'd want to wean off of the decongestant spray to see if that helps.Visiting with a plastic surgeon with ENT (Ear, Nose and Throat) training would help with assessing both of these issues.

Greetings,If one of the goals of your rhinoplasty was to reduce the size of your nose, it is possible that the size of your internal nasal passages has been reduced as well.  Additionally, chronic use of nasal sprays can actually negatively impact your ability to breath through your nose over time.  I would consider weaning yourself from these sprays over a period of time to see if this will help you.  Additionally, consultation with a physician who has both otolaryngology and plastic surgery training would be helpful  to make sure that any internal and external issues can be appropriately addressed.  Good luck!

Thank you for your query. As mentioned in the other answers, your nasal blockage may be due to a change in the sensitivity of the nerves in the nose, over resection of the inside structures within the nose causing too wide passageways that cause a sensation of obstruction (empty nose syndrome) or a residual blockage in the airflow within the nose.

However, I suspect that your issues may in fact be due to a condition called ‘rhinitis medicamentosa’ caused by your long-term use of nasal decongestants. When people take nasal decongestants for more than a few days, they have a rebound congestion effect caused by the decongestants themselves. This leads to nasal congestion. The treatment is to stop the decongestants. While this can have an initial period of worsening of symptoms, the blockage can be alleviated by a short course of steroid tablets and steroid nasal spray. You may wish to speak to your operating surgeon to see if they think that this may be a contributing factor. 

Best wishes 

Hello, thank you for  your provided information and question,As you had completed your healing process, by a well- executed Revision Rhinoplasty your nose can be improved functionally and cosmetically for better. However, there is always a finite limite about how much a nose can safely be altered, and previous alterations should be considered as well.Closed and Atraumatic Technique will prevent tissue damage, provide you maximal healing, minimal edema&swelling  and no scar on your columella.Best Regards,

Dear MrsJosef,Thank you for your question. Revision rhinoplasty is challenging for even the most experienced surgeons, and generally becomes harder after each subsequent surgery. The method of some rhinoplasty surgeons is to reduce the nose in all areas, which can cause breathing problems that are difficult to fix. You need to be evaluated and the cause of your airflow obstruction needs to be determined. Only then can anyone definitively answer your question, which is if another surgery is warranted. Good luck,Nirmal R. Nathan, M.D.

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgeons

ACGME-Trained Craniofacial Surgeon

In addition to the other comments, consider also that you may be overusing nasal decongestant sprays and have developed rhinitis medicamentosa -- a condition that leaves you dependent upon those sprays. The first step is to wean yourself off of those sprays, which can be very challenging as withdrawal of the spray feels very unpleasant. Seek out a local ENT doctor who can assist you in weaning from those sprays, which can be helped with different medications.

This is a complex and there can be multiple causes.  It could be mechanical - not enough space or it could be changes in the sensitivity of the lining of the inside of the front part of the nose from multiple surgeries.  Air may be flowing in but the nerves cannot feel the cool air being pulled in giving rise to a sensation of blockage. You could go and discuss your concerns with your surgeon who could give you some advice, best wishes.