Functional Rhinoplasty

A functional rhinoplasty therefore does not start from a single finding. What matters is understanding where the cause of restricted nasal breathing lies, and which structures are involved.

Function and form of the nose cannot be fully separated from one another. Changes to the nasal framework can influence breathing, while functional corrections can, at the same time, affect the external shape.

Dr. med. Simon Zimmermann performs functional rhinoplasties at Clinic Selnau in Zürich with the aim of improving nasal breathing while preserving the natural shape and structural stability of the nose.

Our Approach

Every case of restricted nasal breathing has its own cause.

A deviated nasal septum can obstruct airflow. Enlarged turbinates can reduce the space available within the nose. Unstable or narrow nasal valves can cause areas of the airway to narrow further during inhalation. Often, several factors act together at once.

For this reason, a functional rhinoplasty begins with a careful examination of the internal and external nose. What matters is not only establishing that nasal breathing is restricted, but understanding why.

The treatment plan is then guided by the structures actually responsible for the symptoms. The aim is not the most extensive operation possible, but a targeted correction of the anatomical causes while preserving the natural structure of the nose.

Form & Function

The nose is both an airway and part of the face.

A functional correction should therefore never be planned in isolation from the external shape. Particularly with a crooked nose, an unstable nasal wall or changes to the nasal valves, functional and aesthetic aspects are often directly connected, a structural weakness can affect nasal breathing and alter the external shape at the same time.

For this reason, the internal anatomy, the nasal framework and the external shape are always assessed together during planning.

When a wish for aesthetic change exists alongside restricted nasal breathing, both aspects can often be planned within the same operation. Functional and aesthetic goals are not considered separately, the nose is understood as a single anatomical unit whose shape, function and stability are interconnected. Patients whose primary concern is the external shape can find more detailed information under Rhinoplasty.

A functional rhinoplasty may be considered for concerns including:

• Restricted or one-sided nasal breathing
• A deviated nasal septum
• Enlarged turbinates
• Narrowing of the internal or external nasal valves
• Instability of the lateral nasal walls
• A crooked or structurally asymmetric nose
• Changes following injury or nasal fractures
• Functional issues following a previous nasal operation, see also Revision Rhinoplasty
• A combination of functional and aesthetic concerns

Not every case of restricted nasal breathing has a purely anatomical cause. Allergies, mucosal conditions or other factors can also play a role. A thorough examination is therefore essential before determining whether, and to what extent, surgical treatment makes sense.

Planning & Analysis

A functional rhinoplasty begins with a detailed analysis of nasal breathing and the underlying anatomy.

During consultation, your nose is examined from the inside and outside. This includes assessing the nasal septum, the turbinates, the nasal valves and the stability of the nasal framework. What matters here is not only the anatomy at rest, the stability of the lateral nasal walls and nasal valves during inhalation is also considered.

At the same time, we assess the external shape and proportions of the nose. Particularly where structural changes are involved, it is important to understand how the internal and external anatomy relate to one another.

Standardised photography supports the assessment of the external nose. Where a change to the shape is also planned, 3D simulation can help visualise possible changes and build a shared understanding of the intended direction. The skin and surrounding soft tissue are also taken into account, as they influence how changes to the underlying bone and cartilage framework present after surgery.

Planning is always guided by the individual cause of the symptoms. Not every functional rhinoplasty requires the same corrections.

The Procedure

Which structures are treated during a functional rhinoplasty depends on the cause of the restricted nasal breathing.

Where the nasal septum is deviated, septal correction may be necessary. Enlarged turbinates can be treated in a tissue-preserving way where they meaningfully restrict airflow. Where nasal valves are narrow or unstable, the affected areas may need to be structurally stabilised.

In some cases, a correction within the nose is sufficient. Where the functional restriction is connected to the shape or stability of the external nasal framework, however, both areas need to be treated together.

The focus here is on preserving, and where necessary restoring, stable anatomical structures.

Cartilage can be used in a targeted way to support weakened areas or stabilise the nasal valves. Where suitable material is available within the nose, it can be used directly. Which technique makes sense depends on your individual anatomy.

The surgical approach is likewise chosen according to the corrections required. In suitable cases, the operation can be performed through a closed approach, with incisions inside the nose. More complex structural changes may require an open approach, where a more comprehensive view of the nasal framework is needed.

What matters is not the technique itself, but that the cause of the functional restriction is treated precisely, and the stability of the nose preserved over the long term.

Breathing Requires Structure

Free nasal breathing does not depend only on how wide an airway appears.

Equally important is that the surrounding structures remain stable during inhalation. The nasal valves play a particularly important role here, if their support is weakened, areas of the nose can narrow during inhalation and impair airflow.

For this reason, functional rhinoplasty does not simply mean creating more space within the nose. It is about restoring the anatomical conditions for airflow that is as free and stable as possible, while preserving existing structures as far as possible.

A functional nose should not only be able to breathe freely. It should also remain structurally stable and naturally shaped.

Healing & Results

After a functional rhinoplasty, the nose needs time to heal.

Swelling inside the nose is normal during the early healing phase and can make nasal breathing feel restricted at first. The functional result cannot therefore be assessed immediately after the operation.

As healing progresses, swelling subsides and the internal structures stabilise. Nasal breathing can change and improve gradually as a result.

Where the external shape of the nose has also been corrected, the skin gradually adapts to the altered bone and cartilage framework as well. As with an aesthetic rhinoplasty, the final result develops over a longer period.

The course of healing depends on the extent of the operation, the structures treated and the individual tissue response.

The aim is not only a short-term widening of the airway, but a functionally stable nose whose shape and structure remain preserved over the long term.

Consultation

A functional rhinoplasty begins with the question of why your nasal breathing is restricted.

During your consultation with Dr. med. Simon Zimmermann at Clinic Selnau in Zürich, we discuss your symptoms and carefully examine the internal and external nose. The nasal septum, turbinates, nasal valves and the stability of the nasal framework are assessed, along with the external shape of the nose and its proportions within the face.

On this basis, we discuss which anatomical changes are contributing to your symptoms, and which of these can meaningfully be treated.

Where aesthetic changes are also desired, these are included in the planning from the outset. Standardised photography and, where appropriate, 3D simulation support this shared planning process.

We discuss openly what functional result can realistically be expected, which surgical steps are required, and what limitations and risks need to be considered.

The aim is not to change as many structures as possible. It is to understand the cause of the restricted nasal breathing and to develop a treatment plan that brings function, form and long-term stability into balance as effectively as possible.