Plastic Surgery Blog

Types of Nose Surgery to Breathe Better: Improving Nasal Airflow with Surgical Options

Breathing freely through the nose is essential for good health and comfort. Chronic nasal obstruction can lead to issues like poor sleep, snoring, and even increased risk of respiratory infections. In fact, nasal breathing helps filter and humidify air to prevent illnesses such as colds and flu, regulates airflow, and even reduces risks like tooth decay. Conversely, blocked nasal passages can contribute to problems like sleep apnea, since unobstructed nose breathing plays a key role in healthy sleep patterns. 

When structural issues inside the nose prevent you from breathing well, surgery may be recommended to correct the problem. There are several types of nose surgeries to help you breathe better, ranging from a simple septoplasty to more complex combined procedures, often with the added benefit of improving the nose’s appearance as well. This article outlines when to consider nasal surgery for breathing issues, the common surgical options, what to expect from the process, and how they can effectively restore clear nasal airflow.

When Is Nose Surgery the Right Solution for Breathing Problems?

If you have persistent difficulty breathing through your nose, it may be time to evaluate surgical options. Often, people first try medications (like nasal sprays or allergy treatments) to reduce congestion. But when such treatments don’t resolve the issue and nasal breathing remains chronically impaired, structural problems might be the cause. Quality of life is a key factor – surgery is usually considered when nasal blockage and mouth-breathing are significantly affecting your daily life or sleep. Some common causes of nasal airway obstruction that might warrant surgery include:

  • Deviated septum – a crooked or off-center nasal septum (the cartilage and bone dividing the nasal cavity) that can partially or completely block one nostril.
  • Enlarged turbinates – overgrown or chronically inflamed turbinates (bony structures inside the nose) which narrow the air passages. Allergies or sinusitis can cause turbinate swelling; if persistent, a turbinate reduction surgery may be needed to open the airway.
  • Nasal valve collapse – weakened or narrow nasal valve areas (the nostril sidewalls or tip) that collapse inward when you inhale, limiting airflow. If you notice your nostrils pinching or collapsing during deep breaths (and breathing strips or dilators improve it), you likely have a valve issue that surgery can fix.
  • Nasal polyps or tumors – soft benign growths (polyps) or other masses inside the nasal passages that can block airflow.
  • Chronic sinusitis – long-term sinus infections or inflammation that cause swollen tissues or blockage in the nasal passages.
  • Trauma or congenital deformities – a history of a broken nose or congenital nasal deformity that resulted in structural blockage. These often involve a deviated septum, crooked nasal bones, or collapsed areas that may be corrected surgically.

Septoplasty

Septoplasty is one of the most common functional nasal surgeries. It’s a procedure to straighten a deviated septum – the wall of cartilage and bone dividing your nasal cavity into two sides. When the septum is significantly crooked or displaced, it can block airflow on one or both sides of the nose. The main goal of septoplasty is to improve breathing by clearing the nasal airway obstruction caused by a deviated septum.

During a septoplasty, the surgeon works through the nostrils (usually no external incisions) to reposition and straighten the septal cartilage and bone. Portions of the septum may be trimmed or removed and then reinserted in the proper alignment. By restoring the septum to the midline, the nasal passages become more open and symmetric, allowing air to flow freely on each side. Once healed from a successful septoplasty, people typically find it much easier to breathe through their nose than before.

Nasal Valve Repair

The nasal valve area is the narrowest part of the nasal airway, located in the middle to lower part of the nose (near the internal or external “nostril” regions). If this area is too narrow or has weak cartilage support, it can collapse inward when you inhale, dramatically reducing airflow. Nasal valve collapse often causes a sensation of clogged nostrils or the sides of your nose “sucking in” when breathing. To correct this, surgeons perform a nasal valve repair (also called nasal valve reconstruction or nasal valve augmentation).

Nasal valve repair surgery aims to improve airflow by strengthening and widening that critical narrow section of the nasal passage. In practice, this usually means adding structural support with cartilage grafts. The surgeon may take a small piece of cartilage (often from the septum, ear, or rib) and precisely place it to brace the nasal sidewalls or valve area. By doing so, the nostril is less likely to collapse and remains more open during inspiration. Essentially, the procedure “props open” the inner nasal doorway.

