Interviewer: What to know if you're considering rhinoplasty to help your breathing. That's next on The Scope.
Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.
Interviewer: Dr. Eric Cerrati is a plastic surgeon at University of Utah Health that specializes in cosmetic and reconstructive surgery of the face and the neck. If you have been considering rhinoplasty to help improve your breathing, we're going to answer the questions you might have right now. There are a couple of reasons why somebody might get one. One is because that they want to improve their appearance. But the other one is because maybe they have some sort of a breathing issue. So let's pretend I'm a person that has a breathing issue and I've come in to talk to you about rhinoplasty. What would you tell me as a patient at this point?
Dr. Cerrati: So there's a lot of different aspects to nasal obstruction. You can have, one, the very common one is a deviated nasal septum which is a divider inside your nose. It usually leads to unilateral nasal obstruction. But then other causes of nasal obstruction include like internal and external nasal valve collapse. And those are usually addressed more with the rhinoplasty approach than just an endonasal septoplasty.
Interviewer: All right. So rhinoplasty covers a certain particular type of breathing issue that you would have. If you have those other issues, there are other procedures?
Dr. Cerrati: Yes. Usually a rhinoplasty would correct, say, when you breathe in, if one side of your nose kind of collapses or doesn't have the support to maintain that negative pressure, rhinoplasty approach can help provide more support to the external nose.
Interviewer: All right. So beyond kind of what you just described, there are other factors that go into whether or not this would be the right procedure for my breathing problem and to know if I was a candidate.
Dr. Cerrati: So really, the best thing is a physical exam done by someone who's experienced. I would recommend, if someone's interested in a rhinoplasty or has nasal obstruction, to really go to someone who is trained in treating people with all the different types of pathology that could cause nasal obstruction.
Patience Makes Perfect Rhinoplasty Results
Interviewer: And what kind of result could I expect after the procedure if I had some sort of a breathing issue?
Dr. Cerrati: So that's actually a good question. So the same way that you would have swelling on the outside of your body, say if you had a cut or a bruise or that sort of thing, you just have that same healing process and swelling that occurs inside of your nose. So a lot of times, right after the surgery, you don't necessarily have perfect breathing right away. Your inside of your nose has to undergo the same healing processes. So within a week or two and all that swelling has resolved, the goal is to have a more open airway bilaterally.
Interviewer: And generally, does it really kind of change a person's life? I mean, are they able to, at that point, breathe in a way that they haven't before ever?
Dr. Cerrati: That's the hope.
Interviewer: That's why you do what you do, right?
Dr. Cerrati: Oftentimes it has significantly improved. There is part of a nasal obstruction that can be more subjective but a lot of times, we do get a significant improvement.
Rhinoplasty Procedure and Recovery
Interviewer: And then if somebody has a procedure, how long does it take? You'd mention about the two weeks to start noticing some breathing improvement, but what about getting back to your life? So you go and you have the procedure, go back to work, that sort of thing.
Dr. Cerrati: Yeah. So most times, the initial recovery we tell people about a week. Usually you can have some bruising and swelling kind of externally on the face which will improve over the first week. A lot of times, you'll have a cast on your nose. Depending on what type of work you do, you may or may not want to be visible or back at work during that time. But by halfway through the second week or by the end of the second week, you're kind of back to all normal activities.
Interviewer: Got you. And then what about scars or any sort of external things that are going on after surgery? Are there any visible scars?
Dr. Cerrati: So there's actually two different approaches to rhinoplasty, one's an endonasal and one's the external rhinoplasty. So the endonasal is just all incisions inside the nose and we can address a lot of different issues with that approach. However, there are indications where an external approach is going to be better. That will involve a small incision right at the columella, right underneath the nose. It's really just a five or six millimeter incision. And after about two or three months of healing, that scar is completely invisible.
Interviewer: Got you. So really not much if anything at all, especially if it was done inside.
Dr. Cerrati: Right.
Interviewer: Yeah. You had mentioned briefly about looking for a doctor that has experience in this. Give me some more information as a patient how I could pick the right doctor for this procedure to make sure, because you're messing with my face.
Dr. Cerrati: Definitely. So I would recommend someone who is board-certified in facial plastic surgery or plastic surgery. So for myself, I did a residency in head and neck surgery, which is a five-year training program. And I did an additional year in facial plastic surgery, and that was sponsored by the American Academy of Facial Plastic and Reconstructive Surgery. So really concentrating just on the kind of shoulders up for the last six years.
Interviewer: So there are some people that aren't board-certified in that they can still do this procedure?
Dr. Cerrati: Oh, yeah, definitely.
Interviewer: All right. So you want to look for somebody with that extra year of training?
Dr. Cerrati: Someone who is, yeah, board-certified by the American Academy of Facial Plastic and Reconstructive Surgery or the American Board of Plastic Surgery.
Small Risks Lead to Better Breathing
Interviewer: What are some of the common questions or concerns you get kind of beyond what I already asked?
Dr. Cerrati: So a lot of the common topics that people bring up, you kind of addressed them with indications and who's a candidate and what different approaches to rhinoplasty. But it is a surgical procedure so there are risk and complications involved. So the main risk would be bleeding or infection, but those are very small. If you're doing something to the septum or trying to address breathing that you know there's a chance you could have a septal perforation or a hole that goes from one side of the nose to the other.
Again, all these complications are, I would say, are single-digit, very, very small percentages. And then lastly, some of these . . . in correcting the nasal obstruction can lead to some external changes. Obviously we aim for symmetry and a lot of times, the cosmetic result comes with the improvement of the nasal obstruction.
The one thing that wasn't addressed is that if someone has any questions about changing the external appearance of their nose, that's also done through a rhinoplasty approach. But again, the main goal of any type of nasal surgery is to make sure that their nasal breathing is functionable and is not changed even when the external appearance is altered.
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updated: December 8, 2017
originally published: August 14, 2019
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