Dec. 27, 1999 (Atlanta) -- More than 130,000 patients per year undergo rhinoplasty to improve the shape of their nose, although some experience difficulty with nasal breathing afterward. Experts say newer techniques allow the nose to be reshaped without the same level of breathing problems.
"Rhinoplasty has really evolved in the last twenty years," says Lawrence Reed, MD, a plastic surgeon and assistant professor of plastic surgery at Cornell University in New York. "The focus is now on repositioning the nose rather than removing a lot of cartilage. But patients who had the surgery years ago often complain of sleeplessness and other nasal airway problems. This is because removing too much cartilage causes the sides of the nose to collapse during inhalation."
Fortunately, the problem can be corrected. "We restore the over-operated areas by making a tiny pocket for patients' cartilage," says Daniel Becker, MD, who is from the University of Pennsylvania. Cartilage taken from behind the ear or inside the nose can be regrafted into these pockets.
Researchers at the University of Illinois evaluated its effectiveness in 46 patients using a written questionnaire. Participants rated their nasal breathing on a scale of one to five both before and after the procedure. Some 98% reported improvement in nasal breathing, with an average two-and-a-half-fold improvement, according to a report in the journal Archives of Otolaryngology -- Head and NeckSurgery. These results caused one rhinoplasty patient, who asked to remain anonymous, to opt for the procedure after nearly 30 years.
"I didn't know that anything could be done so I just lived with it," she says. "My breathing problem woke me up at night and it got worse as I got older. After I learned about the surgery, I was afraid it would change the shape of my nose. And I dreaded the bruising, swelling, and pain I had after the first surgery."
Since the operation, she's had a different story to tell. "Now I wonder why I waited so long. I must have tried every pillow, antihistamine, and breathing strip on the market. But the surgery is the only thing that worked. Now I sleep through the night and nobody even knows I had the surgery. I was back to work after a long weekend and I didn't even need the pain medication." Additionally, her health insurance paid for the procedure.
"Relief of breathing problems is medically necessary no matter what the cause is," says Becker. "So the plans generally cover the surgery. But it's important that patients seek out board-certified surgeons. Ear, nose, and throat surgeons, with additional training in facial plastic surgery, and plastic surgeons are qualified to do the procedure," he says.
- More than 130,000 people each year undergo rhinoplasty to improve their appearance, but they often experience difficulty with breathing afterward.
- Surgeons can now correct this breathing problem without changing the shape of the nose.
- Because relief of breathing problems is considered medically necessary, most insurance companies will pay for the second surgery.