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 26

Functional Rhinoplasty

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
4.9 out of 5 stars 60 reviews

Airway surgery

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 108 reviews

Nasal breathing and Functional Rhinoplasty

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
4.7 out of 5 stars 44 reviews

Deviated septum can be corrected without changing nose appearance

Unfortunately everyone fears looking unnatural. This is up to your surgeon's aesthetic understanding, ethics, and experience in rhinoplasty. As you may already know, rhinoplasty is the most challenging and meticulous procedure performed by Plastic Surgeons. This is why you see so many "bad noses" out in public. You cannot hide or camouflage a bad nose job.

Also, it is much harder to correct a nose after a rhinoplasty to improve breathing. The best shot at it is the first time. It is very possible and is always the foremost goal of my practice to improve nasal features and not only not affect breathing but to improve it. When someone wants ONLY their breathing improved then the goal is just that.

Having said that, depending on the type of nose and what causes the breathing problem, anatomically, sometimes a SUBTLE change in appearance may be produced. I always discuss this with my patients during the consultation. A change in appearance is many times not produced. It all depends on the the anatomy.

For example: If the nasal blockage is in the internal valves (inside the nose) then a spreader graft may be needed to open up the angle and passage way. This may slightly widen the middle third of the nose but usually not enough for someone to notice (once the swelling is gone!). However, if the blockage is only on one side, then only one side gets straightened and may become a little wider.

Breathing problems that are only a result of a deviated septum can be corrected without changing any of the noses appearance. If the deviation causes a twist in the nose, then obviously the nose will look different when it is straightened, but for the better.

More often than not, patients want some change in appearance at the same time while we are working on the breathing. There are too many variations to discuss here. However, your surgeon will be able to tell you if your breathing problem will have any effect on the appearance.

For the most part, it is only small changes that may not even be noticeable or ZERO change at all. Only a detailed exam will tell you.

Ashkan Ghavami, MD
Beverly Hills Plastic Surgeon
4.1 out of 5 stars 96 reviews

Nose surgery for breathing problems

A septoplasty and/or rhinoplasty can help improve your breathing and does not have to be performed in a manner that changes your profile or look.


Dr. Karamanoukian

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 93 reviews

Rhinoplasty for Breathing Problems

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
4.0 out of 5 stars 7 reviews

Nose surgery without changing your loooks

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
4.9 out of 5 stars 60 reviews

Airway surgery without changing the shape of the nose

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 15 reviews

Correcting nasal breathing problems without altering the external appearance

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 18 reviews

Most breathing problems can be fixed without changing look

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
4.7 out of 5 stars 34 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.