Scar Tissue / Adhesions Post Rhinoplasty

I had primary (closed) rhinoplasty 6 months ago as well as a turbinectomy. I'm now having problems breathing as it feels like there is something blocking my nose. I also feel a lot of stretching/pulling/tugging inside. When I look inside, I see bands of skin that seem to be pulling inward (bottom outer area towards the center of the nose). These seem to be getting tighter as my nose heals and with that, it's getting harder to breath. Is this scar tissue easy to remove? How is it done?

Doctor Answers 12

Scar tissue after rhinoplasty

I assume you have discussed this issue with your plastic surgeon.  There may be some scarring around the internal valve of the nasal passages causing this problem.  It would be wise to wait a while and allow the scar to soften.  Also using a Q-tip to stretch that area may be of some benefit.  If no improvement results then a procedure to relieve the constriction may be required.

All the best,

Tal Raine MD FACS

Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

Post-operative adhesion between the septum and the lateral wall of the nose where the turbinates used to be

From your description, the most likely cause of your breathing difficulties is a post-operative adhesion between the septum and the lateral wall of the nose where the turbinates used to be. 

This can often be released and resolved very simply and easily, in the office using either local or topical anesthetic.  Following the release of the adhesion, often a stent will be placed to prevent the adhesion from reforming, during the early  healing period.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

Scar tissue in your nose after Rhinoplasty Surgery is typically dealt with in the office with topical anesthetic.

If you had septal and turbinate work performed during your Rhinoplasty Surgery, you may have formed scar tissue (synechiae) that could be obstructing your breathing. These bands of scar tissue may be divided in the office with topical anesthetic (lidocaine on a piece of cotton), and you should notice improved breathing immediately.

You may want to consult a reputable ENT for a second opinion.

I hope this is helpful for you.

Regards from NJ:

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Scar Tissue after Rhinoplasty

Hopefully you are describing synechiae, which are bands of scar tissue that are relatively easy to remove  under local anesthesia. There are other possible causes of your breathing problem; you need an examination by your surgeon.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Problems breathing after rhinoplasty

Dear Fergi,

Breathing problems that occur after rhinoplasty may be due to many different problems.  While what you see may indeed be a scar formation, it could also be a result of weakening of the structural support of the nose.  Both can be corrected, albeit with different methods.  A proper examination by the original surgeon, or an ENT/Facial Plastic surgeon is imperative so that the right diagnosis and treatment can be offered.  Many times function is sacrificed for aesthetics, but if your surgeon is a rhinoplasty expert, this should not happen.  

Best of luck,

Dr. Michelle Yagoda, NYC

Michelle R. Yagoda, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breathing difficulties after rhinoplasty can be due to a number of reasons

As you recover from rhinoplasty there are a number of conditions that can cause difficulty breathing. The earliest problems come from swelling and debris. Adhesions or bridges called synechea can also form that might be easily treatable by an office procedure. More complex but less common problems can also arise. These are from loss of support of the sidewalls of the nose called the nasal valve. The first thing you should do if you have difficulty breathing after a rhinoplasty is to discuss this with your surgeon. If these problems persist more than a year after surgery you might seek a second opinion from a rhinoplasty specialist.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 125 reviews

Scar Tissue / Adhesions Post Rhinoplasty

What you describe sounds like it could be nasal synechiae, scar tissue that forms along the internal mucosa where the incisions were made for the turbinate surgery, rhinoplasty or the septum or both.  The strands of scar sometimes will attach to the nasal wall and the septum thus creating the pulling that you describe, as well as block air flow. Depending on where the scar is, how far up in your nose and how thick it is will determine the best way for you to move forward to remove it. Definately schedule an appt with your surgeon so he/she can take a look and go over your options.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 106 reviews

Closed rhinoplasty and adhesion

By six months, you should not have any unusual scarring within your nose at this point. I suggest that you get re-evaluated by your doctor.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breathing problems after rhinoplasty

Airway and breathing problems can occur with rhinoplasty, and as you have had the turbinates removed there must have been breathing problems even before the procedure. After six months your breathing should be better, and you should not see any scars or adhesion inside. Best to see your surgeon and let him have a look.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Closed Rhinoplasty and Scarring

Hello, after rhinoplasty it is generally a good idea to wait a year to assess the final result and before performing revisions.  You may have developed scarring near the internal valve, or near the incision for the approach to the rhinoplasty.  You should show your surgeon your concerns.

Jeff Scott, MD
Everett Plastic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.