Functional Rhinoplasty

Grant S. Hamilton III, MD, FACS

It is an honor for me to edit this issue of Facial Plastic Surgery. Functional rhinoplasty may have an emphasis on improved nasal breathing but the concomitant improvement in nasal shape certainly improves our patients' quality of life too. Nasal obstruction is one of the most common reasons for patients to seek a consultation from otolaryngologists or facial plastic surgeons and can be a deceptively complex topic to diagnose. The inseparable interplay between mucosal, structural, and sensory causes of both subjective and objective nasal obstruction makes functional rhinoplasty an endeavor fraught with pitfalls of misdiagnoses and missed diagnoses.

In this issue, the contributors have provided insight in to holistic solutions that have the potential to treat the most common dysfunctions of nasal airflow and form. I'm excited that this collection of articles can serve as a primer for the beginning rhinoplasty surgeon and offer some advanced insights for more experienced surgeons. The organization of concepts presented herein begins with an overview of the evaluation of the patient with nasal obstruction followed by a thoughtful discussion of the aesthetic consequences of common functional rhinoplasty techniques. Wever critically examines the evidence in support of these techniques. There are also multiple articles dealing with specific solutions to complex problems of the septum as well as internal and external nasal valves. Some of these are innovations being published for the first time. Finally, Winkler offers recommendations for preventing iatrogenic nasal obstruction. There are also up-to-date perspectives on two- and three-dimensional computer imaging technologies in rhinoplasty and an interesting case report involving a migrating nasal implant.

I extend my deepest gratitude to the many talented contributors to this issue. I appreciate your hard work and thoughtful insight in preparing these manuscripts. I am excited to present this issue to you and hope that you enjoy reading it as much as I did.