How Many People Have Long Term Difficulty Breathing After Rhinoplasty?

Question

My biggest fear is having more congestion and restricted airways after surgery. I enjoy running and challenging myself physically. My doctor mentioned there is a chance of long term issues. Has anyone ever experienced that? From a professional point of view what are the odds of that happening? He thought my situation would actually be the reverse, but that is not a guarantee and probably why I have not scheduled the appointment. Thanks so much! If you need pictures I can attach some!

Ronald J. Edelson, MD · Answer

It is certainly an important consideration. Careful pre operative assessment should help avoid breathing problems. I commonly perform inferior turbinate reduction to avoid airway problems after surgery and this has been quite successful. Ask your surgeon about it.

Kenneth Hughes, MD · Answer

Hopefully, your rhinoplasty surgeon will give you an honest estimate of the percentage of his or her patients who have had breathing problems following rhinoplasty. I do think that these problems are technique dependent, and certain surgeons have more postsurgical breathing problems than others. Kenneth Hughes, MD Los Angeles, CA

Sam Naficy, MD, FACS · Answer

A well-performed rhinoplasty using modern techniques of structural grafting will often improve your breathing instead of making it worse.

Nima Shemirani, MD · Answer

Dear dasikins,

	
		Most experts in rhinoplasty can prevent problems with breathing after surgery
	
		Of course, nothing is guaranteed, but we do surgical maneuvers inside the nose to help prevent post-operative collapse
	
		Seek out a surgeon who does a significant number of rhinoplasties for both cosmetic and functional issues


	Best regards,

	Nima Shemirani

Steven Turkeltaub, MD · Answer

The better question is not how many people have breathing problems after rhinoplasty but will you? If your surgery is performed by a competent rhinoplasty surgeon who also addresses other potential/existent intranasal breathing issues such as enlarged turbinates and septal deformities, the risks for you should be fairly low.

Edmund Fisher, MD · Answer

Rhinoplasty specialists often see patients that had surgery from (hopefully) prior decades who have serious breathing problems. Reduction rhinoplasty, performed to create a smaller nose, still carries some risks. The advantage of modern rhinoplasty is that cartilage is very conservatively removed instead of aggressively cut out. The trend is towards folding and permanently suturing the cartilage to achieve aesthetic goals while preserving tip support and nasal valve function. Common pre-existing causes of nasal obstruction such as a deviated septum and turbinate hypertrophy are easily addressed if needed at the time of rhinoplasty.

Steven Wallach, MD · Answer

If you asked me this 30 years ago, I would say there was a good chance for potential airway problems. Now, I think most surgeons try to maintain function while improving the aesthetics, but initially you may feel congested after surgery.

William Portuese, MD · Answer

It is extremely important for your surgeon to examine the internal portion of the nose and determine if there is any pre-existing nasal obstructive issues. These include a deviated septum, turbinate hypertrophy, and the function of the nasal valve. Any of these issues should be addressed surgically at time of the rhinoplasty to prevent postoperative nasal obstruction. Any breathing-related issue his typically billed to the patient's insurance for medical necessity. Rhinoplasty is considered cosmetic and must be paid for by the patient themselves.

Peter E. Johnson, MD · Answer

Breathing problems can occur after rhinoplasty, but in practice the risk is a small one. Rhinoplasty can change the airway resistance at the internal valve inside the nose, and the external valve. The external valve or nostril, and the internal valve can be supported or strengthened during rhinoplasty and an excellent surgeon will anticipate the need for proper structure and support, as well as proper aesthetics.

Richard A. Zoumalan, MD · Answer

Rhinoplasty, if done by an expert who is familiar with how to do septoplasty well and turbinate surgery well (surgery inside the nose), can actually improve breathing. In 2012, I published a study in the Archives of Facial Plastic Surgery which shows this to be true for those with moderate to severe breathing issues before rhinoplasty. For those without any breathing problems, a rhinoplasty did not worsen breathing. This study was done over the course of 7 years. 

	The article's title is: Subjective and Objective Improvement in Breathing After Rhinoplasty.

	Please seek out an expert who frequently performs rhinoplasty when you are considering surgery. I hope this helps.  - Dr. Richard Zoumalan, Beverly Hills.

How Many People Have Long Term Difficulty Breathing After Rhinoplasty?

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