Functional Rhinoplasty
Reshaping the nose so it both looks balanced and breathes well.
What it is
Functional rhinoplasty is reconstructive surgery on the external nose, performed when the visible structure of the nose itself contributes to obstructed airflow. The most common structural problems are weak or collapsed nasal valves (the narrowest segment of the airway, where the upper and lower cartilages meet), drooping or under-supported tip cartilage, and dorsal asymmetries from prior trauma. Functional rhinoplasty addresses these issues while also refining the outward proportions of the nose.
Why we do it
Septoplasty alone fixes the inside of the nose. Functional rhinoplasty fixes the outside. When both are needed, doing them together is more effective and less burdensome than two separate operations. About one in three patients with chronic nasal obstruction has a structural component (valve collapse, for example) that septoplasty cannot reach. Patients who have had a septoplasty alone but still struggle to breathe through their nose almost always have a valve or tip support issue that functional rhinoplasty resolves.
What happens during the procedure
Performed under general anesthesia. A small incision is made at the base of the nose (between the nostrils) along with internal incisions to access the cartilage framework. Cartilage grafts (typically harvested from the septum or, when needed, from the ear or rib) are used to widen and support collapsed valves, reinforce tip projection, and rebuild any deficient structural elements. The skin is redraped over the new framework and closed with very fine sutures.
Who it’s for
Patients who have nasal obstruction that does not respond to septoplasty alone, who have a history of nasal trauma with asymmetry, or who want the airway addressed at the same time as cosmetic refinement. Performed by a board-certified plastic surgeon in collaboration with the airway team.
Recovery and what to expect
An external splint is worn for one week. Bruising around the eyes is common and resolves in 10 to 14 days. Most patients return to non-strenuous work at one to two weeks. The visible result is about 80 percent settled at three months and fully refined at 12 months as the deeper tissues mature.