Trouble Breathing and Nasal Voice After Rhinoplasty, Is This Normal?

Swelling (both inside and outside of the nose) can persist for months.  Voice change and congestion are all related to this

I read your concern. Since you had turbinate work during you may just have some crusting in your nose that may need professional cleaning. An in-ofice, diagnostic nasal endoscopy may be helpful in determining why you're having congestion.

I hope this is helpful.

Regards from NJ.

 

Most patients have difficulty breathing through their nose following rhinoplasty.  This typically improves in the first couple of months following surgery.  Sometimes dry mucous or crusting may make it more difficult for you to breathe.  Saline nasal sprays are helpful in these cases.

It's very common to have a congested voice after rhinoplasty due to the postoperative swelling on the internal nasal linings. This can lead to a nasally voice. If you had an endotracheal tube placed between your vocal cords during your surgery you may have some hoarseness from this, though it is not normal for this symptom to last 5 weeks.

If your voice sounds weak/strained you should probably be examined by an otolaryngologist (ear, nose, throat specialist) to examine you further.

1 month after rhinoplasty, you will likely still have significant swelling both externally and internally.  You may still have some congestion which would lead to the nasal voice.  If you had general anesthesia, this may be a residual effect of the endotracheal tube on your vocal cords though too.  Rhinoplasty should not however significantly cause issues with your voice.   Seek your surgeon for follow up.

You had a lot of work done and will have internal external swelling for 8-10 weeks minimum. If you had endoscopic sinus surgery then nasal voice is a common occurrence initially.  This happens because you have opened up air chambers which cause additional resonance.  In my experience this is usually noticed more by the patient themselves and not by other people as much. It usually disappears in several months.

Hey Gothamgirl - thanks for your question - nose surgery is the operation I do most and invariably with routine post-op care each week for the first 3 weeks, my patients are breathing better than they have ever breathed their whole life.  Your problem could be one of 3 main problems - the most likely is that you have retained secretions and or scabs in the nose which have not been cleaned and cleared out - the second likely reason for the nasal voice and breathing issue is that during the rhinoplasty, the surgeon may have compromised the middle vault of the nose in an attempt to make the nose smaller but to the detriment of the function of the nose and the third possibility is that the lining is still swollen to a great degree.  Again, the most like is that the nose needs more local attention and care - return to your surgeon and let them re-examine you and your nose - wish you the best during your healing process. 

Paul Kelly, MD (advfacialplastics.com)

You had a lot of surgery done. Swelling is to be expected. I find that turbinate work often result in prolonged stuffiness. Have your surgeon look in the nose.

I had rhinoplasty about 5 weeks ago and I'm realizing that my voice is very nasal now. I also feel that I have to strain my voice to speak loudly...otherwise people can't really hear me. I feel very congested still. Is this normal after 5 weeks? I heard that it could be swelling and I'm hoping that is the only issue. I don't want my voice to sound nasal permanently. I had rhinoplasty/septoplasty and my turbinates/sinus worked on.

you had a lot of work done and swelling is definitely still resolving, especially on the inside. one other reason for weakness of your voice is irritation of the vocal cords from the endotracheal tube (anesthesia) during surgery. rest your voice and let time do it's thing

What you are describing is the nasal quality of a impaired internal nasal valve.  The nasal valve compromise, after the Rhinoplasty, could be due to:


Failure to suture closed the top section of the intracartilagenous incisions allowing collapse and valve compromise

Swelling of the mucosa at the internal valve location

Crusting inside the nose at the nasal valve level


You should see the plastic an cosmetic surgeon that did your Rhinoplasty and have an examination of the inside of your nose to check for any unusual issues that could be readilly treated.