Ghatkopar (East), Mumbai)
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Functional Rhinoplasty In Mumbai
Surgical Correction of Nasal Breathing Obstruction and Structural Deformity at Shree Hospitals
Functional rhinoplasty is surgery to correct structural abnormalities of the nose that cause nasal airway obstruction and impair nasal breathing. While cosmetic rhinoplasty addresses nasal appearance alone, functional rhinoplasty focuses on restoring the nasal airway by correcting the underlying anatomical causes of obstruction - including a deviated nasal septum, collapsed nasal valves, enlarged inferior turbinates, or nasal structural deformities following trauma. At Shree Hospitals, our specialist plastic and ENT surgeons perform functional and combined functional-cosmetic rhinoplasty to restore normal nasal breathing while achieving a natural and harmonious nasal appearance.
Difficulty Breathing Through Your Nose? Consult Our Rhinoplasty Team at Shree Hospitals
Quick facts
Conditions Treated: Deviated Septum, Nasal Valve Collapse, Turbinate Hypertrophy
Anaesthesia: General Anaesthesia
Approach: Open (External) or Closed (Endonasal) Rhinoplasty
Duration: 1.5 to 3 hours
Hospital Stay: Day Case or 1 Night
Support Team: Plastic surgeons, ENT surgeons, anaesthetists
Key Benefit: Restored nasal breathing and structural correction
What is Functional Rhinoplasty?
The nose serves as the primary airway for breathing, warming, humidifying, and filtering inspired air. Normal nasal breathing depends on a clear, unobstructed nasal airway supported by a strong structural framework of bone and cartilage. When this framework is distorted - by congenital deviation, nasal trauma, or structural weakness - the nasal airway narrows and nasal obstruction results. Patients experience difficulty breathing through the nose, mouth breathing, snoring, poor sleep quality, exercise intolerance, nasal dryness, recurrent sinusitis, and reduced sense of smell. Functional rhinoplasty corrects the structural causes of this obstruction, restoring the nasal airway and its physiological functions.
The main anatomical causes of nasal airway obstruction addressed by functional rhinoplasty include: deviated nasal septum (the central partition between the two nasal passages, displaced to one side by trauma or congenital development, causing unilateral or bilateral obstruction); nasal valve collapse (the internal and external nasal valves, which are the narrowest parts of the nasal airway, can collapse on inspiration due to weak cartilage support, causing dynamic obstruction); inferior turbinate hypertrophy (the inferior turbinates, bony projections on the nasal sidewall covered in mucosa, can become permanently enlarged due to chronic allergic rhinitis or vasomotor rhinitis, reducing the airway); and external nasal deformity (after fracture or previous surgery, the nasal bones or cartilages may be malpositioned, distorting the nasal airway as well as the nasal appearance).
At Shree Hospitals, functional rhinoplasty is performed by our specialist plastic surgeons and ENT surgeons working together where indicated. We perform both open rhinoplasty (a small incision on the columella - the skin between the nostrils - giving full exposure of the cartilage framework) and closed rhinoplasty (all incisions inside the nostrils, leaving no external scar). The choice depends on the extent of reconstruction required. We use spreader grafts, batten grafts, alar rim grafts, and septal reconstruction techniques to restore the structural support of the nasal airway while preserving or improving nasal appearance. Turbinate reduction (by submucosal diathermy, microdebrider turbinoplasty, or partial turbinectomy) is performed simultaneously for patients with inferior turbinate hypertrophy.
Who Is a Candidate for Functional Rhinoplasty?
Functional rhinoplasty is indicated for:
- Patients with persistent nasal obstruction significantly impacting quality of life (sleep, exercise, breathing comfort) despite adequate medical management (nasal corticosteroid sprays, antihistamines for allergic rhinitis)
- Deviated nasal septum confirmed on nasal endoscopy and CT scan causing unilateral or bilateral airway obstruction
- Nasal valve collapse (internal or external) demonstrated by the Cottle manoeuvre (gentle lateral distraction of the cheek improving nasal airflow) or nasal endoscopy
- Post-traumatic nasal deformity with nasal airway obstruction and structural malposition after a nasal fracture
- Cleft nasal deformity - the displaced alar cartilage in a cleft lip nose causes both cosmetic asymmetry and functional airway obstruction requiring combined correction at skeletal maturity
- Athletes and physically active patients in whom nasal obstruction significantly limits exercise capacity and sport performance
Is Functional Rhinoplasty Right for You?
