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Functional Rhinoplasty

Oblique-Internal-FinalRhinoplasty is the surgical modification of the structure and function of the nose, also known as “nose job surgery” or nose reshaping. A functional rhinoplasty is a nasal surgery that is designed to correct specific anatomic issues that are negatively affecting your breathing. In many cases, this has to do with the anatomy inside the nose in an area called the internal nasal valve. Narrowing here causes a constant blockage of airflow (static obstruction) and weakness of the cartilage may lead to collapse during breathing (dynamic obstruction). The external nasal valve is in the opening of the nostril. Weakness or tightness in this area can further contribute to breathing difficulty. The nasal valves are often treated with cartilage grafts and suture techniques to widen the airway, add support to the nose, and prevent collapse during breathing.

Base-View-Internal-FinalSeptoplasty is the surgical modification of the structure of the nasal septum, typically performed to straighten it, repair a fracture, or remove spurs (tissue blocking the nasal passage). The septum is a midline structure, composed of bone and cartilage, that divides the nose into a right and left compartment. It plays a crucial role in nasal structure and function, helping to define the tip of the nose and support the middle part of the nose. The septum also contains some sensory tissue which allows us to smell. External nasal trauma – even when the nose is not broken – is the most common cause of septal injury and later deformity. Most people do not seek medical attention after minor nasal trauma, and the injured septum heals in a crooked manner that obstructs the nasal passages. In extreme cases, patients may develop a septal hematoma (collection of blood within the septum). If left untreated, this may result in collapse of the middle part of the nose (saddle nose deformity), which can cause lifelong issues with nasal structure and function. Any suspicion of septal hematoma requires urgent medical attention. For some patients, no obvious cause is found for their deviated septum (i.e., they were “born with it”).

Spreader-Grafts-FinalAs a nose specialist, Dr. Ransom offers his patients a unique ability to address both the internal and external parts of the nose. Functional rhinoplasty, however, is not a cosmetic surgery, and should not be treated as such. Cosmetic changes to the nose may be combined with functional rhinoplasty for a more comprehensive approach. We are dedicated to working with you to create a plan that addresses all of your aesthetic and breathing concerns.


Am I a candidate?
Alar BattenPatients with a history of a broken nose, significant breathing problems, or nasal obstruction, may be a candidate for functional rhinoplasty or septoplasty. Functional rhinoplasty is generally not performed for patients who have undergone a previous cosmetic rhinoplasty; these patients require revision rhinoplasty, which is described elsewhere on this site. Most patients have a history of nasal trauma, either recent or in the past, and experience ongoing issues with breathing, snoring, or recurrent sinus infections. Dr. Ransom will assess your nasal structure and function during your consultation, and is happy to discuss the details of all types of nasal surgery.


Frequently asked questions

Q: Does insurance cover functional rhinoplasty or septoplasty?

LCSGA: In many cases, your insurance will cover functional changes to the nose to improve breathing, fix a fracture, or reconstruct a damaged portion of the nose. Insurance does not pay for cosmetic changes, though this can be added to functional surgery. Dr. Ransom is in-network with most major PPO plans as well as Medicare. We are happy to look into your benefits following your consultation.


Q: What can I expect after my procedure?

A: In most cases, you will have a cast on the nose for about a week after the procedure. This helps to protect the nose from accidental trauma, and also stabilizes the bones during the initial healing phase. No packing is used in the nose, which makes recovery much more comfortable. Your nose may feel congested for a few days, but this resolves relatively quickly. Pain is generally limited. You may feel tired for a couple days and should limit your activities to concentrate on resting and recovery.


Q: How long is the recovery from rhinoplasty?

A: Recovery from functional rhinoplasty will depend on the exact areas addressed and techniques used. For most patients, the initial recovery is quick – typically a week. Due to swelling inside the nose, many patients feel “stuffed up” for a few days. Bruising is related to any work that has been done on the nasal bone. This is generally limited, though swelling will occur throughout the nose. Much of this resolves over the first week, but some swelling will persist after that and may take longer to go away completely. Functional improvements are typically seen after the internal swelling resolves, generally within a few weeks of the procedure.


Q: How long is the recovery from a septoplasty?

A: For most patients, the initial recovery is quick – typically a few days to a week. Due to swelling inside the nose, many patients feel “stuffed up” for a few days. Occasional spotting is normal, but any heavy bleeding should be reported to the doctor. Pain is minimal and Dr. Ransom does not use nasal packing, making recovery more comfortable for his patients. If you have stents placed, these are removed one week after the surgery. Breathing improvements are typically felt immediately after this.