Is breathing through one nostril bad? ( is it curable?)

A thorough evaluation of nasal breathing can be one of the
most complex assessments done by a facial plastic surgeon. Categorically the
sources of obstruction can be divided into two groups. Mucosal disease (puffy
and stuffy nasal lining) or structural/anatomical issues.


The first category can be due to a variety of reasons, the
most common ones being allergies, infections, chemical irritations, or systemic
diseases. These are diffuse processes that will affect both sides of the nose
equally. One of the common areas of obstruction with this regard is considered
to be the inferior turbinate hypertrophy, referring to the spongy tissue on the
sidewall of the nose that can chronically expand and limit the nasal airflow. However,
understanding the concept of nasal cycle is key in assessment and interpretation
of turbinate hypertrophy. Nasal cycle refers to the universal phenomenon that
every couple of hours one side of the nose becomes dominant for breathing, as
the other side gets engorged with more blood flow. Thus, a snapshot visualization
of turbinates might not be an accurate indicator of their role in an individual’s
obstructive symptoms, as one would not know their cycling state.


The structural category of obstruction starts with deviation
of nasal septum (midwall partition of the nose) as the most common cause. This
can be either congenital (patient is born with deviation) or acquired (for
example, due to previous trauma or surgery). It is known that around 70-80% of
people have a noticeable septal deviation on the exam. However, not all those
people will complain of subjective nasal obstruction. Thus, it is usually the
degree of deviation and/or presence of another underlying constrictive factor
that makes the patient symptomatic. Such distinction could be one of the most key
and challenging aspects of nasal congestion evaluation. The pattern of
deviation could be such that patient can recall being consistently obstructed
on one side. However, in some severe cases, the deformed septum can have turns
and twists affecting both sides and making the assessment more challenging. Other
major structural issues contributing to nasal obstruction include internal or external
nasal valve constriction, adenoid hypertrophy, polyps, concha bullosa, and
tumors.  

Breathing through one side at a time is normal for the nose. it is called the nasal cycle. This has to do with the nasal turbinates. A crooked nasal septum can make one side always more blocked. You might need medical treatment by an otolaryngologist or allergist. This can sometimes fix the issue. Bur you should get an exam by someone who is well versed in nasal function.

Breathing through one nostril that switches from side to side can be due to allergic rhinitis causing swelling intermittently on one side of the nose and then the other one, referred to as the nasal cycle. This can be treated with medication. If the obstruction is more static, then a septoplasty may correct it.

Nasal obstruction that alternates sides is most commonly due to turbinate hypertrophy. The turbinates are often reduced during septoplasty or other nasal surgical procedures in order to improve the nasal airway. The turbinates swell in response to inflammation such as allergens, smoke, etc. If symptoms do not response to medical management, such as a nasal steroid spray, then surgery may be an option.
Be sure to see a nasal surgery expert.
All the best,

Hello Ivan and thanks for your question.Given that the nose and nasal breathing passages are three dimensional structures, a complete examination is needed to determine the diagnosis and the exact reason for breathing difficulty. In our office we used a headlight and other instrument to come up with the exact cause for this issue.  
The following are the 3 main reason for mouth breathing and difficulty breathing through the nose:1. Septal deviation2. Turbinate enlargement3. Nasal Valve collapse4. Major allergic rhinitis5. Any combination of the above.I would highly recommend visiting a few plastic surgeons who specialize in this exacting and artistic procedure. In our office we provide patients with a personalized, individualized and complementary consultation to address these similar issues.
For more information and many before and after examples please see the link below.
Best wishes and good luck.
Dr. Sajjadian