Patient Testimonial: Rhinoplasty in NYC with Dr. Dibelius – Improving Breathing and Confidence?

(0:00) Hey everyone, today I want to talk about a really interesting topic and that’s the issue of nasal

(0:05) breathing after surgery, in particular when it goes wrong and breathing is either not corrected

(0:11) or worsened after a nasal surgery. The two nasal surgeries I want to talk about, obviously

(0:18) rhinoplasty surgery, but also something called septoplasty. This is a surgery that is performed

(0:26) to improve breathing.

It’s referring to correcting the nasal septum, which is the wall between the

(0:33) right and left sides of your nose. Sometimes it’s deviated to one side and blocks the breathing

(0:37) and it can be corrected surgically. Today I want to talk about what happens when you

(0:42) have a breathing problem and you undergo a surgery and it fails, or in a worst case scenario you

(0:49) actually have worsened breathing afterwards.

So the first scenario I want to talk about is a

(0:53) septoplasty. This is actually a really common thing. People have deviated septums all the time

(0:58) and septoplasty is a very successful surgery in the majority of cases, but there’s a handful of

(1:04) patients who undergo septoplasty and it just didn’t help very much and the question is why.

(1:11) So in my experience I’ve seen a couple things. One, I think it points to the fact that the septum

(1:17) was probably not the breathing issue to begin with and therefore correcting it didn’t make a

(1:23) change or enough of a change to have the patient say, oh you know what that’s better. So it brings

(1:27) up the idea that there’s something else in the nose that regulates nasal breathing and it’s called

(1:31) the nasal valve.

The nasal valve is broken up into two components, the internal nasal valve and the

(1:37) external nasal valve, but you can kind of think of it as just one unit. It’s the front of your nose

(1:42) that regulates how much airflow goes in. If it’s collapsible or if it’s bulky or weak, these are all

(1:50) reasons that the airflow will be stopped before it even really enters the nose and you will feel

(1:55) it as obstruction.

So if the septoplasty failed to correct the breathing problem, it’s important

(2:00) for the surgeon to assess for nasal valve problems and then have that discussion with you.

(2:06) After a rhinoplasty, the nasal valve issue can actually be affected by the surgery itself.

(2:13) A lot of the nasal valve is actually the tip of the nose and many of the maneuvers

(2:18) that are used to narrow or sculpt the tip of the nose can actually reduce the function of the nasal

(2:24) valve and the quack breathing and this is a horrible outcome.

In fact, a lot of the field

(2:28) has developed techniques that are known as structural rhinoplasty techniques. The whole

(2:34) idea and philosophy behind this school of thought in rhinoplasty is to preserve the structure of the

(2:39) nose and in particular the nasal valves because to sacrifice this and to get an aesthetic result

(2:45) for many surgeons is just not something that we feel is appropriate. It’s something we try

(2:51) to avoid at all costs.

So if you’ve had a rhinoplasty and developed a new difficulty

(2:57) breathing, again it points to the nasal valve and this is where you have to consider that the

(3:03) treatment is actually a reconstruction of the nasal valve itself. So if you think any of this

(3:08) applies to you, you’re having some breathing issues after a nasal surgery, it’s probably

(3:12) a good idea to get a very thorough evaluation, have somebody check it out and make sure they

(3:18) understand the anatomy of the nose and what could be causing it. So if any of this speaks to you and

(3:22) you want to set up a consultation, give us a call, send us an email.

We’d love to meet with you.