Functional rhinoplasty is appropriate when:
- Nasal airway obstruction has been present for more than 3 months and has not responded to nasal steroid sprays used correctly for at least 3 months (for patients with allergic or vasomotor rhinitis component)
- Nasal endoscopy or CT scan of the sinuses has confirmed the anatomical cause of obstruction (deviated septum, turbinate hypertrophy, valve collapse, or structural deformity)
- The patient does not have active nasal infection, uncontrolled allergic rhinitis, or autoimmune nasal disease (granulomatosis with polyangiitis) that should be treated first
- The patient has realistic expectations - functional rhinoplasty improves but does not always eliminate nasal airway obstruction completely
- The patient is 16 to 18 years or older (when nasal growth is complete) for structural work to the cartilage and bone framework
Why Restoring Nasal Breathing Improves Overall Health?
Nasal obstruction has consequences extending well beyond nasal discomfort:
- Sleep quality: nasal obstruction causes mouth breathing at night, which is strongly associated with snoring, obstructive sleep apnoea, dry mouth, and non-restorative sleep
- Cardiovascular health: chronic mouth breathing and snoring associated with nasal obstruction are independent risk factors for hypertension and cardiovascular disease
- Exercise capacity: nasal breathing produces nitric oxide from the paranasal sinuses which dilates the pulmonary vasculature and improves oxygen uptake - mouth breathing bypasses this mechanism
- Sinus health: nasal obstruction impairs mucociliary drainage of the sinuses, predisposing to recurrent sinusitis and postnasal drip
- Children: persistent nasal obstruction in children causes craniofacial growth abnormalities (the characteristic "adenoid face"), dental malocclusion, and impact on academic performance due to poor sleep
Over 90% of patients report significant improvement in nasal breathing after functional rhinoplasty at Shree Hospitals.
Our rhinoplasty team at Shree Hospitals uses structural correction techniques including spreader grafts, valve repair, and septoplasty to restore the nasal airway while maintaining or improving nasal appearance, delivering durable long-term functional results.
24×7 Emergency Care
Our Approach to Functional Rhinoplasty
At Shree Hospitals, functional rhinoplasty is tailored to each patient's specific anatomical diagnosis. We combine comprehensive pre-operative assessment with precise structural surgical correction to restore nasal function while respecting and improving nasal aesthetics.
24×7 Emergency Care
Thorough Pre-Operative Functional Assessment
Every patient presenting with nasal obstruction undergoes a comprehensive assessment including anterior rhinoscopy, nasal endoscopy (flexible or rigid) to assess the septum, turbinates, nasal valves, and posterior choana, and CT scan of the paranasal sinuses to assess septal deviation, turbinate size, sinus disease, and bony anatomy. Rhinomanometry (measurement of nasal airflow resistance) may be used to quantify the degree of obstruction and to assess improvement after treatment. Skin pinch test and Cottle manoeuvre clinically assess nasal valve function.
Septal Reconstruction and Straightening Septoplasty
The deviated portions of the quadrilateral cartilage and the perpendicular plate of the ethmoid are repositioned or removed to open the obstructed nasal passage. Unlike traditional septoplasty which removes cartilage, our surgeons prefer a cartilage-sparing approach - the deviated septal cartilage is scored, fractured, and repositioned rather than excised wherever possible, preserving structural support for the nasal tip and dorsum and reducing the risk of late saddle nose deformity (collapse of the nasal bridge).
Nasal Valve Repair with Structural Grafts Nasal valve collapse
Our surgeons address internal valve collapse with spreader grafts (pieces of cartilage placed between the upper lateral cartilage and the septum to widen the valve angle) and external valve collapse with alar batten grafts or alar rim grafts (cartilage grafts placed to stiffen and support the collapsing nasal sidewall on inspiration). All graft material is harvested from the patient's own nasal septum (preferred) or from the ear concha or rib if additional material is needed.
