Will I Be Able to Breathe Through My Nose After Rhinoplasty?

Last reviewed: 6 July 2026, Mr Tim Biggs

Mr Tim Biggs is a Consultant ENT Surgeon, Rhinologist and Facial Plastic Surgeon (MB BCh, PhD, FRCS ORL-HNS)

One of the most common concerns before rhinoplasty is whether breathing will still work afterwards. For many patients the fear isn't the surgery itself, it's nasal packing: both nostrils blocked for days, forced onto mouth breathing, with something that has to be pulled out afterwards. With current techniques, that scenario doesn't happen here. Nasal packing isn't used at all, and patients breathe through their nose, congested but not blocked, from the day of surgery.

Why nasal packing has become unnecessary

Nasal packing was traditionally used for three reasons: to control bleeding, to support internal structures while they settled, and to limit swelling. All three can now be managed without it. Precise dissection, intraoperative medication to control bleeding, careful handling of the mucosal lining, and Piezo ultrasonic bone work between them mean packing isn't needed to achieve the same safety margin. Most rhinoplasty surgeons in the UK still pack routinely, largely because their instrumentation and technique haven't changed to make it avoidable. That's a technique decision, not a difference in how cautious the surgery is.

How the surgery itself protects early airflow

Piezo ultrasonic bone work

Piezo reshapes nasal bone using ultrasonic vibration rather than a rasp or an osteotome and mallet. Because it cuts bone selectively without the blunt trauma of mechanical force, bleeding and swelling in the tissue around the bones are both reduced. Less internal swelling in the first two weeks means more airway stays open during exactly the period breathing feels most restricted.

Turbinoplasty, when it's needed

Blockage isn't always about the septum or the bones. Enlarged inferior turbinates, the structures lining the sides of the nasal passage, are a common independent cause of congestion, particularly at night. Where this is present, Piezo-assisted turbinoplasty reduces turbinate bulk while preserving the healthy lining the nose still needs, rather than over-resecting tissue. This is assessed and planned before surgery, not added routinely to every case.

What breathing actually feels like, week by week

●       Week 1: stuffy, similar to a heavy cold, caused by swelling rather than obstruction. Both nostrils remain usable throughout.

●       Week 2: congestion clearly easing, external splint removed around day 7.

●       Weeks 3 to 6: airflow continues to improve as internal swelling settles.

●       Beyond 6 weeks: residual tightness from swelling resolves and baseline breathing is established, unless a separate functional issue needs its own correction.

The external splint, not an internal obstruction

A small splint sits on the outside of the bridge to support the bones while they settle, and comes off after about a week. Nothing sits inside the nose that needs to be removed. There's a real difference between an external splint, which doesn't touch the airway at all, and internal packing or internal splints, which some surgeons still use and which do restrict breathing until removed.

If breathing was already a problem before surgery

A deviated septum, nasal valve collapse, or long-standing turbinate hypertrophy are assessed at consultation, separately from the cosmetic plan. Where a functional problem is combined with a request for cosmetic change, septorhinoplasty is carried out. Where the concern is functional only, with no cosmetic reshaping involved, septoplasty, turbinoplasty and FESS are carried out at Medicana Clinic, Winchester, self-pay or via major insurers.

Why this depends on the surgeon, not just the technology

Piezo instrumentation and packing-free technique are tools, not guarantees. Reducing swelling and avoiding packing only protects breathing if the underlying structural plan, particularly at the internal nasal valve, is correct. Rhinoplasty performed without proper functional assessment can narrow the airway even when it looks good externally. That's why this is planned by a specialist ENT surgeon assessing the airway alongside the aesthetic result, not by aesthetic goals in isolation.

About Mr Tim Biggs

Last reviewed: 6 July 2026, Mr Tim Biggs

Mr Tim Biggs is a Consultant ENT Surgeon, Rhinologist and Facial Plastic Surgeon (MB BCh, PhD, FRCS ORL-HNS), and one of a small number of surgeons in the UK holding RCS Board Certification specifically in cosmetic nasal surgery. He is the only rhinoplasty surgeon in Hampshire currently combining dorsal preservation with Piezo ultrasonic instrumentation, has authored over 60 peer-reviewed publications, and holds a PhD in mucosal immunology. He is College Tutor for Surgery at Queen Alexandra Hospital, Portsmouth, and co-founder of the South East Rhinology Forum, a professional meeting for consultant rhinologists across the South East of England.

Open approach structural rhinoplasty with Piezo. On-table transformation showing the immediate change to tip and base shape once the framework is reshaped, before any of the natural post-operative swelling settles. Nostrils are more symmetrical and nicely open.

Mr Tim Biggs, PhD, FRCS (ORL-HNS). www.timbiggs.co.uk | www.adnovaclinic.com

Frequently asked questions

Is breathing recovery different after cosmetic rhinoplasty compared with functional septorhinoplasty?

Often, yes. Cosmetic-only cases usually involve less disturbance to the airway itself, so early breathing can feel more comfortable than after septorhinoplasty, which directly corrects the septum and can cause more internal swelling in the first two weeks, even though the functional outcome is better.

Can I use saline nasal rinses in the first few days after surgery?

Yes. A gentle saline wash is generally used from day one, twice daily, to keep the lining clear while swelling settles. Exact timing is confirmed at your post-operative appointment.

When should I contact the clinic if breathing feels worse rather than better?

If breathing suddenly worsens rather than gradually improving, particularly alongside increasing pain, fever, or unexpected bleeding, contact the clinic promptly rather than waiting for the next scheduled follow-up.

Does general anaesthetic affect breathing in the days after surgery?

No. Any grogginess from anaesthetic clears within hours and has no bearing on nasal breathing during recovery, which is governed by swelling and structure, not anaesthetic.

Is snoring more common in the first few weeks after rhinoplasty?

Yes, mild snoring is common in the early weeks, even in patients who didn't snore before, caused by temporary swelling rather than any structural problem. It typically resolves as swelling settles.

How soon can I fly after rhinoplasty?

Generally at least 14 days, to allow initial healing and swelling to settle before the change in cabin pressure.

When does sense of smell return to normal?

Smell is closely tied to nasal airflow, so it can be reduced during the congested early weeks and typically returns over the same period that breathing itself normalises.

Consultation

For cosmetic rhinoplasty, consultations are at Adnova Clinic, Fareham, self-pay and all-inclusive, £200, with free follow-up appointments. To book, contact Natasha Read on 01489 663273 or timbiggssec@adnovaclinic.com.

For functional breathing problems, including septoplasty, turbinoplasty and FESS, consultations are at Medicana Clinic, Winchester, self-pay or via major insurers. To book, contact Michele Hewlett on 020 7870 5910 or info@ent-surgeons.uk.