Can Rhinoplasty Surgery Make my Breathing Worse?

When it comes to rhinoplasty, form and function go hand in hand. A nose which is straight, well balanced and well-constructed should also function well in terms of breathing. After rhinoplasty, there may be a period of a few weeks or months during which the nose is more congested than baseline but this should be a transient phenomenon. In the long run, rhinoplasty which is performed by an expert surgeon should improve your ability to breathe (if you have any difficulty) or maintain your nasal airway in cosmetic surgeries. 

Thank you for your question. Rhinoplasty surgery has no direct effect on bad breath. Bad breath is mostly caused by cavities, gum disease, respiratory infections, or bronchitis. In some cases, it can be due to sinus infection but rhinoplasty surgery does not cause these issues. Hope this helps.

It is very true that older techniques in rhinoplasty could make patients have breathing problems. Modern structural rhinoplasty is very different. Using surgery methods that are non-destructive we can deliver very good cosmetic changes without sacrificing function. In my practice we often combine functional and cosmetic surgery where we are making patients breath better while improving the appearance of their nose. It is essential that you talk to your surgeon about these concerns and make sure they use modern structural techniques

There is always a risk of compromising breathing when performing rhinoplasty. Although preservation of critical aspects of the anatomy are respected during the rhinoplasty procedure, this is not always possible. From a strictly physical perspective it is harder to breathe through a smaller structure and in most instances, the aesthetic goal is to achieve a smaller nose.

The great majority of air on breathing in flows through the bottom portion of the nose, therefore efforts to narrow the bridge and usually the middle third of the nose have little impact on the breathing. However, overzealous resection of cartilage of that mid-third, and/or narrowing of the nostrils can in fact reduce air movement. This is something you need to discuss with your surgeon, who if he is also an otolaryngologist/ENT, can for sure properly advise you about.

It has been proven that a properly preformed rhinoplasty actually improves breathing. However, whenever you have surgery on the nose, there is a chance that breathing may worsen. For this reason, it is important to pick a highly skilled surgeon to maximize your chance of a good outcome.  

Some of the maneuvers that refine and reduce the nose may lead to problems with nasal breathing even if such problems did not exist before surgery. Fortunately, an experienced surgeon will widen and support the nasal valve and/or bolster the nasal tip to prevent this from happening. Also, it is important to remedy any deflections of the nasal septum or enlargements of the turbinates (mounds of tissue inside the nose that are involved in warming and humidifying inspired air) at the time of surgery. See a facial plastic surgeon for a thorough evaluation of the septum, turbinates, and nasal valve.

The rhinoplasty operation, if done incorrectly, can certianly worsen the breathing. The surgeon should evaluate the nose internally to make sure there are no anatomical issues can be addressed durring the surgery. The surgeon should also perform the rhinoplasty in a method that conserves the nasal tip cartilages, instead of  removing them. Older techniques thinned and reshaped the nose by removing cartilage. Today's techniques shape the nose by reshaping the cartilages rather than removing or cutting them. Make sure your surgeon practices the latter technique.

You certainly don't have to sacrifice a smaller, better looking nose for a well functioning nose. When done well, cosmetic rhinoplasty should not lead to a worsening in nasal breathing. However, there are some surgeons who use a more reductive approach to surgery which can lead to problems down the road with scarring, pinching and chronic nasal obstruction. I have performed revision rhinoplasty procedures in many patients who remark that their nose looked great for many months (or even a couple years) before they began having difficulty with breathing. It's important to ask your prospective surgeon what techniques they use to help prevent this from happening.

Part of preoperative planning is informed consent: A Surgeon discusses all of the potential risks and benefits of a procedure with a  patient and the patient acknowledges (in written form) that the Surgeon has done so and that all of the patient's questions were answered. When discussing Rhinoplasty, the possibility of temporary and permanent nasal obstruction should always be discussed.  With modern Rhinoplasty techniques, great emphasis is placed on preservation of nasal function;  in experienced hands, nasal breathing should be unaffected or even improved.  Most patients get some degree of nasal stuffiness (related to swelling of the nasal lining), that gradually improves over the course of several weeks.