Functional Rhinoplasty

What Is a Functional Rhinoplasty?

Functional rhinoplasty surgery focuses on the nasal breathing function of the nose. It is often “included” as part of a modern cosmetic rhinoplasty but sometimes is done as a standalone treatment. Many of the same techniques and maneuvers that are employed in cosmetic rhinoplasty are also used in functional rhinoplasty. Adjunct procedures such as inferior turbinate reduction and sinus surgery can help further improve nasal function and breathing in particular.

What Are the Different Types of Functional Nose Problems?

At City Facial Plastics in NYC, we perform functional rhinoplasty to resolve issues inside the nose that are interfering with breathing and sinus health. This procedure does not reshape the outer nose. Instead, it reshapes the interior components.

Some of the nasal problems that can be corrected through rhinoplasty include:

• Deviated septum
• Nasal valve collapse
• Nasal polyps
• Turbinate hypertrophy (enlarged turbinates)

Reshaping the cartilage or removing blockages during a functional rhinoplasty helps improve breathing and reduce snoring. It also improves sinus drainage and helps to minimize the chance of sinus infections.

Is It Possible to Combine Cosmetic and Functional Rhinoplasty?

While functional rhinoplasty in NYC does not alter the outer shape of the nose, it can be combined with a cosmetic nose job. Since nose surgery is already in progress, making alterations to the nose appearance does not require as much time or separate surgeries. Many people take the opportunity to fix both functional issues and nose shape preferences in one procedure.

If you are experiencing breathing or sinus problems due to restricted nasal passages, functional rhinoplasty may be right for you. Dr. Gary Linkov is a talented plastic surgeon in Manhattan, NYC who offers both cosmetic and functional rhinoplasty. Contact our office in Manhattan to schedule a consultation. Ask about the option of combining nose reshaping with your functional rhinoplasty for improved appearance and nasal function.

Who Is a Good Candidate for Functional Rhinoplasty?

There are certain symptoms that may be associated with poor nasal function, including:

• Nasal congestion
• Mouth breathing
• Dry mouth
• Reduced sense of smell
• Nose bleeds

Indications for a functional rhinoplasty include:

• History of nasal trauma – This can result in a deviated septum or nasal valve collapse
• History of cancer reconstruction – After a nasal reconstruction various parts of the nose may require additional support to improve nasal breathing
• Congenital deformity – Deviated septum and other abnormalities may predispose to poor nasal function and warrant functional rhinoplasty
• Age-related changes – As the nose ages, it loses its structural integrity, especially at the nasal tip

What Is the Relevant Anatomy for Functional Rhinoplasty?

The following nasal structures contribute to our ability to breathe through the nose, including:

• Septum. The central partition between the two sides of the nose. A deviated septum is the most common reason for nasal obstruction, especially if unilateral (on one side).
• Internal nasal valve. The narrowest area of the nasal cavity.
• External nasal valve. Serves as the gateway to the nose.
• Inferior turbinates. Shelf-like structures on the inside of the nose that are responsible for the majority of airflow direction.
• Nasal mucosa. The inner lining of the nose that contains hair cells important for humidification, heating, and filtering of air inhaled through the nose. Surgery focuses on preserving mucosa whenever possible. Functional rhinoplasty is meant to address structural abnormalities and will not improve problems intrinsic to the nasal mucosa, such as allergies.

How Is Functional Rhinoplasty Done?

First, a rhinoplasty doctor must obtain a detailed medical history and must ascertain the symptoms most affecting the patient. The surgical plan may include a combination of internal or external nasal procedures to improve nasal function.

Internal functional nose surgery procedures:

• Septoplasty (straightening the nasal septum)
• Inferior turbinate reduction (submucous resection, out fracture, turbinectomy)
• Polypectomy (microdebrider removal)
• Sinus surgery (concha bullosa resection)

A well balanced nose can improve our appearance and can help us breath better. We now know that nose surgery that makes a nose smaller can adversely impact on our ability to breathe well through the nose. Cosmetic rhinoplasty that aims to improve how we look must be balanced with functional rhinoplasty, geared towards improving nasal breathing, in every nose job surgery.

