Nose surgery for breathing can help correct structural problems that disrupt airway function. There are several types of nose surgery that can help a person breathe better, including septoplasty and nasal valve repair.
Breathing through the nose helps prevent respiratory diseases such as colds and flu, regulates air flow and reduces the possibility of problems such as tooth decay. When a person’s nasal passages are not clear, a person can lose these benefits.
ONE 2020 revision highlights that unobstructed nasal breathing plays an important role in proper sleep physiology by stimulating ventilation and increasing the resistance of the nasal airways.
Nasal obstructions can lead to sleep apnea, and nose surgery for breathing is a useful treatment option that doctors may recommend.
This article will explain the main types of nose surgery a person can consider and what to expect in terms of procedure, cost, recovery and more.
People who have persistent trouble breathing through their nose may benefit from nose surgery.
Reasons for difficulty breathing through the nose
- structural abnormalities
- nasal polyps, which are soft, benign growths inside the nose
- volumes
- long-term sinusitis
There are several types of surgery that a doctor can perform to reduce or eliminate a nasal obstruction. What is best for each person will depend on the cause of their breathing difficulties.
A septoplasty is a procedure to straighten the nasal septum, the internal cartilage and bone structure that divides the nasal cavity in half.
The main goal of a septoplasty is to improve breathing by removing obstruction of the nasal airways resulting from a deviated septum.
Nasal valve repair is a type of surgery that targets the narrowest point in a person’s nasal airway.
This operation intends to improves breathing and airflow by strengthening and remodeling the structural support of the nostril.
Surgeons use cartilage graft to increase the structural stability of the nasal valve.
The turbinates are bony structures covered with soft tissue found inside the nose. They humidify and warm the inhaled air. If the eddies get too big, they can block the air flow. There are several sets of turbines in the nose.
Doctors can perform turbinate reduction in several ways:
- Strobiectomy: A surgeon removes all or part of the socket.
- Turbine: A tool changes the position of the turbine. An example is submucosal socket resection, which involves removing bone from the lower sockets.
- Laser removal: Radio frequency energy or laser light shrinks the turbinate tissue.
A surgeon can perform this procedure in conjunction with a diaphragmoplasty.
The term “nose job” usually refers to rhinoplasty, a surgical procedure that changes the shape of the nose. This surgery can be cosmetic and change a person’s appearance, or it can be functional and make it easier for the person to breathe.
Rhinoplasty can correct issues such as structural abnormalities and injuries to the nose.
Doctors can perform rhinoplasty as a stand-alone procedure or in combination with another type of surgery, such as a septum.
Sinus surgery involves opening blocked sinus passages. Like nasal surgery, sinus surgery can help people with breathing difficulties. Sometimes surgeons combine the two types of surgery.
Preparing for surgery involves reviewing the person’s medical history and assessing their current health status, using tests such as a blood test.
The surgical team will create a plan for the person during the operation. According to American Society of Plastic Surgeons (ASPS)this may include:
- following specific instructions regarding medications and supplements, such as stopping the use of blood-thinning medications several days before surgery
- fasting from a fixed time onwards, such as midnight the night before the operation
- smoking cessation
An anesthesiologist—a doctor who administers anesthesia—will discuss sleep medication options with the person undergoing surgery. They may recommend general anesthesia or intravenous sedation with a local anesthetic.
The exact procedure during nose surgery and the length of the procedure depend on the type of surgery a person is having.
On the day of surgery, the person arrives at the hospital several hours before the scheduled operation. Preoperative procedures from this point may include monitoring vital signs and starting an IV line to administer fluids and medications.
Depending on the procedure, the anesthesiologist administers either general or local anesthesia. If using general anesthesia, doctors insert a breathing tube through the person’s mouth. This process is known as intubation.
The type of nose surgery a person has dictates the location of the incision.
For example, the ASPS explains that a closed rhinoplasty may involve an incision hidden inside the nose, while an open rhinoplasty involves an incision in a part of the septum called the columella. Once the repair is complete, the team sutures the incision.
Doctors extubate or remove the breathing tube after closing the incision. Extubation can occur while the person is still asleep or after they have regained consciousness. Hospital staff may then transfer the person to a recovery room for post-operative monitoring.
According to British Association of Aesthetic Plastic Surgeons (BAAPS), the person can go home the same day as surgery or spend a night in the hospital. It can depend on the type of surgery a person has and whether they experience complications.
Before discharge time, hospital staff will provide:
- instructions for home wound care, such as dressing changes;
- prescriptions for antibiotics and pain relievers, if necessary
- a recommendation for when to see a doctor for suture removal, unless the sutures used are dissolvable
After nose surgery, a person may experience swelling, numbness, or bruising. They may also temporarily lose some sense of smell.
The doctor may place a metal or plastic splint on the outside of the person’s nose. They may also place non-absorbable packing material in the nostrils.
A health professional will advise a person about the length of recovery.
The surgeon’s office will schedule a follow-up visit after the procedure to ensure recovery and healing are progressing as they should.
The result of nose surgery can changes gradually as a person’s body ages. The effectiveness of this treatment can also vary depending on the reason for the operation. However, success rates and patient satisfaction survey results are promising:
- Rhinoplasty: A small
2019 study with 90 participants found that the mean satisfaction score on the Rhinoplasty Outcomes Assessment was 79.5% after surgery. - Septoplasty: The ASPS states that septoplasty more often has consistent results. Improvements most people experience include better breathing, reduced snoring and better sleep.
- Turbulent surgery: ONE
2022 systematic review found a low complication rate and long-term positive outcomes after turbinate surgery for the treatment of allergic rhinitis. - Nasal valve repair: The American Academy of Otolaryngology—Head and Neck Surgery states that nasal valve repair can improve quality of life and effectively relieve symptoms.
- Septorhinoplasty: ONE
2020 cohort study with 256 participants found that the mean patient satisfaction score after septal rhinoplasty was 87.4%.
The BAAPS highlights the potential risks of rhinoplasty nose surgery. These risks can also occur with other types of nose surgery. They can include:
- bleeding or blood clots
- contamination
- scars
- pain
- bruises
- swelling
- decreased or increased sensation
- prolonged healing time
- extrusion — when the internal suture, bone, or cartilage protrudes through the skin
- allergic reaction to anesthetic
- Respiratory problems
- new damage to the nose
- changes in the sense of smell;
- perforation of the diaphragm
- asymmetry
- unsatisfactory result
- Stroke
- heart attack
- death
The cost of nose surgery for breathing depends on the type of surgery and the person’s insurance coverage.
The table below shows the amounts a person can expect to pay with Medicare coverage:
These prices are based on Medicare payments and copayments in 2022. Costs may vary by location and additional physician fees may apply.
Anyone who regularly has trouble breathing through their nose may want to talk to a doctor. A chronic feeling of fullness in the nasal area and regular sleep disturbances are other signs that it’s time to seek help.
An ear, nose, and throat specialist, called an otolaryngologist, can perform an evaluation, reach a diagnosis, and recommend treatment for nasal breathing difficulties.
Unobstructed nasal breathing is an important part of good health and sleep regulation.
People who experience persistent difficulty breathing through their nose may benefit from surgery to correct anatomical problems that block their nasal passages.
There are several types of nose surgery and each comes with the risks that come with any surgery. However, recovery is often simple and the results can provide the added comfort and health benefits of unobstructed nasal breathing.
