Functional Rhinoplasty

Krista L. Olson, MD

Sunthosh Kumar Sivam, MD

It has been a pleasure to serve as Guest Editors for this Facial Plastic Surgery edition focusing on the nuances of functional rhinoplasty. We chose the title of this edition carefully as the word nuance perfectly describes the way we live and practice on a daily basis—we are meticulous, detail-oriented surgeons, and we find the subtleties in everything we do. Our distinguished authors cover a broad range of topics that will be of interest to both the novice facial plastic surgeon and the experienced one. For the majority of us, functional rhinoplasty comprises a significant portion of our practice, so we felt using this topic as a launching platform to discuss the subtleties we encounter on a frequent basis would be beneficial.

We begin the issue by breaking down the components of the evaluation of the patient with nasal obstruction before moving on to discuss procedures that challenge us all such as concurrent repair of septal perforation and considerations for functional rhinoplasty in the patient with obstructive sleep apnea. We then explore the repair of the nose after failed minimally invasive procedures, an area that has recently surged in popularity with the advent of new techniques, as well as functional nasal surgery in a compromised soft-tissue envelope.

As facial plastic surgeons, we are recognized for our skill in correcting the complex posttraumatic nasal deformity as detailed in this article that leads nicely into a discussion of options for grafting material often used in these cases. The article on complex septal reconstruction elucidates some of the nuances specific to one of the most common situations we encounter as facial plastic surgeons.

An in-depth discussion of pediatric functional rhinoplasty details the key points we need to consider in this population to ensure a durable outcome. Cleft rhinoplasty carries a significant set of considerations and is an area many of us find to be extremely challenging yet very rewarding.

We then transition into a discussion of techniques to alleviate nasal obstruction in the patient with facial paralysis and follow that with a presentation of the intricacies of a favorable butterfly graft as a technique to correct nasal obstruction as well as other methods to help manage the elusive middle vault and tackle lateral wall insufficiency. Finally, we top off our edition with an article on postoperative pain management reflecting current efforts to curb an opioid epidemic while maintaining patient comfort.

We are very thankful for the expertise each author has shared on these important topics and for the time they have spent hopefully making nuances more appreciated.

Publication History

Article published online:
27 July 2023