The difference(s) between a functional and a cosmetic rhinoplasty is(are) of philosophy and goals, not necessarily of specific surgical maneuvers. A functional rhinoplasty is focused on improving nasal breathing by widening or strengthening the opening of one or both nasal cavities. A cosmetic rhinoplasty may be like a functional rhinoplasty but may also involve maneuvers that narrow or reduce the size of the nose. Most patients desire both functional and cosmetic improvement, demanding a mixed philosophy which informs the surgical approach. Overall, it is important to work towards a natural appearing result that fits each patient’s unique facial features when performing a functional rhinoplasty, cosmetic rhinoplasty, or a rhinoplasty that incorporates both functional and cosmetic goals. An in-person consultation is always necessary to evaluate the nose to determine the most appropriate approach. Seek a fellowship-trained facial plastic surgeon if you have concerns about your nose.
What is the Difference Between a Functional and a Cosmetic Rhinoplasty?
Dr. Jeffrey Harmon
Some Maneuvers are Primarily Cosmetic
Maneuvers that may be more cosmetic than functional include:
- Dorsal hump (bump) reduction, which is meant to reduce the height of the nasal bridge
- Dorsal onlay graft, which is meant to increase the height of the nasal bridge
- Nasal tip cartilage suturing (stitching), which is meant to narrow the nasal tip
- Nasal tip grafting (e.g., columellar strut graft, caudal septal extension graft), which is meant to control the projection and rotation (i.e., upturn) of the nasal tip
- Lateral crural trim, which is meant to decrease the “fullness” of the nasal tip
- Lateral and medial osteotomies, which are meant to narrow the nasal bridge
The above maneuvers change the height of the nasal bridge, the size and shape of the nasal tip, and the projection and/or rotation of the nasal tip. One or more of these maneuvers may be an appropriate approach to achieve a patient’s cosmetic goals. However, this list is not comprehensive, as there are many other maneuvers available to surgeons.
Maneuvers that Widen and/or Strengthen Can be Functional and Cosmetic
Maneuvers that open a collapsed area of the nose or strengthen the opening of one or both nasal cavities can improve restricted nasal breathing as well as the appearance of the nose.
Maneuvers that may be functional as well as cosmetic include:
- Spreader grafts that widen the nasal bridge and open up the interior of the nasal cavity
- Lateral crural grafts that open and strength the valve that keeps the opening of the nose stable
- Grafts that straighten and strengthen the nasal septum
While most osteotomies are intended to narrow the nasal bridge, they can be used to return a previously fractured nose to a more symmetric position, thereby opening a previously narrowed nasal cavity.
All functional rhinoplasty procedures should seek to at least preserve and, when possible, enhance the cosmesis of the nose. The focus of functional rhinoplasty, however, should be on improving air flow through the nose. There may be instances in which the cosmesis of the nose is sacrificed when function of the nose is by far the most valued goal of a patient.
Facial Plastic Surgeons Have an Eye Towards Long-Term Results
A facial plastic surgeon has an aesthetic eye regardless of the primary goals of a rhinoplasty. As a result, there is not a purely functional or cosmetic procedure. Instead, each procedure is tailored to the individual patient based on a detailed discussion of their aesthetic and functional goals. A facial plastic surgeon’s aesthetic eye should be aimed towards the future such that the best, most natural appearing, long-term result that is possible is achieved, not necessarily the most trendy result immediately after surgery.
Trust Your Face to a Facial Plastic Surgeon
It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck.
Request a Consultation
Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more.
This blog post is for educational purposes only and does not constitute direct medical advice. It is essential that you have a consultation with a qualified medical provider prior to considering any treatment. This will allow you the opportunity to discuss any potential benefits, risks, and alternatives to the treatment.