Chances of Good Cosmetic Result from Functional Rhinoplasty?

I broke my nose as a child had a functional Rhinoplasty, then a cosmetic Rhinoplasty a few years later - everything great for 20 years but now, a couple of years rhinitis (enviromental) has weakened everything, and I have both internal and external valve weakness.

I have had this confirmed by 2 surgeons. If I inhale forcefully my nostrils close. Its causing sleep apnea and breathing problems and I have been offered an op to correct the problem using grafts. Does this type of surgery always make the nose look wider and any tips for a good cosmetic result?

Doctor Answers 12

Functional and cosmetic rhinoplasty: one and the same

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Form follows function. The two are tied together. Nostrils that collapse on inspiration are often the result of thin lower lateral cartilages, and are usually fixable. Usually, the nose looks better when this is done, and the "done look" of an overly pinched appearing tip can be reduced or eliminated.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Impact of functional surgery on Nasal Appearance

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Having a good functional and a good cosmetic result after nasal surgery are not exclusive. In rhinoplasty surgery a change in one part of the nose may necessitate a change in surrounding tissue to achieve a balanced, proportional, attractive nose. See an experienced surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Functional rhinoplasty results

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The functional aspect of the nose sounds like valve flaps and vestibular stenosis. This is repaired through spreader grafts placed internally on the inside of the nose to spread outwards the upper lateral cartilages. Indeed the nose will look 2 mm wider on each side at the mid-third of the nose when these grafts are placed. It will also help the breathing and bolster the upper lateral cartilages so they do not flail and flap inward upon inspiration. If your sleep apnea is very severe this may have to be done. It cannot be done as an outpatient procedure, but may have to done at a hospital with an overnight stay.

Cosmetic Result with Functional Rhinoplasty

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If grafts are placed inside the nose, it will appear wider. When done properly by a highly skilled surgeon, cosmetic results will be optimized. In this case, achieving optimal function will result in a modified appearance, but it is possible to perform the surgery in such a way that the nose will still be aesthetically pleasing. Hope this helps answer your question. Thank you and best of luck.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Functional and aesthetic surgery of the nose

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The approach to nasal surgery must always include consideration of aesthetic and functional ideals. In the case of functional surgery, techniques exist that can improve 'valve' function and preserve nasal form (for the most part). Of course, each situation must be dealt with individually and you would need a personal examination to determine what is right for you.

The nomenclature of 'external valve collapse' and 'internal valve collapse' is poor and leads (in my opinion) to much ambiguity and lack of consensus for optimal treatment among surgeons. It is important you find someone who is knowledgeable in both functional and aesthetic surgery to increase the chances of an optimal result.

Good luck to you!

Sam Most, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

Dynamic and Fucntional restoration of the nose and airway: possible cosmetic consequences

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The key thing here is the dynamic appearance of the nose. If you took a picture when breathing in deeply now, you would likely have a pinched appearance to the nose. If you fix your nose with structural supporting grafts, it is likely that your nose will look nearly the same at rest but look better when you forcibly inspire.

Cosmetic Result from Functional Rhinoplasty

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Although a functional rhinoplasty is just that, functional, we, as surgeons, strive to make it as cosmetic as possible. This is especially true when we must do something to the external nose, as you need. To find out what you can expect, you need to talk to the surgeon you choose at length.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Cosmetic results from functional Rhinoplasty

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Your nose may appear wider if spreader grafts are placed to keep the valves open. This should be a subtle change unless your nose and your skin are very thin. The best tip for a good cosmetic result is to go to someone very experienced with revision rhinoplasty. Look for someone in your area who is certified by the appropriate board, and do ask to see before/after photos. Good luck.

Functional rhinoplasty for nasal collapse.

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 Your own cartilage can be used to open your airway with minimal increase in width. You should see an experienced revision rhinoplasty surgeon to do this.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Revision rhinoplasty to restore breathing can look natural too

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Rhinoplasty has evolved over the past three decades. We now leave more structure or put structure in to support the nose and keep it from collapsing with breathing; also to withstand aging. Placing grafts in revision surgery to treat internal and external nasal valve collapse can strengthen the nose and improve breathing, even reduce apnea if the nose is a contributing cause. The nose may appear a little bit wider, but not in an unaesthetic way. Grafts can be placed so that the walls of your nose are strengthened but don't look "fat." I suggest you seek out a specialist in revision rhinoplasty to discuss your goals and concerns.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 134 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.