I am often asked by prospective patients if rhinoplasty will impair their ability to breathe through their nose. While this is a potential complication of rhinoplasty, I strongly believe that if done properly, rhinoplasty will typically increase rather than decrease nasal airflow.
In what situations does rhinoplasty cause a breathing problem? The most common scenario in which this complication happens is from over-narrowing of the tip cartilages. The tip is formed by two cartilages (lower lateral cartilages) which account not only for tip shape but also for function of the nostril opening, also termed the external nasal valve. When the tip cartilages are narrowed, there is the potential that the external valve and nostril space decreases, causing impaired airflow. In some cases, this problem is immediate. But in other cases, the problem can emerge gradually as the process of scar contracture causes the tip cartilages to slowly move inward. This typically happens when the cartilages have been weakened significantly, usually through excessive removal of cartilage.
How is this problem avoided? Structural rhinoplasty is able not only to avoid reduction of airflow, but in most cases can increase airflow. The reason is that structural rhinoplasty creates improvement in tip shape through the addition of supportive cartilage grafts which make the tip stronger. These grafts create an aesthetically favorable triangular base shape to the nose and also stent open the nostril margin and external valve. In fact, this approach can correct nasal obstruction caused by previous reduction rhinoplasty.
The photos below show the before and after base views of a recent rhinoplasty I performed. The upper photos show the constricted tip cartilage and the effect on nasal valve pinching and obstruction. The lower photos show the surgical correction through structural rhinoplasty with the effect of improved appearance and function.