Not being able to breathe after nasal surgery...what can I do?

Question

I've wanted a rhinoplasty for years but I'm claustrophobic and the thought of not being able to breathe after surgery terrifies me. I read about the Kotler nasal airway and wanted to know if anyone had feedback about it.

Nima Shemirani, MD · Answer

Dear Kathysume,The Kotler nasal airway is one of a few different options to help the nose heal on the insideNo matter what you place inside the nose, it usually gets a little stopped up, and you can breathe through your mouthIn addition, it is important to see a rhinoplasty specialist who can also open the inside of your nose because typical rhinoplasty surgery is aimed at making the nose smallerIf you do not open the nasal airways at the same time, you may have breathing issues that you did not have before surgeryWhen you are ready, visit a few rhinoplasty surgeons who can address all of your concernsBest,Nima Shemirani

Scott C. Sattler, MD, FACS · Answer

Your ability to breathe nasally will be impacted to some degree over the short term after rhinoplasty - the hope is that the operation actually helps your breathing and not diminishes it.

Andrew Pichler, MD · Answer

Nasal congestion is common after rhinoplasty. This rarely causes insurmountable issues once everything is thoroughly explained to the patient by the PS. One thing is however important to pay attention to is that any concurrent septal deviation or other intra nasal obstruction, potential or existing, is also addressed.

Michael M. Kim, MD · Answer

Hello Kathysume,All patients dislike the sensation after surgery when they have restricted nasal breathing. Previously many surgeons would fully pack the nose with gauze strips. This would fully occlude the nose until the gauze was removed.Now, the septal leaflets are often quilted to each other with suture and/or splints are used. I used both to maximize the nasal airway as it heals. However, despite using nasal splints like Kotlers or Doyles, you will still be a lot more stuffy for about a week, then you were before surgery (there are some exceptions to this), and sometimes the splints get blocked by crusts or clots. The sensation would be like having a cold where you have a stuffy nose that will last until the splints are removed usually 5-7 days later.I believe that when I tell my patients the above information, they seem to be fine postoperatively since they know what to expect.Good luck.Michael M. Kim, MD

William Portuese, MD · Answer

In our practice, when patients are claustrophobic and want to undergo any type of nasal surgery, we place a small injection of cortisone into the inferior turbinates on the internal portion of the nose to prevent swelling from occurring.  We do not place any  plastic stents /packing  inside the nose, since they are painful and obstruct the nose even worse when the swelling ensues around them

Stephen Weber MD, FACS · Answer

It is very unusual for someone to not be able to breathe through their nose after surgery. Congestion is very common but total obstruction of the nose would be rare. Splints and flexible airways can be used but it is important to ensure that anything placed inside your nostrils is not so large that it distorts the nose while you're healing. Ask your surgeon for their thoughts on this issue. I am pretty sure they will offer a plan that can reassure you. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Michael Elam, MD (retired) · Answer

Dear Kathysume, While rhinoplasty and decreased breathing function through the nose may seem claustrophobic to patients prior to their procedure I have not had any patients that actually had any traumatic experiences or claustrophobic episodes due to the procedure. I have performed well over 4000 rhinoplasty procedures and patients who state that they are claustrophobic do not typically have any problems post operatively. The patients small packs are removed by the morning after surgery. The medication the patients  have during anesthesia and post surgery is also helpful for anxiety and keeping the patient relaxed. Most patients can breathe through their nose to some degree immediately following rhinoplasty surgery and then return to normal function or improved function post surgery. Best regards, Michael V. Elam, M.D.

Ronald V. DeMars, MD (Retired) · Answer

The intranasal airways usually get obstrucetd by dry secretions fairly quickly. You can always breathe through your mouth. You may want to consult with your Primary Care doctor for some antianxiety meds.

Not being able to breathe after nasal surgery...what can I do?

Answers (8)

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