Will rhinoplasty affect my voice?

Any surgery to the outside or the inside of your nose can potentially affect your singing voice. If you are only having changes to the outside it is less likely, but any internal work can possibly have a big effect on the quality of your singing voice. I strongly caution professinal singers against doing nasal surgery unless they are willing to take the risk.

It is generally accepted that cosmetic rhinoplasty will not affect your voice. Not to worry. Dr. G

This is a very good question, because this is obviously a concern for those who sing professionally.  My advice to patients is that although it is possible that there will be vocal changes, it is highly unlikely.  The biggest risk to the voice during Rhinoplasty is intubation, or placement of a breathing tube past the vocal cords.  To ensure the patients safety, I use a Board Certified Anesthesiologist to make sure that the intubation is smooth, and I place the patient on Prevacid (proton pump inhibitor for gastric acid control) for 1 week before and 1 week after the procedure.

Being based in West Hollywood, we see many patients who work in the entertainment industry. A natural concern is whether rhinoplasty can alter the singing voice. If the patient has a severely deviated septum and a nasally voice to begin with, then a septoplasty to straighten the nose and correct breathing issues may potentially remove that nasally quality to the voice. Otherwise, a nose job will not have any affect on the voice.

Some patients may be concerned that rhinoplasty could
lead to a change in their voice, particularly relevant to specific professions
that are dependent on personal vocal character. There was a scientific research
study published in the Plastic Reconstructive Surgery Journal in January 2014 that
concluded that patients should be advised of a possible risk to voice changes
following a nose job. This study was conducted in Iran, with Farsi speaking
patients and there was a self-assessment component to the study that may have
led to inaccuracies in the data collection and potential flaws in the study.
Generally speaking surgeons in the USA and Europe, believe that the risk in
rhinoplasty effecting voice is very small. There are many potential variables
that can influence your voice and vocal acoustics including the anatomy of the
voice box, ethnicity and language (Middle Eastern languages including Farsi can
have a more nasal component relative to English or European dialects). Dr. De
Silva believes that in the great majority of his patients voice is not affected
by rhinoplasty, however in certain patients with specific anatomy, ethnicity,
certain lingual dialects there maybe subtle changes in voice. Often patients
who have functional breathing issues with their nose benefit from rhinoplasty,
as the nasal airways may be opened during the surgery and the nasal tonality
reduced.

Immediately after the surgery as a consequence of
swelling there is likely to be a change in the quality of your voice as a
consequence of swelling and congestion. However with the resolution of the
swelling over the first period of weeks, the natural vocal characteristics
return.

A further consideration in effecting voice during
surgery is the type of anaesthesia. Geneal anaesthesia often involves placement
of a tube inside your airway that has the potential to damage the vocal cords.
Dr. De Silva continually uses newer technques to reduce potential risk and
improve results, and avoids the potential for trauma in rhinoplasty by using
twilight anaesthesia also known as sedation. By using sedation anaesthesia, no
tube is placed in the airway, and this avoids potential mechanical damage to
the airway associated with general anaesthesia.

Professionals dependent on their voice for career
should consider subtle changes to their voice before undergoing rhinoplasty.
Most people report an improvement in singing after rhinoplasty coupled with
septoplasty with or without turbinectomy, as the airways are more open after
surgery. However every person’s situation is unique and your concerns should be
assessed and discussed with your surgeon. Although all surgery carries
potential risks, the influence of rhinoplasty on altering voice is relatively
small. Dr. De Silva takes care to ensure necessary precautions are taken with
rhinoplasty to ensure the airway is maximized during surgery to improve
breathing and reduce risk of changes to voice. Dr. De Silva has completed
numerous rhinoplasty procedures on professionals dependent on their unique
vocal characteristics including actors, actresses, vocalists, singers and
celebrities taking precautions to preserve vocal character.

The rhinoplasty procedure should not affect the voice appreciably.  There might be some very, very subtle differences if this is a large volume reduction rhinoplasty and the patient is a professional singer.  It would be very subtle at best.  

Hi Malaysia7444,

Great question.

Yes, rhinoplasty surgery could potentially alter the voice. Most of the voice changes are in the immediate period of healing due to swelling, mucous, or congestion, and generally resolves with time. Long-term changes to the voice can theoretically occur by altering the resonance of the voice. However, any voice changes are undetectable, except to professional vocalists. Some vocalists appreciate the change or improvement, while some don't. I agree with Dr. Yagoda, and only after a comprehensive evaluation can a rhinoplasty surgeon, laryngologist, and your vocal coach help determine appropriate options for you. Best of luck.

Dr. Chaboki

Properly done rhinoplasty should have no effect on your voice. If the internal functional aspects of the nose are improved during the surgery (such as fixing a deviated septum) there is a strong likelihood that your vocalization should significantly improve. This is because the air flowing through your nose through your vocal chords is freer to move with no obstruction. The other important thing to consider is that under general anesthetic a very small diameter tube should be place through the vocal chords in order to avoid any damage. I've operated on a number of celebrity singers and none of them have ever had any problems at all after the surgery. Of course, you must realize that there is always a tiny chance that voice changes could occur despite your best efforts and you must take this into consideration when deciding upon having elective cosmetic surgery.

Dear Malaysia,

As a Facial Plastic Surgeon and Otolaryngologist specializing in care of the professional voice, I will tell you that rhinoplasty and any nasal surgery can change your voice.  However, this is regarding sounds purely produced through the nose.  For example, the "mmm", "nnn" and "nng" sounds will be clearer.  Sounds that come purely from the mouth like the "ppp"  and "ttt" will be unchanged. 

Singers often fear nasal surgery when they are armed with misinformation. For example, singers often refer to Barbra Streisand's choice not to have surgery because it might alter her voice.  Ms. Streisand's  trademark sound was humming, a sound produced mainly through her nose. In addition, her "nasal twang" was due to hyponasal air flow...that is that too little air was emitted through the nose.  Properly done surgery, by nature, will increase air flow through the nose.  For most singers, this will result in clearer sound and the need to use less diaphragmatic support to emit the same sound volume.  However, as in Ms. Streisand's case, nasal surgery could reduce the "nasal twang: so loved and characteristic of Ms. Streisand's voice. 

Best of luck in your decision.

Dr. Michelle Yagoda, NYC Facial Plastic Surgeon and Otolaryngologist specializing in care of the professional voice

Hello, friend in Malaysia.

You need not worry. Rhinoplasty will not change your voice.

Dean Martin, a great and famous American singer never suffered any voice problems after his rhinoplasty. Neither did Milton Berle, Fannie Brice and others.

If rhinoplasty changes peoples' voices, fewer such operations would be done. Go for it!!!

Best wishes.

-Robert Kotler, MD, FACS