External functional nose surgery procedures:

• External nasal valve repair (alar grafting, open septoplasty)
• Internal nasal valve repair (spreader graft)
• Nasal bone straightening (osteotomies)

What Is the Recovery After a Functional Rhinoplasty?

Functional rhinoplasty recovery depends on the exact procedures involved. General recovery principles include:

• First 48 hours – Oozing from the nose is possible. Wear a drip pad under the nose to catch the spots of blood. Pain is usually mild to moderate and can usually be managed without narcotic medications (such as acetaminophen).
• 1-2 weeks – Primary swelling and most bruising resolve in the first two weeks (if external structures were manipulated). Splints, casts, and sutures are removed typically at one week. Nasal stuffiness slowly improves.
• 8-12 weeks – The redness of the external incision, if used, diminishes. Tip swelling improves and can be aided by steroid injections.
• 3mo – 1 yr – Tip swelling continues to improve and eventually resolves to leave you with a final functional rhinoplasty result.

It is important to avoid strenuous activity such as exercise or heavy lifting for at least 1 week. Sneeze with your mouth open and do not blow your nose for the first 2 weeks. Avoid contact sports for at least 6 weeks if external functional nasal procedures were performed.

What Are the Risks and Complications of Functional Rhinoplasty?

The possible risks of functional rhinoplasty include:

• Unfavorable cosmetic outcome (as certain external modifications can alter how the nose looks)
• Pain (minimal, improved with over the counter acetaminophen)
• Bleeding (minimal oozing, rarely requires intervention)
• Infection (very rare assuming no foreign materials are used)
• Persistent nasal breathing difficulty (this highlights the importance of choosing the correct surgical technique and addressing the main structural problems)

Are Patients Satisfied After Functional Rhinoplasty in Manhattan, NY?

Many people learn to live with reduced nasal airflow and forget how incredible it can be to fully breathe through the nose. Difficulty breathing through the nose is a major quality of life issue. There is major satisfaction when the proper surgery is performed and the patient’s nasal function improves.

Is Functional Rhinoplasty Covered by Insurance?

Most functional rhinoplasty surgeries are covered by insurance. Sometimes a cosmetic rhinoplasty is done at the same time as functional rhinoplasty surgery, in which case the cosmetic portion of the procedure is not covered by insurance. Keep in mind that some surgeons may not accept in-network insurance. In these situations, rhinoplasty cost, including the surgeon’s fee, facility fee, and anesthesia fee, is calculated based on the complexity of the functional rhinoplasty and communicated to the patient before this type of surgery is scheduled.

Who Is the Best Functional Rhinoplasty Surgeon in NYC?

Dr. Gary Linkov is one of the top-rated plastic surgeons in New York specializing in functional rhinoplasty. Dr. Linkov is the best specialist with extensive experience treating all conditions of the nose. He is the  Chief of Otolaryngology and Facial Plastic Surgery for the Veterans Hospital in Brooklyn, NY, where he operates on complex nasal deformities on our country’s veterans. Dr. Linkov’s private practice in Manhattan’s Upper East Side focuses on cosmetic and functional rhinoplasty.

Functional Rhinoplasty Before and After

Dr. Gary Linkov is a board-certified plastic surgeon in New York City for functional rhinoplasty. If you want to improve your nose, contact our City Facial Plastics office, located in Midtown Manhattan, for a functional rhinoplasty surgery consultation. You can have the nose shape you want with the functional rhinoplasty options we offer.

Dr. Linkov is a double board-certified by the American Academy of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head & Neck Surgery. A native of New York, Dr. Linkov graduated as a salutatorian from Cornell University and received his Medical Degree at Columbia University College of Physicians and Surgeons. Dr. Linkov conducted advanced head and neck cancer research at the world-renowned Memorial Sloan Kettering Cancer Center. Dr. Linkov is a former Adjunct Assistant Professor at New York University (NYU), where he taught Rhinoplasty.

Dr. Linkov is a top-rated facial plastic surgeon in New York who specializes in lip lift, facelift, rhinoplasty, and hair transplant. He has been named one of the top 5 lip lift surgeons in the United States, is listed in the prestigious SuperDoctors New York™ registry, and has appeared on the Dr. Oz Show, where he discussed the state-of-the-art hair transplantation procedure.

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