Rhinoplasty, or a “nose job,” is not always done to make someone look better. People who may benefit from functional rhinoplasty include those who have suffered nasal trauma due to accident or injury and people whose nasal anatomy interferes with their ability to breathe normally. Modern nose job techniques allow for a more balanced result, and the ability to more beautifully combine aesthetics and utility.
While everyone experiences nasal obstruction at some time, such as when you get a cold, ongoing functional airway obstructions may warrant surgical correction.There are several symptoms that may indicate functional airway obstruction:
- Mouth breathing (particularly while sleeping)
- Chronic nasal congestion
- Dry mouth
- Difficulty with breathing through your nose while exercising or during strenuous activity
- Frequent nosebleeds
- Sleep issues
If left untreated, chronic airway obstruction can lead to a decreased quality of life, including difficulty with physical activity and affect every day activities (due to chronic mouth breathing).
Functional Rhinoplasty Procedures
Generally, functional rhinoplasty is done to correct airway obstruction issues. Since malformations of different types can cause obstruction, there are different procedures available to address them:
- Nasal Septoplasty: This procedure is done to correct a deviated septum, which is when the dividing wall between each nasal passage is bent, bowed or otherwise deviated. This can cause blockage of one or both air passages. During nasal septoplasty, a plastic surgeon straightens the wall to open up the nasal airway. This may involve cutting and repositioning portions of the septum.
- Nasal Polyp Removal: When polyps in the nasal passages cause obstruction, surgical removal may be the best option. Nasal polyp removal is an endoscopic procedure. A small camera on the end of a narrow tube will be inserted into the nose so a plastic surgeon can see inside your nose. Very small surgical instruments will hen be used to delicately remove the polyps and open up the air passages.
- Turbinate Reduction: Turbinates are structures in the nose that help to moisten and warm air as it enters. It’s normal for turbinates to enlarge somewhat when you are fighting infection or have an allergic flare-up. For people with turbinate hypertrophy, or permanently enlarged turbinates, correction may be needed to open up the airway. There are multiple techniques for turbinate reduction, and a plastic surgeon will choose the method that he or she believes to be best for you.
- Nasal valve collapse correction: Nasal valve collapse is a leading cause of nasal airway obstruction. Valve collapse can happen as a result of aging or trauma, or occur in people with naturally narrow noses. An all-too-common cause of valve collapse is a previous rhinoplasty that has weakened the surrounding cartilage. Nasal valve collapse correction surgery often includes the use of cartilage grafting in order to rebuilt the damaged area.
Combining Functional and Cosmetic Rhinoplasty
For many people, it makes sense to have cosmetic rhinoplasty at the same time as a functional rhinoplasty. To consolidate both into one surgical session can cut down on expense, recovery time and may even yield better results both aesthetically and functionally. It’s important to choose a facial plastic surgeon who is experienced with blending functional and cosmetic rhinoplasty for the best results. Note that while some insurance plans will cover rhinoplasty done for corrective functional reasons, they will not cover the costs of any cosmetic improvements.
If you’re thinking about functional rhinoplasty, consult with a board certified facial plastic surgeon with lots of rhinoplasty experience. If you are also interested in aesthetic improvement, discuss this with your plastic surgeon at the same time. You may be pleasantly surprised at being able to meet multiple goals with the same procedure.
Waleed Ezzat, M.D., F.A.C.S. is double board-certified in facial plastic and reconstructive surgery and otolaryngology/head and neck surgery. He operates under the philosophy that natural beauty is the best kind of beauty. Dr. Ezzat addresses each aesthetic or reconstructive challenge by considering the whole facial anatomy rather than focusing on one isolated area. This comprehensive approach maintains a goal of fully functional and natural-looking results that fit perfectly within each individual’s unique genetic makeup.
