Dr Adriana Rodríguez

Functional nasal surgery · MÁLAGA


Breathing well begins with understanding what is affecting nasal function

Difficulty breathing through the nose can have different causes. A functional assessment helps identify which structures are involved and determine which treatment may be appropriate in each case.

function and structure

Breathing and the shape of the nose cannot always be considered separately

Nasal function depends on several structures involved in airflow: the septum, turbinates, nasal valves and, in some cases, the external anatomy of the nose.

That is why a functional assessment goes beyond identifying where an obstruction occurs. It also involves understanding how these structures relate to one another and what changes may be needed to improve breathing.

When there is also an aesthetic goal, both aspects can be planned together and addressed in a single operation. In these cases, functional surgery and rhinoplasty form part of one surgical plan, tailored to each patient’s anatomy and priorities.

SEPTUM
When significantly deviated, it can restrict airflow.

NASAL VALVES
Narrowing or collapse can affect breathing.

TURBINATES
When enlarged, they can contribute to nasal obstruction

causes of nasal obstruction

Not all breathing difficulties have the same cause

Nasal obstruction can arise from different conditions. Some affect the structure of the nose, while others involve the lining of the nose or the paranasal sinuses. Identifying what is contributing to the problem is the first step in deciding whether medical or surgical treatment is indicated.

DEVIATED SEPTUM

When the septum bends towards one side, it can reduce the space available for airflow.

TURBINATE HYPERTROPHY

Enlarged turbinates can contribute to a persistent feeling of nasal blockage.


NASAL VALVE ABNORMALITIES

Narrowing or collapse in these areas can make it harder for air to enter, particularly when breathing in.


CHRONIC SINUSITIS AND NASAL POLYPS

Persistent inflammation of the nasal lining or the presence of polyps can affect both breathing and sinus drainage.


ANATOMICAL VARIATIONS

Structures such as a concha bullosa, or other anatomical variations, may contribute to obstruction in some patients.

Dra. Adriana Rodríguez, cirujana plástica facial en Málaga

FUNCTIONAL ASSESSMENT

Understanding the cause before choosing a treatment

The decision to recommend functional nasal surgery should not be based solely on a feeling of blockage. The assessment aims to identify which structures are contributing to the problem and how far they explain the symptoms.

The examination may include direct assessment of the nasal anatomy and, when necessary, an endoscopy to examine the nasal passages more closely and identify possible sites of obstruction.

In selected cases, a CT scan may provide additional information about the paranasal sinuses, anatomical variations or situations requiring more detailed planning.

NASAL EXAMINATION

Allows the visible anatomy and the relationship between the structures involved in airflow to be assessed.

ENDOSCOPY

May be used when a more detailed examination of the nasal passages is needed to identify possible areas of obstruction.

CT SCAN

Requested when imaging may help clarify the anatomy or plan treatment in particular cases.

SURGICAL TREATMENT

Addressing the cause without doing more than is necessary

When the assessment confirms an anatomical cause that may benefit from surgical correction, treatment is tailored to the structures responsible for the obstruction.

For some patients, this may involve correcting a deviated septum, reducing the size of the turbinates or treating sinus conditions through endoscopic surgery. In other cases, the nasal valves or the external structure of the nose may also contribute to the obstruction.

The aim is not to apply the same technique to every patient, but to operate only on the structures affecting nasal function.

/01

Septoplasty

Corrects a deviated septum when it makes a significant contribution to nasal obstruction.

/02

Turbinates

When enlarged turbinates contribute to breathing difficulties, treatment may be considered to improve the nasal airway while preserving their function.

/03

Endoscopic sinus surgery

For certain sinus conditions, endoscopy allows surgery to be performed through the nostrils, without external incisions.

Dra. Adriana Rodríguez, cirujana plástica facial en Málaga

IMAGE-GUIDED SURGERY

Additional guidance when the anatomy calls for more precise planning

In selected complex cases or revision procedures, image-guided surgery systems may assist surgical planning.

Surgical navigation allows the endoscopic view to be matched in real time with information from a previous CT scan. This helps the surgeon navigate anatomy that may be complex, variable or altered by earlier surgery.