Turbinate Reduction

Inside your nose, there are structures called turbinates (usually three on each side – inferior, middle, and superior turbinates). Turbinates are bony ridges covered in soft tissue that warm, humidify, and filter the air you inhale. However, when the inferior turbinates (the largest ones) become enlarged or swollen chronically, they can take up too much space and cause nasal congestion. This enlargement, or turbinate hypertrophy, can result from allergies, chronic sinus inflammation, or simply anatomical variation. If medication (like antihistamine or steroid nasal sprays) doesn’t adequately shrink the turbinates, a turbinate reduction surgery may be recommended to physically reduce their size and open the nasal airway.

There are a few different surgical techniques to reduce turbinates, ranging from conservative reshaping to partial removal:

  • Submucosal resection (Turbinoplasty): The surgeon adjusts the turbinate’s position and removes a portion of the internal bone or tissue while preserving the outer mucosal lining. This can shrink the turbinate’s bulk without significantly affecting its normal function.
  • Partial turbinectomy: In more extreme cases, part of the turbinate tissue is removed to create more space. This is less commonly needed, as surgeons try to preserve as much turbinate function as possible.
  • Radiofrequency or laser ablation: A minimally invasive method where probes or laser energy are used to shrink the turbinate tissue by causing controlled scarring. This can be done under local anesthesia and has a quicker recovery, though it may be a bit less precise in sculpting the turbinate size.

Rhinoplasty

Rhinoplasty, commonly known as a “nose job,” is a surgical procedure that changes the shape of the nose. While rhinoplasty is often associated with cosmetic improvements, it can also be done (or combined with other techniques) for functional reasons – meaning to improve breathing. In fact, a well-planned rhinoplasty can address both appearance and airway function simultaneously. Rhinoplasty is a very individualized surgery; it can involve modifications to the nasal bones, cartilage, and soft tissue to achieve the desired form and function.

From a breathing standpoint, functional rhinoplasty might involve steps like straightening the nasal septum, reinforcing collapsed nasal valves, or correcting deformities from prior injuries that are causing blockage. For instance, if a patient has a crooked nose due to trauma, they may have both a deviated septum and external nasal deviation; a rhinoplasty can realign the nose externally while an internal septoplasty fixes the septum. Similarly, if a hump on the nasal bridge or a drooping tip is contributing to airway narrowing, the rhinoplasty can address those issues. Rhinoplasty can repair structural abnormalities or injuries to the nose that impede breathing, while also enhancing appearance if desired.

Dr. Steve Laverson, a board-certified plastic surgeon in San Diego, specializes in this holistic approach. With over 30 years of experience and thousands of nasal surgeries performed, Dr. Laverson plans each rhinoplasty to suit the patient’s needs – whether that’s refining a bump, adjusting the tip, or resolving breathing problems – so that the result is a nose that looks natural and functions well

Combined Functional Nasal and Sinus Surgery

Sometimes nasal breathing problems don’t exist in isolation – they can be part of a broader sinus issue. For instance, chronic sinusitis or nasal polyps might accompany a deviated septum. In such cases, a patient might benefit from combined functional nasal and sinus surgery. This means that during the same operation, the surgeon (often an ENT specialist, sometimes in collaboration with a plastic surgeon) addresses both the nasal passage and the sinus openings.

Sinus surgery typically refers to procedures like Functional Endoscopic Sinus Surgery (FESS), where an endoscope and instruments are used to clear blocked sinus pathways, remove polyps, or drain chronic infection. By opening clogged sinus passages, sinus surgery can reduce sinus pressure, improve sinus drainage, and indirectly improve breathing as well. When a patient has anatomical nasal blockage (e.g., deviated septum, turbinate hypertrophy) and chronic sinus blockages, it makes sense to correct everything together if possible. 

Combining these surgeries has the advantage of one anesthesia and one recovery period for the patient. It’s a comprehensive approach to fully restore nasal airflow and sinus health at the same time. 

