What are the difference between Vestibular stenosis/ functional rhinoplasty and a septoplasty?

I recommend you see a rhinoplasty expert who also performs a nasal endoscopy as part of your examination to assess your nasal cavities. Nasal breathing is rather complex and nasal obstruction is typically multifactorial. It is impossible to make a recommendation via this forum as to which surgery is best for you. With that said, a septoplasty is often performed in conjunction with a rhinoplasty; not only to straighten a possibly deviated septum, but also to harvest septal cartilage for grafting purposes to support your nose in deficient areas to allow you to breathe better. In fact, a rhinoplasty for functional purposes to improve nasal breathing can only be performed in conjunction with cartilage grafting (preferably from the nasal septum). A rhinoplasty without cartilage grafting frequently leads to worsening nasal breathing from nasal valve collapse over time. Nasal vestibular stenosis repair is a generic term where cartilage is utilized to support the nasal sidewalls for functional improvement. Best wishes!

Rhinoplasty is commonly preformed to improve breathing and relieve nasal obstruction.  Nasal obstruction can be caused by multiple caused including:Deviated SeptumNarrowed nasal valveNarrowed opening on the noseWeak and malpositioned cartilage of the noseFor these reasons, the examination of the nose is critical to identify the cause of nasal obstruction and the correct surgical plan.  It is impossible to answer your without an examination.  

vestibular stenosis is a condition.functional rhinoplasty is any operation that treats breathing, not just shape of the breast.septoplasty is the specific operation that treats a crooked septum.Be sure to discuss with your board certified plastic surgeon exactly what your goals are, and how reliably they can be expected to be achieved.

Hello, it may be helpful to think of the nose as two separate but related parts. There is the breathing/function portion and the outward/external portion. The external portions (ie the appearance of your nose) can be changed without necessarily changing the breathing portion, and vice versa. Additionally both the appearance of the nose and the function of the nose can be altered at the same time in the same procedure.  If both issues are being addressed, it often requires some surgery on the septum (aka septoplasty) and then alterations to the outward appearance of the nose which can include reshaping the tip cartilages.  I would recommend asking the surgeon specifically what portions of the nose he/she will be addressing and what the intended goals are with each respective portion. Hope that helps and good luck. 

Great Question!  A septoplasty can be done by an ENT or a plastic surgeon.  They take the crooked cartilage out, which often helps open the nose and helps the patient breathe better.  For some people this is all they need.  A septoplasty is a surgery for breathing and does not affect how the nose looks at all. 
Repair of vestibular stenosis is actually a cpt code that is billed in a functional rhinoplasty.  A functional rhinoplasty is a "nose job" that is done with the primary goal of improving breathing.  While a well done functional rhinoplasty should also look good, the goal (for insurance) is breathing, not looks.  We differentiate this from a cosmetic rhinoplasty, which is where the patient breathes fine but wants it to look different.  I would argue that any rhinoplasty done well should look great AND help you breathe better.   The difference is drawn mostly for insurance.   
The repair of vestibular stenosis is a code for putting in spreader grafts.  These are little cartilage grafts that work like "internal breathe right" strips.  For some people who have valve collapse in addition to a deviated septum, both procedures are needed.
The way to find out what you need is to visit a facial plastic surgeon.  This is a doctor who trained in ENT but also in facial plastic surgery, so they are expert in form and function of the nose!  A thorough evaluation and looking in the nose with a camera (endoscopy) will tell what you need.
Best of luck
Dr Rodman

  Vestibular stenosis refers to the very narrow angle between the septum and the upper lateral cartilage where airflow goes through.  A functional spreader graft can help open up the angle to improve airflow.  A septoplasty is performed in the back of the nose to improve airflow dynamics when there is a deviated septum present.  Functional rhinoplasty improves air flow through the nose, but does not change the shape of the nose.  Medical necessity and preauthorization are prior to performing the surgery and billing medical insurance.  A visible change to the nose is considered cosmetic rhinoplasty, and must be paid for by the patient.

Deviated septum refers to crookedness or deviation of the center dividing wall of the nose resulting in blockage. Vestibular stenosis or nasal valve collapse refers to inadequate strength or narrowing of the sidewalls of the nose resulting in collapse during inspiration from the inspiratory airflow pressure. In some cases it may refer to actual fixed narrowing of the nasal entrance from scar tissue or injury. These problems can occur individually or together.

What a great question! This is honestly one of the most confusing terms out there. It exists because of insurance issues. Rhinoplasty is surgical term meaning nose surgery. It can affect aesthetics, breathing, or both. Often it includes a septoplasty during the operation but not always. Vestibular stenosis means internal or external valve collapse which mean narrowing of the nose leading to breathing issues. Insurance covers this and for insurance we call it "repair of vestibular stenosis". If you are not going through insurance we refer to generally as rhinoplasty. During that rhinoplasty there are maneuvers (spreader grafts for internal valve collapse or alar batten grafts/rim grafts for external valve collapse) that we can do to help you breath better. Don't get caught up in the details of the grafts. They are common parts of many rhinoplasty procedures as many people have some amount of valve collapse (ie. vestibular stenosis).
Septal deviation is only fixed by straightening the septum (septoplasty) which can be done alone or as part of a rhinoplasty to make the nose look different or to fix other parts of the nose (valve collapse/vestibular stenosis). I hope that helps clarify this confusing issue!
Jeffrey Watson

Fellowship Trained Rhinoplasty Specialist
M.D., Harvard Medical School

Great question. I do this operation weekly and patients often come to me with airflow issues and don't understand the difference. I enjoy explaining this one! A septoplasty can be done through a simple incision inside the nose. It removes the crooked part of the septum that is causing airflow problems on one side, sometimes both sides. Another part of the airway that often causes a problem is the INTERNAL nasal valve or vestibule. This is the narrowest part of the airway and so if it is opened up, it causes great relief! This is what Breathe Right strips do. They open the internal nasal vale. If you use your finger and pull the face skin up and out next to your nostril, it opens this valve inside. It's not actually opening the outer nostril part, which most people think is the problem. Essentially, a functional rhinoplasty repairs this narrowing by giving you a permanent internal Breathe Right strip (speaker grafts). The only way to do this is an open rhinoplasty approach, which means a small incision on the columella (skin between the nostrils). At the same time your nose can be reshaped cosmetically, but you'd have to pay a cosmetic fee.