Eight Reasons Patients Have Rhinoplasty
Rhinoplasty is as often functional as it is aesthetic. This page sets out eight distinct reasons patients are referred for or request nasal surgery, from trauma and septal deviation to polyps and chronic allergic obstruction.
Rhinoplasty modifies the shape, size or proportions of the nose, working on the bone, cartilage and skin of the upper and lower nose. It is an operation conducted at the scale of millimetres — small changes in structure produce disproportionate changes in appearance and in airflow, which is why technique matters more here than almost anywhere else in aesthetic surgery.
The reasons patients have it fall into eight groups, and most are not primarily cosmetic.
1. Restoring the nose after injury
Trauma from road accidents and sport is a common route to nasal surgery. Untreated, a displaced nasal fracture can leave persistent headaches, chronic difficulty breathing and reduced sense of smell alongside the change in appearance. Reconstruction addresses the structural damage; the aesthetic correction follows from it.
2. Correcting congenital differences
Structural problems of the nasal cavity present from birth, and nasal deformity associated with cleft lip and palate, are corrected surgically — usually alongside other reconstructive procedures rather than in isolation.
3. Deviated septum
The commonest anatomical problem in the nose. A deviated septum produces nasal congestion and chronic mouth breathing, and with them dry mouth, nosebleeds, headaches and disturbed sleep.
Functional rhinoplasty, or septoplasty, straightens the deviated cartilage. Aesthetic changes can be made in the same operation but are optional — the functional correction stands on its own.
4. Breathing difficulty
Structural malformations that restrict airflow are corrected surgically. The change patients report is usually in sleep quality and exercise tolerance rather than in appearance.
5. Size and shape
A nose that is disproportionate to the rest of the face, in either direction, is the reason most people associate with the operation. It is a legitimate one, and it is worth being specific at consultation about what exactly you want changed.
6. Asymmetry
A deviated bridge or asymmetric nostrils; a tip that is bulbous, over-pointed or disproportionate; a dorsal hump. These are addressed by reshaping the underlying bone and cartilage rather than the skin.
7. Chronic allergic inflammation
Where allergic rhinitis does not respond to antihistamines or decongestants, the turbinates — the structures inside the nasal passage that warm and humidify air — may have become permanently enlarged. Turbinate reduction decreases the obstruction. It can be performed on its own, with no change to the external appearance of the nose.
8. Nasal masses and polyps
Non-cancerous nasal polyps are associated with asthma, chronic sinusitis and allergy. They obstruct breathing, worsen allergic symptoms and reduce the sense of smell. Removal can be performed alone or combined with structural correction.
The point to take from this
Several of these are medical rather than cosmetic problems, and several of them present as something else — poor sleep, recurrent headaches, exercise intolerance. If any of the functional descriptions above match your experience, the assessment worth having is a structural one.
The procedure this relates to
Surgery to change the shape of the nose, its relationship to the rest of the face, or the way it works. Aesthetic and functional aims are usually addressed in the same operation.
Before you act on this
Everything here is general. What applies to you depends on your anatomy, your history and what you are trying to achieve, and none of that can be assessed from a page. If a question here is yours, bring it to a consultation.