Will I really lose breathing ability with a rhinoplasty permanently?

Question

I had a consult w/ a known rhinoplasty surgeon & he said I'm most likely going to lose 30%-40% of my breathing ability after the procedure. I have a halo bulbous tip, slight pump, deviated septum. He wants 2 make my tip smaller, narrow my nose, reduce bump, break my nose in 3 places. I breath perfectly now & don't want to feel like I can't breath. Is this common? Can any doctors speak to this? Does this mean what he wants to do is too drastic or just the reality of the procedure? Thanks!

Toby Mayer, MD · Answer

Your breathing should not be worse after septorhinoplasty! See a more experienced rhinoplasty surgeon who can give you good airway and an attractive nose!

J. Phillip Garcia, MD, FACS · Answer

Hello,
Rhinoplasty is not only a cosmetic but a functional operation.  This means that breathing should either stay the same or improve after the operation.  In the majority of cases the breathing improves. Decrease in air flow after the operation is unacceptable in ANY type of rhinoplasty.  There is always a recovery period after the operation in which nasal congestion is normal but in a few weeks the breathing should be improved. I recommend seeking another consultation with an experienced rhinoplasty surgeon.
Regards,

Aaron Stone, MD · Answer

Are you sure he/she said that? That is a significant loss in nasal airflow and if it was common most people would not have the surgery. Straightening a deviated septum usually improves nasal airflow. If the nasal bones are short the combination of septoplasty and removal of the hump with infracture can cause too much narrowing of the nasal airway. In that case your options would be 1) leave the hump 2) tip the top of the nasal bones keeping the bottom out with packing or 3) place spreader grafts prophylactically to avoid the narrowing. Without photos or a face to face examination no doctor can say anything specific with respect to your case. You should either see that surgeon again to make sure you did not misunderstand him/her and/or see another surgeon.

Johnson C. Lee, MD · Answer

A rhinoplasty should not compromise your breathing ability to achieve a great aesthetic result. Often times, rhinoplasties can be done to even improve breathing by modifying the septum or placing grafts that help open up the airway. You should consider asking surgeon or other surgeons what steps they may take to help minimize any risk of losing your ability to breathe through the nose. Hope this helps!Johnson C. Lee, MD Plastic Surgery @drjohnsonlee

William Portuese, MD · Answer

A thorough internal  examination of the nose is required to answer your question. A rhinoplasty procedure to adjust the tip, bridge, and hump alone should not affect your breathing unless there is already a significant deviation of the nasal septum on the inside. If that's the case, then perform a septoplasty in addition to a rhinoplasty procedure to ensure proper breathing after the rhinoplasty procedure.

Chase Lay, MD · Answer

If it's a "known" rhinoplasty specialist he/she is probably just giving you the facts based on your goals.  Listen to surgeons when they give you cautionary information prior to a surgery.  More than that, get a few more consults.  Duh.Chase Lay MD

Anup Dhir, MD · Answer

Hello and thank you for your question. It is difficult to comment on your case without examining you. Generally, there should be no breathing problem after rhinoplasty. Maybe you should get a second opinion from another cosmetic surgeon.therhinoplastysurgeon.com

Arian Mowlavi, MD, FACS (license on probation) · Answer

I will have to disagree with your portrayal of your planned septorhinoplasty which should in fact make you breathe better. Lessening the bulbous tip bulk will actually take weight off of your external nasal valve; Performing osteotomies to improve dorsal contour should actually make you breathe better; a septoplasty is supposed to make you breath better (that is the only goal of a septoplasty).

Jon A. Perlman, MD (retired) · Answer

Some patients are at risk of airway obstruction if proper techniques are not employed to protect the airway when a dorsal hump is removed.  Spreader grafts, turbinate crush and outfracture and septoplasty are techniques that are used to protect the airway in appropriate cases.Perhaps you should consider getting a second opinion if you're certain that you understood the initial consultants warning.  Best wishes,
Jon A Perlman MD FACS 
  
Certified, Am Board of Plastic Surgery 
  
Member, Am. Society for Aesthetic Plastic Surgery (ASAPS) 
  
Member, Am. Society of Plastic Surgeons (ASPS)
  
Beverly Hills, Ca

David Alessi, MD - Account Suspended · Answer

A competent surgeon will improve your appearance and improve or maintain your airway.  It is highly unlikely that a rhinoplasty plan would include making your airway worse.  There are things that can be done to minimize any impact that making the nose small should have on breathing.  Seek out a consultation with a double board-certified surgeon in Facial Plastics and ENT for a consultation.  Best wishes.

Will I really lose breathing ability with a rhinoplasty permanently?

Answers (11)

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