How to Prepare for Nasal Surgery for Breathing

Preparing for nose surgery is a critical step to ensure everything goes smoothly on the day of the operation and during recovery. According to the American Society of Plastic Surgeons guidelines, a proper pre-surgical plan will include specific instructions you need to follow in the weeks or days leading up to the procedure:

  • Medications: You’ll be instructed to stop taking certain medications or supplements that can increase bleeding risk.
  • Smoking: If you smoke, you will need to stop smoking well before surgery (often at least a few weeks prior).
  • Fasting: For surgeries done under general anesthesia or IV sedation, you’ll likely need to fast (no eating or drinking) after a certain time the night before – commonly from midnight before the surgery day.
  • Logistics and Recovery Setup: You should arrange for someone to drive you on surgery day and stay with you afterward (at least the first night). Plan to take adequate time off work or school to recover (this could be a few days to a week for a septoplasty or turbinate reduction, and one to two weeks for rhinoplasty).

What to Expect During the Procedure

On the day of your nasal surgery, you will arrive at the surgical facility (hospital or outpatient surgery center) a few hours before the scheduled time. After check-in, a number of pre-operative steps occur: the nursing staff will review your consent forms and allergies, you’ll change into a gown, and they will start monitoring your vital signs (blood pressure, heart rate, oxygen, etc.). 

You’ll meet your anesthesiologist who will go over the plan and then proceed to administer the anesthesia. For most functional nasal surgeries (septoplasty, rhinoplasty, etc.), general anesthesia is common – meaning you’ll be completely asleep and not feel anything. If general anesthesia is used, once you’re unconscious the anesthesiologist will insert a breathing tube through your mouth into your airway to protect it and help you breathe (this is called intubation).

The surgery itself will vary in length and technique based on what’s being done. Generally, for septoplasty or turbinate surgery, all incisions are made inside the nostrils – the surgeon lifts the lining of the septum or turbinate to access and modify the structures, all through the nostrils. For rhinoplasty, the incisions could be entirely inside the nose (this is called a closed rhinoplasty) or sometimes a small incision on the columella (the bridge of tissue between your nostrils) is made for an open rhinoplasty approach

After the structural corrections are done, the surgeon will close the incisions with stitches. Internal incisions usually use dissolvable stitches. If it’s an open rhinoplasty, the tiny external columella incision is closed with a few fine stitches that will be removed about a week later. 

Once everything is complete, the anesthesiologist will wake you up and remove the breathing tube (if one was used). The medical team will make sure your pain is controlled and that you’re recovering properly from anesthesia.

Recovery Timeline and Post-Operative Care

Recovery from nasal surgery is generally very tolerable for most patients, but it does require patience and following your post-op instructions closely. Depending on the extent of surgery, you may go home the same day (outpatient surgery) or spend one night in the hospital for observation. Many septoplasties, turbinate reductions, and routine rhinoplasties are outpatient. More involved surgeries (or patients with certain medical conditions) might be kept overnight for monitoring.

Before you’re discharged, you will receive detailed post-operative care instructions. The nursing staff or surgeon will review how to take care of your nose in the days following. Typically, instructions include:

  • How to do wound care: e.g. keeping any external incision (if you have one under the nose) clean and lightly applying ointment, if prescribed.
  • Medications: You may receive a prescription for an antibiotic (to prevent infection) and a pain reliever.
  • Activity restrictions: You’ll be reminded not to blow your nose for a week or two, avoid strenuous exercise or heavy lifting.

You will also be scheduled for a follow-up visit, usually about 5–7 days after surgery. At that appointment, the surgeon will typically remove any splints or packing that were placed.

Common things you might experience in the first days of recovery include swelling of the nose and face, bruising under the eyes, a feeling of nasal congestion, and some minor bleeding or mucous discharge from the nose. You might also have a reduced sense of smell initially due to swelling. 

Most patients are pleasantly surprised at how quickly they notice improvement once the initial healing phase passes. For a simple septoplasty or turbinate reduction, you might feel breathing improvements as soon as one week post-op, and it only gets better from there. For combined rhinoplasty, it may take a few weeks to really appreciate the breathing difference because of more extensive swelling, but the end result is usually very positive.