Turbinate Reduction and Combined Correction
Where inferior turbinate hypertrophy contributes to nasal obstruction, turbinate reduction is performed simultaneously with the rhinoplasty. Our preferred technique is submucosal diathermy turbinoplasty or microdebrider-assisted turbinoplasty, which reduces the submucosal tissue bulk while preserving the turbinate mucosal surface and its physiological functions (humidification, air warming, and air conditioning). This is preferred over older techniques of complete turbinate excision, which risks empty nose syndrome (paradoxical nasal obstruction, crusting, and dryness despite a wide-open airway).
Top Rhinoplasty and Facial Plastic Surgeons in Mumbai
Every specialist at Shree Hospitals is board-certified and has an average of 15+ years of clinical experience in functional rhinoplasty, septoplasty, nasal valve repair, turbinate surgery, and post-traumatic nasal reconstruction
24×7 Emergency Care
Dr. Suyash Yashwant Patankar
Consultant Plastic, Reconstructive
Dr. Arun V. Sheth
Consultant Plastic, Cosmetic
Dr. Abhijeet Dharmaji Sawant
Consultant Plastic, Reconstructive, Aesthetic
Dr. Udit Dalmia
Consultant Plastic, Aesthetic
Plastic and Reconstructive Surgery Services
We offer a comprehensive range of plastic and reconstructive surgery procedures including functional rhinoplasty, cleft repair surgery, scar revision, skin grafting, flap surgery, microsurgery, breast reconstruction, and wound debridement, all delivered by specialist plastic and reconstructive surgeons.
Microsurgery
Precision microsurgical reconstruction for complex nasal defects requiring free tissue transfer after cancer surgery or trauma. Our microsurgery team provides 24/7 emergency and elective reconstruction.
Step by Step Process of Functional Rhinoplasty at Shree Hospitals
Step 1 - Consultation, Assessment, and Photography
The rhinoplasty surgeon takes a detailed history of nasal symptoms, their duration, severity, and impact on sleep and daily function. Nasal endoscopy is performed in clinic to directly visualise the septum, turbinates, nasal valves, and any polyps or sinus disease. The Cottle manoeuvre and nasal skin pinch test assess valve function. Standardised nasal photographs (frontal, lateral, oblique, base, and worm's eye views) are taken and reviewed with the patient. Where cosmetic concerns coexist, the functional and cosmetic goals are discussed and a combined functional-cosmetic rhinoplasty plan is developed. CT scan of the sinuses is reviewed if available or ordered if not.
Step 2 - Surgical Planning and Consent
The surgical plan is documented in detail, specifying the approach (open or closed), the specific structural corrections planned (septoplasty, spreader grafts, batten grafts, turbinate reduction), the graft harvest site (septum, ear, or rib), and whether a cosmetic rhinoplasty component is to be performed simultaneously. The patient is counselled about expected outcomes, the bruising and swelling period (significant swelling resolves over 3 to 4 weeks, but subtle nasal swelling takes 12 months to resolve), and the risks of surgery (infection, bleeding, asymmetry, need for revision). Full informed consent is obtained.
Step 3 - Anaesthesia and Patient Preparation
Functional rhinoplasty is performed under general anaesthesia. The patient is positioned supine with the head elevated 15 to 20 degrees to reduce intraoperative bleeding. The nasal mucosa is injected with dilute local anaesthetic and adrenaline solution to minimise bleeding in the operative field. The face is prepared with antiseptic solution and draped.
Step 4 - Nasal Approach and Exposure
For open rhinoplasty, a transcolumellar incision (inverted-V incision on the columella between the nostrils) is combined with bilateral marginal incisions inside the nostrils to lift the nasal skin envelope off the underlying cartilage framework, giving complete exposure of the lower lateral cartilages, upper lateral cartilages, nasal septum, and nasal dorsum. For closed rhinoplasty, all incisions are inside the nostrils and the cartilage framework is accessed through limited delivery or non-delivery approaches.
Step 5 - Structural Correction
The planned structural corrections are performed sequentially. Septoplasty addresses the deviated septum, with harvested cartilage preserved for grafting. Spreader grafts are sutured between the upper lateral cartilages and the septum to open the internal valve angle. Batten or alar rim grafts are placed to support the collapsing nasal sidewall. Turbinate reduction is performed via the endoscope. For post-traumatic cases, fractured nasal bones are osteotomised (intentionally re-fractured) and repositioned to straighten the nasal dorsum. All cartilage work is performed with careful attention to symmetry under loupe magnification.
