I had Rhinoplasty 8 years ago and have horrible congestion and asthma ever since.Can a Revision Rhinoplasty cure this?(photo)
Doctor Answers 3
Rhinoplasty and polyps
A rhinoplasty is unlikely to fix chronic sinusitis, nasal polyposis. You will need evaluation by an Otolarygologist including CT scan of sinuses to identify the cause of your congestion.
Nasal congestion and polyps after rhinoplasty
When we think of the airway the nose and lungs are separate structures but they often act as a single entity. If you have asthma you have a 20% risk of nasal polyps because the same underlying inflammation affects nose and lungs. Prior rhinoplasty is not a risk factor for polyp formation. The rhinoplasty may have affected the septum and nasal valve. Asthma, Aspirin sensitivity, and nonallergic rhinitis have a greater chance of polyp formation than seasonal allergy which explains the negative allergy testing. If your nasal airway was much better after the sinus surgery or prednisone then polyps are the more likely culprit. Polyps are likely to recur if the surgery wasn't complete and/or the inflammation that causes them wasn't addressed with Postop nasal steroids, nasal budesonide rinses, and montekulast. I recommend a repeat sinus CT for polyps and blood test for eosinophils and IgE which measure systemic inflammation. Hope that helps
Functional Evaluation of Nose Required
Thanks for your post. I am not sure why your symptoms occurred after your rhinoplasty surgery. You need a comprehensive evaluation for functional nasal obstruction and persistent chronic sinusitis with polyps to correctly determine the nature of your congestion and asthma. Your nose does not appear to be collapsed or abnormal in appearance, so a revision rhinoplasty is likely not indicated or helpful. You may be suffering with hypersensitivity to allergens not already tested, or perhaps have mold, fungus or other manifestations for your asthma and polyps. If your symptoms improved after FESS but now have returned, you may require additional medical/ surgical therapy for your sinuses. Sinus cultures, biopsy of recurrent polyps, nasal irrigation with anti-fungals, antibiotics and steroids may be useful if recommended by your ENT specialist. I recommend you focus your efforts on a functional evaluation and not a revision rhinoplasty at this point. Best wishes.
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