Revision Rhinoplasty: The Ultimate Guide Part 5


This is likely the most significant challenge in revision rhinoplasty surgery, and it’s often more difficult than most patients—and even many surgeons—realize. The more I study nasal breathing, the more I understand just how complex and poorly understood it can be. Throughout history, many cultures and ancient practices have focused on nasal breathing as a key to superior health and optimal human performance. We know intuitively that mouth-breathing is uncomfortable, unattractive, and certainly not conducive to peak human performance.

However, improving nasal breathing after damage is not straightforward. It’s not just about making the nasal airway bigger—removing too much of the nasal airway structures can lead to a profound and intolerable nasal obstruction known as “empty nose syndrome.” Additionally, we can’t simply adjust our grafts and sutures during surgery to check if the breathing is better, because the patient’s immediate response wouldn’t be reliable due to swelling, bleeding, and mucus production. It often takes months before we know if the breathing has improved.

There is also a subjective threshold for breathing improvement that varies among patients. For some, a 20% improvement in subjective airflow can be a life-changing outcome, while for others, even a 60% improvement might not be enough to feel better. Unfortunately, there’s no way to predict this beforehand. As surgeons, the best we can do is evaluate the structures involved in nasal breathing—the side walls of the nose, the septum, and the turbinates—and then perform surgery to configure them as effectively as possible based on their appearance.

If you’re experiencing breathing difficulties after rhinoplasty and are considering revision surgery, I invite you to schedule a consultation with our office. Our practice specializes in complex rhinoplasty cases, and we understand the unique challenges involved in these procedures. Contact us now to discuss your situation and learn how we can help you breathe easier and achieve the results you desire. Our team is committed to providing personalized care and expert guidance through every step of the process.

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