Nose Surgery for Breathing Problems

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.

Hello, thank you for your inquiry. Rhinoplasty is not just a cosmetic procedure, it can be performed to improve your breathing as well. It is a low risk operation, but with any procedure on your face, you may have questions and concerns. Rhinoplasty will change the appearance of your nose. Best wishes!

Every patient is different when it comes to nasal breathing and the shape of the nose. In many cases, nasal breathing can be improved surgically without changing the shape of the nose much, if at all. This surgery might consist of septoplasty, turbinate reduction, and/or repair of the nasal valve. In some cases, septoplasty or nasal valve repair might change the shape of the nose somewhat, but these changes are usually relatively minor.
If there is significant nasal or septal collapse, such as a saddle nose deformity, it's possible that a full rhinoplasty procedure might be needed to rebuild the structure of the nose, which would change the shape of the nose as well.
Each procedure and patient are unique, so be sure to see a nasal expert like a facial plastic surgeon for appropriate diagnosis and treatment.
All the best,

I have found that using computer imaging for rhinoplasty patients is an excellent teaching tool and helps allay a lot of fears patients have about "looking different" after surgery. I would suggest finding a physician who offers this during the rhinoplasty consultation to make sure you both are on the same page before your surgery.

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. Best, Dr. Karamanoukian

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.