Effectiveness of Nose Surgery in Relieving Breathing Difficulties

One of the most important questions patients have is, “Will this surgery really help me breathe better?” The good news is that functional nasal surgeries have a high success rate and patient satisfaction overall when performed for the right reasons. Numerous studies and patient surveys have shown that relieving structural nasal issues surgically leads to significant improvements in breathing and quality of life. Of course, results vary per individual and the specific problem being addressed, but let’s look at each type of surgery’s effectiveness:

  • Septoplasty: This procedure tends to have very stable, lasting results in correcting a deviated septum. Most people who undergo septoplasty experience better breathing, less nasal congestion, a reduction in snoring, and improved sleep afterward.
  • Turbinate reduction: Studies (including a 2022 systematic review) find that turbinate surgeries have a low complication rate and yield long-term positive outcomes for nasal airflow.
  • Nasal valve repair: According to the American Academy of Otolaryngology, nasal valve repair significantly improves patients’ quality of life. It effectively relieves the symptoms of nasal valve collapse, which include difficulty breathing in and a feeling of nasal blockage.
  • Rhinoplasty / Septorhinoplasty: Functional rhinoplasty, especially when combined with septal and valve corrections, also shows high satisfaction. Beyond the cosmetic happiness, patients in studies have expressed about 79–87% satisfaction regarding their breathing and overall outcome post-surgery.

The vast majority of people who undergo nasal surgery for breathing report significant improvements in their ability to breathe through their nose, which often correlates with better sleep, better exercise tolerance, and even improvements in how foods taste (since smell is part of flavor). The bottom line: when nasal surgery is done for the right indications (a confirmed structural problem) and by a qualified surgeon, it is usually very effective in restoring clear breathing. Patients often say, “I wish I had done this years ago,” once they experience the difference.

Potential Risks and Complications of Nasal Surgery

Any surgical procedure comes with some risks, and nasal surgeries are no exception – though serious complications are uncommon. It’s important to be aware of the potential risks and discuss them with your surgeon. Many of the risks are shared across septoplasty, turbinate reduction, rhinoplasty, etc., since they all involve the nasal structures. Risks of rhinoplasty (and similarly, other nasal surgeries) can include:

  • Bleeding or hematoma
  • Infection
  • Pain, bruising, and swelling
  • Scarring
  • Altered sensation
  • Septal perforation
  • Breathing problems or unsatisfactory result
  • Anesthesia or systemic risks

When to Seek Medical Advice for Chronic Breathing Issues

Not every stuffy nose requires surgery – so how do you know when to seek a professional evaluation? You should consider contacting a doctor (ear, nose and throat specialist or facial plastic surgeon) if you experience any of the following on a regular basis:

  • Chronic difficulty breathing through your nose
  • Frequent nasal congestion/fullness without relief
  • Sleep disruptions due to nasal blockage
  • Nasal breathing issues that impact daily life

Don’t hesitate to seek help. People sometimes live with poor nasal breathing for years, not realizing it can be fixed. If you’re in San Diego and suffering from nasal breathing problems, you can reach out to Dr. Laverson’s office for a consultation. 

Final Thoughts

Unobstructed nasal breathing is vital for your health, energy, and comfort. When anatomical issues (like a deviated septum, weak nasal valves, or enlarged turbinates) block your airflow, nose surgery can significantly improve your breathing by correcting those issues. There are multiple surgical options – septoplasty, turbinate reduction, nasal valve repair, rhinoplasty, and more – and each targets a specific cause of obstruction. These procedures, often performed on an outpatient basis, generally have straightforward recoveries and high success rates, giving patients the relief of breathing through their nose properly again.

If you’re struggling with chronic nasal breathing problems, consider consulting with a specialist. In many cases, a well-planned surgical procedure can be truly life-changing – restoring not just your airflow, but also your quality of life. Dr. Laverson and the team at Feel Beautiful Plastic Surgery are dedicated to helping patients achieve both a functional and beautiful nose, so you can feel healthy, breathe easy, and of course, feel beautiful.

 

Dr. Steve Laverson

Great cosmetic surgery results provide tremendous value for your lifetime. With more than 30 years of experience and over 40,000 surgeries performed, Dr. Laverson is a highly regarded plastic surgeon both locally in San Diego and internationally.

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