Aesthetic and functional rhinoplasty: how they differ and when they overlap
When people hear "rhinoplasty," most think only about the shape of the nose. In practice, though, a large share of patients who come in for a consultation also have an underlying functional issue: difficulty breathing through one or both nostrils. Understanding the difference between the two components helps set realistic expectations before surgery.
Aesthetic rhinoplasty
It focuses on improving the proportion and harmony of the nose relative to the rest of the face: the bridge, the tip, the width, or the angle with the upper lip. The goal isn’t to "change" the nose, but to adjust it so it fits better with the patient’s own features, avoiding a result that looks artificial or draws attention to itself.
Functional rhinoplasty
It addresses problems that make breathing difficult: a deviated septum, collapse of the nasal valves, or enlarged turbinates. Here the main goal is improving airflow, and the result is judged both by how the nose looks and by how well a patient breathes through it.
Why they are often combined
The internal structure of the nose shapes its external appearance, so in many patients the two issues are related: correcting a deviated septum may also require adjusting the bridge or tip, and vice versa. Combining both approaches in the same surgery — sometimes called septorhinoplasty — avoids a second procedure and a second recovery period. Which technique is then used on the dorsum — preservation rhinoplasty or a classic structural one — is a separate decision that depends on the anatomy of each nose.
Before planning a rhinoplasty — aesthetic, functional, or both — an individualized assessment that takes into account anatomy, breathing, and the patient’s expectations is essential.
Related specialty: Facial Aesthetic Surgery
Related article: Preservation rhinoplasty in Barcelona: what it is, who it suits and where it falls short
References
- 1.Daniel RK, Palhazi P. Rhinoplasty: An Anatomical and Clinical Atlas. Cham: Springer International Publishing; 2018.
- 2.Rohrich RJ, Ahmad J. Rhinoplasty. Plast Reconstr Surg. 2011;128(2):49e-73e.
- 3.Gurtner GC, Neligan PC, editors. Plastic Surgery. Volume 2: Aesthetic Surgery. 4th ed. Edinburgh: Elsevier; 2018.
About the author
Dr. Pablo Vaquero is an attending Oral and Maxillofacial Surgeon at Vall d’Hebron University Hospital (Barcelona) and a surgeon at the Instituto Maxilofacial at Centro Médico Teknon. Trained in Hong Kong, Buenos Aires and Charité Berlin, he is Spain’s National Trainee Representative to the EACMFS and the author of scientific publications and the Lifting Surgery chapter of the SECOM CyC reference manual.