Step 6 - Wound Closure and Post-Operative Care
The transcolumellar incision is closed with 5-0 nylon sutures and the intranasal incisions with absorbable sutures. Nasal splints (internal silicone splints) are placed for 1 week to support the septum during healing. An external nasal splint or plaster cast is applied to protect the nasal bones if osteotomies were performed. Nasal packing is avoided in most cases. The patient is discharged the same day or the following morning. Nasal saline irrigation begins on day 2. Splints are removed at 7 to 10 days. Most patients return to work at 2 weeks and to full exercise at 6 weeks. Final results are assessed at 12 months once all swelling has resolved.
Patient Questions About Functional Rhinoplasty
What is the difference between functional rhinoplasty and cosmetic rhinoplasty?
Functional rhinoplasty addresses structural problems that impair nasal breathing - including deviated septum, nasal valve collapse, and turbinate hypertrophy. The primary goal is to improve nasal airway function. Cosmetic rhinoplasty (also called aesthetic rhinoplasty or a "nose job") addresses the appearance of the nose - reducing a dorsal hump, refining the nasal tip, or correcting asymmetry - without any functional indication. Combined functional and cosmetic rhinoplasty addresses both function and appearance simultaneously in a single procedure, which is appropriate when both issues are present. At Shree Hospitals, we assess both functional and cosmetic aspects at every rhinoplasty consultation to ensure all relevant issues are addressed together where possible.
What is negative pressure wound therapy and does it hurt?
Yes - revision rhinoplasty is performed for patients who have had previous nasal surgery and either have persistent obstruction or are dissatisfied with the result. Revision rhinoplasty is more complex than primary surgery because of scar tissue from the previous operation, possible cartilage shortage from previous excisions, and altered anatomy. An open approach is usually preferred for revision cases to allow full visualisation. Rib cartilage graft may be required if the nasal septum and ear cartilage have been used in the previous surgery. Our surgeons have extensive experience in revision rhinoplasty and will assess the previous operative record and imaging before planning the revision procedure.
Will functional rhinoplasty change the appearance of my nose?
Functional rhinoplasty that is limited to internal structural corrections (septoplasty, spreader grafts via an open approach, internal turbinate reduction) produces little or no visible change to the external appearance of the nose in most patients - the cartilage work is internal. Alar batten grafts placed to support the collapsing nasal sidewall are subcutaneous and not visible on the surface. When nasal osteotomies are performed (to straighten a traumatic nasal bone deviation), this does affect the nasal profile. Our surgeons will discuss any expected changes to nasal appearance at consultation. Many patients choose to address both functional and cosmetic concerns at the same time, taking advantage of the surgical exposure already required for functional correction.
How long does recovery take after functional rhinoplasty?
Most patients take 1 to 2 weeks off work after functional rhinoplasty. Bruising around the eyes (particularly if nasal osteotomies were performed) typically resolves within 2 weeks. Nasal swelling is significant for the first 3 to 4 weeks and takes 6 to 12 months to fully resolve. Nasal breathing improvement is usually noticed immediately after splint removal at 7 to 10 days, though some initial stuffiness from post-operative swelling and crusting is normal for the first 4 to 6 weeks. Contact sports and any activity risking nasal trauma should be avoided for 6 weeks. Swimming (and submerging the face) should be avoided for 4 weeks to allow the intranasal incisions to heal fully.
Evidence-Based Case Studies by Our Specialists
Would Recommend Us
"I had not been able to breathe properly through my nose for years and was constantly mouth breathing at night. The rhinoplasty team at Shree Hospitals operated and corrected my septum and turbinates. I can now breathe freely through both sides of my nose for the first time in years."
Mr. Kiran T.
"After my accident my nose was crooked and I could barely breathe through the right side. The team at Shree Hospitals corrected both problems at the same time. My nose looks straight and I breathe normally now. I only wish I had come sooner."
Mr. Rahul D.
"I had my cleft lip repaired as a baby but the nose remained asymmetric and one side was always blocked. At Shree Hospitals the team performed the cleft rhinoplasty and both the breathing and the appearance improved enormously. It completed my treatment."
Miss Priya S.
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