I had Rhinoplasty 8 years ago and have horrible congestion and asthma ever since.Can a Revision Rhinoplasty cure this?(photo)

All allergists have confirmed I'm not allergic to anything and that it's due to the anatomy of how narrow my passage is now. I even had sinus surgery (FESS) this year to help with this, as well as the polyps that got rid of my sense of smell. It helped for 5 months, but then everything went back to the way it was. Is the recovery the same and do most surgeons not charge if it was a revision to their first rhinoplasty? Will it change the esthetics of my nose?

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. 

Regards

Dr J


Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

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

Mark Loury, MD, FACS
Fort Collins Facial Plastic Surgeon
4.8 out of 5 stars 14 reviews

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. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 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.