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Written by: Ahmed Zeinham
The functional rhinoplasty process, also known as functional nose surgery, is a surgical procedure performed on the nose to address functional problems that may hinder normal nasal breathing, while traditional rhinoplasty primarily focuses on improving the aesthetic appearance of the nose. Functional rhinoplasty aims to restore or enhance the function of the nose. Dr. Saqr Haboush stated that common functional problems that can be treated through functional rhinoplasty include the following:
1- Deviated septum: This is the cartilaginous and bony partition that divides the nasal openings. If it is curved or deviated, it can obstruct the airflow through one or both openings, causing difficulty in breathing.
2- Nasal valve collapse: The nasal valve is the narrowest part of the nasal airway and is prone to collapse, making nasal breathing difficult.
3- Enlarged turbinates: Turbinates are bony structures with a mucosal and vascular lining inside the nose that help moisturize, regulate temperature, and filter the air. If they become swollen or enlarged, they can block the nasal passages.
4- Nasal fractures: Nasal injury can lead to structural abnormalities in the nasal structures, resulting in breathing problems.
5- Congenital nasal deformities: Some individuals are born with structural deformities that affect nasal breathing. The specific steps followed in functional rhinoplasty depend on the specific problems being addressed, surgical techniques, unique patient needs. However, the general steps usually include:
1- Consultation: The process begins with a consultation with a qualified plastic surgeon or otolaryngologist (ear, nose, and throat specialist) who will evaluate the patient's nasal function, discuss their concerns and goals, and assess whether functional rhinoplasty is the appropriate solution.
2- Preoperative evaluation: Before surgery, the patient may undergo various tests and imaging to provide a detailed analysis of the internal nasal structures and assist the surgeon in planning the procedure accordingly.
3- Anesthesia: On the day of surgery, the patient is given either general anesthesia or local anesthesia with sedation to ensure comfort during the procedure.
4- Incisions: The surgeon makes incisions inside the nose, known as internal incisions. This ensures that there will be no visible external scars as the procedure is performed entirely through the nasal openings, a method known as closed rhinoplasty.
5- Internal corrections: The surgeon then addresses the functional issues specific to the patient's condition. For example, if there is a deviated septum, the surgeon will straighten and realign it. If there are issues with nasal valves or valve stenosis, grafts or sutures may be used to support the valves and prevent collapse.
6- Turbinate reduction: If enlarged turbinates are a problem, the surgeon may reduce their size through trimming, cauterization, or internal coagulation using laser or radiofrequency to improve airflow.
7- Bone and cartilage modification: In some cases, the surgeon may need to modify the nasal bones or cartilage to correct structural issues resulting from trauma or congenital deformities.
8- Closure: Once the necessary corrections have been made, the surgeon closes the incisions using absorbable sutures.
9- Recovery period: After surgery, the patient is monitored in the recovery area. There may be some swelling, bruising, and discomfort in the days following the procedure, but this should gradually subside over time.
It is essential to select a skilled and experienced surgeon for functional rhinoplasty to ensure the best possible outcomes and minimize the risk of complications. Like any surgical procedure, functional rhinoplasty also carries some risks, and it is important to discuss these with the surgeon during the consultation.
It is worth mentioning that Dr. Saqr Haboush has 33 years of experience in ear, nose, and throat surgery, particularly in aesthetic, functional, and endoscopic nose surgery. He holds a Bachelor of Medicine and Surgery from the Faculty of Medicine at Damascus University in 1984, a specialization certificate in ear, nose, and throat surgery and head and neck surgery from Damascus University, as well as a diploma in facial and neck surgery from the Beatty-Salpetriere Hospital at the University of Paris, and a university diploma in diagnostic imaging in ear, nose, and throat specialties. He is a member of the French and Syrian Association of Ear, Nose, and Throat and Facial Plastic Surgery.

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