Functional and Cosmetic Rhinoplasty

Reconstructive nasal surgery involves combining several operative procedures to correct both internal and external problems with the nose.  The most common surgery is a Septoplasty which corrects a crooked or “deviated” nasal septum.  The septum is the internal dividing wall between the two sides of the nose and is made up of both cartilage and bone.  When crooked, it can cause nasal obstruction on one or both sides of the nose, contribute to problems with sinus infections and worsen allergy symptoms.  Septoplasty is often combined with a Turbinoplasty surgery, where the inferior nasal turbinate is made smaller, which further improves nasal breathing.  
 
When there is both an internal and external deviation of the nose, often from prior trauma or an injury, then a septoplasty may need to be combined with a Rhinoplasty operation.  This type of rhinoplasty is called a Functional Rhinoplasty.  The operation will attempt to straighten a crooked nose and the internal deviated septum to improve nasal function, i.e., breathing.   Additional measures such as restructuring (grafting) cartilage to make the nose stronger and straighter may be needed.  Conveniently, this cartilage is taken from the nasal septum itself and repurposed for functional enhancement (better breathing).  In some situations, additional cartilage may need to be borrowed from the patient’s ear(s) if the septal cartilage is insufficient or the patient has had prior nasal surgery.  This does not change the shape or function of the ears.  Functional rhinoplasty is performed through an “open” approach where a small incision is made on the outside of the nose just between the nasal tip and upper lip in an area called the columella.  This incision heals extremely well and is very difficult to identify once completely healed.  This is an outpatient surgery and is performed under general anesthesia.  Most patients can return work and some light activity after one week.   Complete healing takes several months.
 
Cosmetic Rhinoplasty is a procedure designed to make changes to the shape of the nose and enhance the cosmetic appearance of the nose.  The height or projection of the nose can be reduced or increased.  A bump on the top of the nose can be removed.  The width of the nose is often narrowed.  The tip of the nose can be made smaller, and rotated up or down.  It is important to discuss specific problem areas with your surgeon.  Realistic, achievable goals will be discussed and photographs taken.  This surgery is usually performed through an open approach, as an outpatient, under general anesthesia.  Return to activity and healing is similar to a functional rhinoplasty.  Most patients can return work and some light activity after one week.   Complete healing takes several months.