Rhinoplasty: Form or Function?

Rhinoplasty: Form or Function?

Patients often ask me to explain the difference between cosmetic rhinoplasty and functional rhinoplasty here in San Diego. The answer is not simple because frequently it’s necessary to correct a functional problem while also improving the appearance of the nose. Rhinoplasty is a cosmetic plastic surgery procedure where form and function are interconnected.

Functional Rhinoplasty

Functional rhinoplasty is a procedure where the patient’s anatomic obstruction is corrected to improve difficulty breathing through the nose. The problem may involve correcting a deviated nasal septum, which will improve the airway. The septum is made of both cartilage and bone, and it separates the right and left sides of the nose. Septoplasty corrects deviations or deflections of the nasal septum to improve the airway. This procedure can also to help straighten a deviated or crooked nose that the patient sees when looking in a mirror or at photographs.

Another functional correction relates to turbinates, which are vascular structures that lie along the inside walls of the nose. Turbinates may be particularly large or swollen during certain times of the day or as a result of underlying allergies. Reducing or shrinking the turbinates at the time of rhinoplasty can improve the airway. In patients with underlying allergies, nasal polyps may develop as a result of chronic irritation. These can be easily removed during functional rhinoplasty to open the airway to improve nasal airflow.

Another type of functional correction helps patients who have suffered major trauma, such as a nasal fracture or even previous nasal surgery. In these cases, the nasal airways may be narrowed in the region of the internal or external valve. The narrow nasal valve can be corrected as part of a functional rhinoplasty to both improve the airway as well as the appearance of the nose. In such cases, it is often necessary to open the collapsed nasal valve region by inserting cartilage grafts, which can be obtained from the nasal septum or other source.

Cosmetic Rhinoplasty

Cosmetic rhinoplasty is performed for the sole purpose of improving the aesthetic appearance of the nose. Patients may complain of a nasal tip that appears too wide or bulbous and ill-defined. Patients may also be concerned about a prominent hump along the bridge of the nose that is more noticeable in profile photographs, making the nose appear too large and too long. In addition, the nasal bones may  appear wide or somewhat deviated and can be corrected at the time of cosmetic rhinoplasty. In the end, cosmetic rhinoplasty is about great communication between the patient and plastic surgeon.

Computer imaging is very helpful to demonstrate the changes that are possible and realistic from a successful rhinoplasty. Imaging is a tool that enhances communication between the patient and plastic surgeon. I encourage patients to bring in photographs of people whom they feel have attractive noses and have similar facial shapes to their own. These photos allow me to have better insight into what a patient finds attractive so that my surgical approach can focus on those features.

In my more than 30 years of experience performing rhinoplasty and revision rhinoplasty surgery as well as ethnic rhinoplasty, it’s often possible to combine functional and cosmetic nasal surgery to improve both the functionality and appearance of a patient’s nose. My training as both a board-certified otolaryngologist – head and neck surgeon and triple board-certified plastic surgeon gives me unique experience and insight into rhinoplasty, which is one of the most challenging cosmetic plastic surgery procedures performed today.

Let’s work together to improve how your nose functions and  looks. Contact my practice to request your own consultation today.

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