Beverly Hills Rhinoplasty Surgery Blog

Nasal obstruction is a complicated issue that is all too often ignored or attributed to “allergies,” “sinuses,” or to a “deviated septum.” Here at Profiles we often have patients who present to us who have been previously evaluated by other physicians who were unable to determine the cause of nasal obstruction.

We always begin by explaining that it is important to understand that nasal obstruction is a subjective sensation and that it occasionally does not correlate with anatomic problems. In other words, some people can have a slightly deviated septum and complain profusely of their difficulty breathing, while other people are completely obstructed on one side of the nose without ever even realizing they have a problem. So if you have trouble breathing through your nose, it is important to let us do a thorough evaluation.

It is true that oftentimes nasal obstruction is due to:

1. A Deviated Septum- where the midline cartilage and/or bone that separates the two sides of your nose is crooked

2. Nasal Allergies- whether seasonal or year-round.

3. “Sinus Problems”- This diagnosis is unfortunately all too commonly applied to patients without proper evaluation.

Nasal obstruction is a complex problem and there are numerous possible explanations with even more possible solutions. We recognize how nagging this problem can be and we understand how complex the solution is. The important thing for you is to find the doctor who will take the time to find out what your source of obstruction is and more importantly knows how to correct this problem.

For further info we recommend you go to our Modern Rhinoplasty online book and read further on Functional Rhinoplasty.

We always appreciate patients who present to us having done some homework on their own because it lets us know that they are really preparing for their surgery and more importantly because it allows us to spend more time in really discussing the available surgical options.

We find a lot of our patients, men and women, present with exactly this question and the answer largely depends on each particular patient’s anatomy.

Sometimes, patients present with a large hump which makes their nose look large, and you will often see these pictures on people’s websites because in reality, though they are the most dramatic results, they are relatively easier to accomplish. Occasionally, these patients also have smaller chins and a chin implant goes a long way in balancing their appearance.

The more difficult cases are those patients who like the overall shape of their nose but feel like their whole nose is just too large. In these cases the tip, middle third of the nose and bridge all have to be reduced equally. While we can and often do exactly this procedure for our patients, it is important in these cases to be very cognizant of skin thickness. In those patients who have thick skin, we caution that while the nose can be made smaller, it should still maintain definition and refinement. In our patients with thick skin, we always let them know that if we attempt to make the nose too small the tip can lose its shape and appear amorphous. So while we make the nose smaller, we stress the importance of tip definition and refinement.

Finally, and perhaps most importantly, we must remember that the primary function of the nose is to help in breathing and this function is critical. Unfortunately, a lot of times with all the mass media exposure to airbrushed pictures, we are exposed to images of people who are not real and to noses that cannot be reproduced without causing problems in breathing. And its for this reason that at Profiles, we always admonish that Form must not supercede Function.

Nasal Allergies, whether seasonal or year-round, generally are not a factor in rhinoplasty. If you experience nasal allergy symptoms, you should be thoroughly evaluated to see if there are any other factors that may exacerbate your breathing problems- such as a deviated septum or enlarged turbinates. If these problems are also present they should be addressed during your rhinoplasty.

Otherwise we find that in general patients have a period of reprieve from their allergy symptoms following surgery. We do counsel our patients not to blow their nose for about 2 weeks after surgery and also to keep your mouth open if you have to sneeze. Overall, there should be no reason why your allergies should affect your surgery with us.