The Tug of War Between Form and Function

Posted on February 20, 2013 in Rhinoplasty

Recently, I have been seeing a number patients regarding revision rhinoplasty. And a common theme has come up in each of these consults: how to balance the aesthetic goals (form) with maintenance, or in most cases, improvement in nasal breathing (function). In most of these cases, patients have had overly aggressive reduction rhinoplasty. And even when the aesthetic result has been adequate, the functional result has been a source of continual frustration for the patient.

When I meet with a patient who is interested in rhinoplasty, we have two important and inter-related conversations. The first is about the aesthetic issues that have led the patient to seek nose reshaping. The goal in this conversation is to examine the nose in the context of the face, and to identify ways of improving symmetry and overall harmony. The second conversation is about breathing and nasal function, including issues with obstruction (e.g., from a deviated septum or previous fracture) and allergies (including enlarged turbinates), as well as the patient’s common activities (e.g., long-distance running). THEN, we put the two conversations together in order to determine the best plan for maximizing the outcome – this allows me to choose an approach that is individualized to each unique patient.

There is a Latin saying that comes to mind here: Vita brevis, ars longa (or,roughly, “Life is short, art is forever”). But just because you want a beautiful nose, no matter how short life may be, you shouldn’t have to sacrifice your breathing or be limited in any way. With an appropriate selection of techniques, as well as conscientious execution, there’s no reason that either form or function has to take precedence.