Current concepts in functional rhinoplasty

Functional rhinoplasty, once a euphemism for revision of the overreduced nose, has evolved into a valuable procedure with primary and secondary applications. We now appreciate that all rhinoplasty is functional and may improve or impair nasal breathing. With increasing attention to the structural analogues of obstruction, we have progressed beyond universal septoplasty to an era of accurate diagnosis and targeted treatment. Current literature focuses on the roles of each component of nasal architecture and the importance of physiologic relationships among them. Warning signs have been identified to heighten our preoperative sensitivity to special diagnostic and surgical needs, and practical new applications of traditional flaps and grafts are now available. Current concepts of functional rhinoplasty stress the need to respect and preserve function. Facial plastic surgeons are trading in old and overly aggressive techniques for new approaches that improve form and function together.