Breathing Troubles Due to Rhinoplasty?

My first rhinoplasty was successful in correcting a deviated septum, but aesthetically I felt my nose could have been reduced in size, so I had a secondary rhinoplasty performed a year later (also a failed attempt). I have noticed a decline in quality of breathing through my left nostril, and was wondering why this happened and if a third revision is necessary?

Doctor Answers 12

Can breathing troubles be due to prior rhinoplasties?

Some patients can experience worsened nasal breathing after rhinoplasty, although this isn't typical. To assess your situation an examination is really needed. Here are some possible causes of nasal obstruction:

  • Narrowing or pinching of the internal nasal valve. This can be prevented during an initial rhinoplasty or repaired with a secondary surgery by placing spreader grafts.
  • External nasal valve pinching or collapse. This involves more of the nostril region (ala) itself and can be a result of weakness in the area due to lack of cartilage support.
  • Septum shifting or persistant deviation.
  • Scar bands within the nasal cavity.
  • Swelling of the internal nasal lining due to allergies or other irritation.

Talk to an experienced rhinoplasty/nasal surgery specialist. You don't have to sacrifice nasal breathing for a better appearing nose. If you're still not happy with how your nose looks, this may be able to be addressed along with your breathing problems.

Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Breathing problem after Second Rhinoplasty

Hi Shaunelle,

Many things could be causing your breathing issues. A persist ant deviated septum, nasal valve collapse or other problems associated with rhinoplasty. A qualified surgeon should examine your nose and determine whether a third surgery would be beneficial.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 274 reviews

Breathing Problems After a Second Rhinoplasty

Rhinoplasty and especially a secondary rhinoplasty are the most challenging cosmetic operations we perform.  As a result, embarking on another surgery should be taken with care.  Mild problems are sometimes better left alone as there is a chance that the outcome could be worse, however, significant problems have a better risk/benefit profile. As you undergo more and more operations, the nose structure is weakened unless additional cartilage is added to make the framework resilient. Patients often need to have either rib or ear cartilage used in these kind of reconstructions.

You should consult with an experienced secondary/revision rhinoplasty surgeon who is adept at these complicated techniques. A perfect nose isn't a realistic expectation, but one that fits your face, is well balanced and functions is a reasonable goal.

Best of luck

Vincent Marin, MD, FACS

San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 47 reviews

Revision Rhinoplasty

A third revision Rhinoplasty and you may end up with  more problems.

Consult an ENT surgeon for air flow studies and see what is the problem. See a plastic surgeon and between the two opinions you may have a good idea of the cause of nasal obstruction and treatment options and POTENTIAL RISKS.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Nasal obstruction after second rhinoplasty

Removal and/or narrowing of your nasal cartilages beyond the level needed to support the nasal passages does result in nasal obstruction.  This may be corrected with cartilage grafting of your nose

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Breathing Trouble Post-Rhinoplasty

This is clearly a case that needs to be thoroughly evaluated by a skilled rhinoplasty and/ or ENT surgeon. There are a variety of reasons as to why your breathing is now worse.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.7 out of 5 stars 132 reviews

Difficulty breathing after rhinoplasty (nose job).

Twenty to thirty years ago rhinoplasty (nose reshaping) was considered a reductive operation or one in which we resect and remove cartilage to give a smaller nose.  Today, as surgeons, we recognize that these operations had disastrous functional results.  Patients had difficulty breathing for years after surgery.  As a consequence, rhinoplasty has technically changed from resecting cartilage to repositioning it.  The open rhinoplasty technique has allowed more precise and stable graft placement.  Rhinoplasty surgeons are now not only creating a more aesthetically pleasing nose, but a stronger functional nose.  A good rhinoplasty surgeon will not only enhance the aesthetic aspects of the nose, but respect and improve the nasal airway at the same time.  

Etai Funk, MD
Houston Facial Plastic Surgeon
4.9 out of 5 stars 66 reviews

Breathing problems after rhinoplasty

There are many reasons for airway obstruction after rhinoplasty, including the septum, nasal structure, and/or mucosa.  Because of that you would need an evaluation first.  Begin with your most recent surgeon, since they are most familiar with your surgery specifics and may offer corrections.  If not, a third source might be necessary and a third procedure. 

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 14 reviews

Breathing Problems after Rhinoplasty

A complication seen after rhinoplasty, specifically after multiple procedures, is airway obstruction.  Solid results after rhinoplasty maintain both the form and function of the nose.  A careful balance must be achieved between aesthetic and functional success of the procedure.  An outstanding aesthetic result is of no use if the functional integrity of the nose is compromised.  It is possible you can be suffering from a number of problems such as internal or external valve collapse, overall lack of structural integrity of the nasal framework, or septal abnormalities to name a few.  I would suggest you be seen by a surgeon proficient in revision rhinoplasty surgery, and have a comprehensive external and internal exam of the nose to figure out the problem.... Good Luck ... Dr. Corrado

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 35 reviews

Breathing Troubles Due to Rhinoplasty

A reduction rhinoplasty may cause compromised breathing post-op,  There are many possible causes of this problem - you need to be examined by an ENT physician or a plastic surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 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.