What is Functional Rhinoplasty?

Functional Rhinoplasty, also known as a Medical Rhinoplasty, is a type of Rhinoplasty surgery which specifically addresses concerns relating to the function of the nose, such as breathing.

Whereas purely cosmetic Rhinoplasty enhances the outward appearance of the nose, Functional Rhinoplasty involves working on the internal structures of the nose to improve concerns, including:

• Breathing
• Snoring
• Sleep apnoea

For many people, breathing difficulties and concerns such as snoring can have a significant impact on their comfort and quality of life.

Cadogan Clinic has brought together a team of the UK's best Rhinoplasty surgeons, who are all highly experienced in performing Functional Rhinoplasty procedures to address a range of concerns.

What Can Functional Rhinoplasty Treat?

Primarily, Functional Rhinoplasty is carried out to reduce the impact of breathing difficulties and sleep disorders, including snoring and sleep apnoea.

These issues typically arise due to airway obstruction; however, there are several causes of this. It is important to understand the underlying cause of the functional concerns affecting the nose for the most effective treatment.

Deviated Septum

The septum is the central portion of cartilage which extends down the middle of the nose, between the nostrils.

If this cartilage is misaligned, the airways can become imbalanced, resulting in one nostril being larger than the other, known as a deviated septum. This can make breathing difficult and may cause snoring or sleep apnoea.

A deviated septum can occur for several reasons:

• Birth defect
• Injury or trauma
• Complications from previous nasal surgery
• Ageing

Septal deviation is one of the most common causes of breathing concerns and sleep disorders, and many patients do not realise they have a misalignment in their septum.

Nasal Valve Collapse

Nasal Valve Collapse occurs when the cartilage on the outer side of the airways weakens, narrowing the airways and reducing airflow.

There are two types of nasal valve collapse:

• Internal nasal valve collapse – The internal nasal valve is located in the middle portion of the nose. A collapse here isn’t visible, so individuals may not be aware.
• External nasal valve collapse – The external nasal valve is at the bottom of the nose, just above the nostrils. This may be visible as the nostrils will visibly narrow when you inhale.

There are many risk factors which may cause the cartilage to weaken and collapse:

• A deviated septum
• Genetics
• Previous Rhinoplasty surgery
• Ageing
• Injury or trauma to the nose

If you are concerned about having a nasal valve collapse, a consultant surgeon can comprehensively examine your nose and determine the cause of your concerns.

Enlarged Turbinates

The turbinates are bony structures within the nose that make up the airways. They are covered in a tissue called mucosa, which protects the inside of the nose from particles found in the air, and also prevents illness by stopping pathogens from passing into the body.

These structures can become irritated and swollen for several reasons:

• Inflammation of the sinuses caused by illness
• Allergies, including hay fever and pet hair
• Environmental irritants such as pollution
• As well as causing breathing difficulties, snoring or sleep apnoea, enlarged turbinates may also result in:
• Headaches
• An altered sense of smell
• Facial pain
• A dry mouth from compensating by breathing through the mouth
• A persistently runny nose

Many people experiencing the symptoms of swollen turbinates may not realise the underlying cause, especially if they have chronic allergies. Addressing the turbinate inflammation may relieve the surrounding symptoms, as well as improve the function of the nose.

Broken Nose

Trauma or injury to the nose may reposition or damage the internal structures above, impacting the function of the nose.

Although many people who experience a broken nose will have their nose straightened soon after the injury, this procedure may not fully address the internal structures, meaning that functional concerns require attention in future.

If you have previously had a broken nose and have noticed a change in the function of your nose, it is important to speak with a consultant ENT surgeon to ensure effective and timely treatment.

What Does Functional Rhinoplasty Involve?

There are different types of Functional Rhinoplasty, which address functional and cosmetic concerns in varying proportions depending on the patient's needs and desired outcomes.

Septoplasty

Septoplasty is a surgical procedure which focuses on treating concerns resulting from a deviated septum. It does not involve making any aesthetic changes to the nose; however, by straightening the septum, the nose may appear visibly straighter.

This procedure is performed under general anaesthetic and takes 1-2 hours to complete as a standalone surgery.

Septoplasty surgery results in improved breathing, reduced snoring and overall enhanced comfort.

Septorhinoplasty

Septorhinoplasty is the most comprehensive type of Rhinoplasty surgery. It combines treating the internal structures of the nose with reshaping the nose to improve the overall appearance.

It can be tailored to the needs of the patient to balance functional and aesthetic outcomes. Septorhinoplasty is carried out under a general anaesthetic and takes up to 3 hours to complete.

In addition to improving breathing difficulties and treating sleep disorders, Septorhinoplasty surgery can address swollen turbinates, weakened cartilage and reshape the nose for a complete nose rejuvenation.

Who is Suitable for Functional Rhinoplasty?

Your surgeon will determine the best type of Rhinoplasty surgery to address your concerns during your consultation. They will discuss your concerns and desired results before performing an examination to diagnose the cause of any functional issues.

To recommend the best Functional Rhinoplasty surgery, your consultant will consider:

• Your symptoms – Your surgeon will comprehensively discuss your symptoms to establish the areas of the nose which require treatment and the type of surgery you need
• The cause of your concerns – Your surgeon will establish the underlying cause of your functional concerns
• Aesthetic goals – Alongside your functional concerns, your surgeon will take into account any aesthetic results you are hoping to achieve to decide on the right type of surgery
• Previous procedures – If your functional concerns have arisen from a previous Rhinoplasty surgery, they will ask for the full details of the procedure to ensure they address the issues effectively

Patients who are suitable for Functional Rhinoplasty usually have primarily functional concerns and may be less focused on dramatically improving the appearance of their nose. Although it is possible to achieve dramatic aesthetic results with Septorhinoplasty, the final outcome may be dictated by how the internal structures have been treated and repositioned.

Functional Rhinoplasty Recovery

Functional Rhinoplasty recovery is influenced by the extent of the surgery and the areas that have been treated.

A standalone Septoplasty typically has a recovery period of 4-6 weeks, whereas a comprehensive Septorhinoplasty may take up to 8 weeks to be fully healed.

Your surgeon will discuss your recovery period during your consultation, so you are able to prepare ahead of your procedure.

• Swelling and bruising – It is normal to experience swelling and bruising around the nose following Functional Rhinoplasty. This may be isolated to the nose itself, or it may extend under the eyes
• Dressings – You will have a splint placed over your nose for 7-10 days after your surgery to support and protect the structure of your nose. It is essential to keep your nose dry and clean to prevent infection
• Breathing – It is normal to have a slightly blocked nose for 2-3 weeks after your Rhinoplasty. This is due to the tissue healing within the nose
• Exercise and activity – You will be asked to avoid exercise and strenuous activity for 4-6 weeks after your Rhinoplasty. This is to prevent strain from being placed on your nose and assist healing
• Sleeping position – To protect your nose, you will be asked to sleep on your back, propped up at a slight angle for 3-4 weeks

During your recovery, you will have 24-hour access to our specialist nurses’ phone line for any questions or concerns that arise.

You will have an appointment with our nurses 7-10 days after your Rhinoplasty, and an appointment with your surgeon 6 weeks after your procedure to monitor your healing and results.

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