Functional rhinoplasty options to help with breathing?

Hello and thank you for your question. Addressing breathing issues is actually one of the most common reasons people seek out and undergo a rhinoplasty. An open rhinoplasty can best address both the functional issues and any potential aesthetic concerns with your nose. I would be able to open up and reinforce your internal and external nasal valves to improve the airflow through your nose!

This truly a surgery of millimeters- and whether you're looking for a minor adjustment or a major transformation, it requires exceptional surgical skill to achieve functional and natural-looking results! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually).

I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination.

A septoplasty and turbinate reduction can improve breathing but also breathing can be improved from a rhinoplasty. If you have a collapse of the internal nasal valve then this can be corrected. I would need photographs to give you a more accurate answer. Also, there is no such thing as a general plastic surgeon. Plastic surgeons are completely trained.

Best Wishes,

Gary Horndeski, M.D.

Hello and thank you for your question. It is difficult to provide a complete opinion without a more detailed description of your concerns. After a turbinate reduction, turbinates can certainly grow (hypertrophy) and be amenable to a repeat reduction. Revision septoplasty is sometimes required in patients who develop a subsequent deviation. Internal and external nasal valve collapse could also be contributing to your concerns. An in person consultation with a board certified otolaryngologist (ENT) may be of great benefit to you to address your breathing concerns.

Many people experience airway blockage in their nasal valves, and this may be repaired with cartilage grafting, depending on somebody's condition. Since you have had previous nasal surgery, I would suggest that you visit with several reputable rhinoplasty specialists so you could see what you expect moving forward from both a functional and cosmetic standpoint. If you do not have enough nasal septal cartilage available for reconstruction, sometimes rib cartilage is necessary. We prefer autologous rib from a tissue bank. Wishing you well moving forward. Sincerely, Dr. Joseph

Thank you for your query. In addition to what you have already had done , the internal valves sometimes need to be addressed. Spreader grafts can be used to open the valves if indeed there is a problem in that part.. Please find an experienced rhinoplasty surgeon who can examine you and help you with all your concerns. All the best

Hello, hope you are well. This is sort of like asking, "I renovated my house a year ago, but I'd like to make it better--what else can I do?" It depends on the current state of your house. Did the last contractor do a good job with the septum and turbinates? Are there nasal valve issues that can addressed with functional rhinoplasty? With a functional rhinoplasty, cartilage grafts are usually used to strengthen the collapsible parts of the nose but there are countless variations on that theme. As you said, you need to see an actual physician who can examine the inside of your nose and identify any areas where there is further room for improvement. I recommend a dual-board certified ENT/Facial Plastic and Reconstructive Surgeon.

Best,
Dr. Tower

Hello and thank you for your question. Rhinoplasty can be designed to help with functional issues as well. Find a surgeon (plastic surgeon or ENT) who specializes in rhinoplasty. I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up. Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag. If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag. Long-term results are much more meaningful than on table results or 1 week post-op results. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

There are many different issues that can cause nasal obstruction, which include chronic sinusitis, your turbinates grew back, external valve collapse, internal valve collapse, and of course allergies. Probably best to see a double board-certified ENT/Facial Plastic Surgeon for an in-person evaluation. If you have chronic sinusitis, then consider getting a CT scan of your sinuses. If you think you have bad allergies, it's best to try nasal sprays, antihistamines, and decongestant. If that has failed, then consider allergy testing by an allergist. Functional rhinoplasty includes possible placement of spreader grafts and Alar batten grafts for both internal and external valve collapse.