It does not replace surgical expertise and is not used routinely. Its value depends on the procedure, the anatomy and the additional information it can provide in each case.

COMPLEX ANATOMY

May provide an additional point of reference when there are anatomical variations or closely related structures.

REVISION SURGERY

For patients who have had previous surgery, it can help the surgeon navigate anatomy changed by earlier procedures.

INTRAOPERATIVE GUIDANCE

Allows the endoscopic view to be correlated with available imaging during surgery.

Dra. Adriana Rodríguez, cirujana plástica facial en Málaga

RECOVERY AND FOLLOW-UP

Recovery depends on the procedure and how the tissues respond

Recovery after functional nasal surgery varies from one patient to another because it depends on the structures treated and the procedure performed.

Swelling, congestion or a feeling of pressure in the nose may occur during the first few days. Recovery is usually gradual as the tissues heal and adapt.

Follow-up appointments allow healing and functional improvement to be assessed, and care recommendations to be adjusted at each stage of recovery.

01

FIRST FEW DAYS

The priority is to protect the operated area, manage swelling and follow local care instructions.

02

GRADUAL RETURN TO ACTIVITY

Returning to normal activities depends on the procedure, individual recovery and the level of physical effort involved.

03

FOLLOW-UP

Follow-up appointments allow nasal function to be assessed as healing progresses and postoperative care to be adjusted if needed.

Dra. Adriana Rodríguez, cirujana plástica facial en Málaga

essential information

Frequently asked questions about functional nasal surgery

when might functional nasal surgery be recommended?

Surgery may be considered when an anatomical abnormality makes a significant contribution to breathing difficulties and the clinical assessment indicates that surgical correction could be beneficial. The decision depends on the symptoms, examination findings and the structure responsible in each case.

what is the difference between septoplasty and rhinoplasty?

Septoplasty focuses on correcting problems with the nasal septum when they affect breathing. Rhinoplasty changes the external structure of the nose and may have an aesthetic aim, a functional aim or both. For some patients, both procedures can be planned together.

can functional nasal surgery be combined with cosmetic rhinoplasty?

Yes. When there is a functional indication as well as an aesthetic goal, both can be addressed within the same surgical plan. The need for each procedure is assessed separately before deciding whether to combine them in one operation.

is a CT scan or endoscopy always necessary?

No. Additional tests are requested when they can provide useful information about the cause of obstruction or help plan treatment. Not every patient needs the same investigations.

when will I start to notice an improvement in my breathing?

Recovery depends on the procedure and the way the tissues respond. Swelling or congestion may occur during the early stages, so improvements in breathing are usually assessed gradually during follow-up.

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medical judgement and evidence

Clinical information informed by experience and scientific evidence

The information on this page draws on clinical practice in functional nasal surgery and, where relevant, on guidelines and scientific literature concerning nasal obstruction, endoscopic sinus surgery, imaging-based planning and image-guided surgery.

MEDICAL CONTENT
ENT specialist and facial plastic surgeon
Last updated: October 2026
SELECTED BIBLIOGRAPHY
Medical references
The selected evidence provides context for some of the diagnostic and surgical principles described on this page, from the assessment of nasal obstruction to endoscopic surgery and navigation in selected cases.
Clinical Practice Guideline: Surgical Management of Chronic Rhinosinusitis
Shin JJ, Wilson M, McKenna M, et al.
Otolaryngology–Head and Neck Surgery. 2025;172(Suppl 2):S1–S47. DOI: 10.1002/ohn.1287
Clinical practice guideline on the indications for and surgical management of chronic rhinosinusitis in adults, including endoscopic sinus surgery.
Position Statement: Intra-Operative Use of Computer Aided Surgery
American Academy of Otolaryngology–Head and Neck Surgery.
Position Statement. Revisado: octubre de 2024.
Consensus statement on the use of surgical navigation in selected cases of endoscopic sinus and skull-base surgery.
Clinical effectiveness of septoplasty versus medical management for nasal airways obstruction: multicentre, open label, randomised controlled trial
Carrie S, O’Hara J, Fouweather T, et al.
BMJ. 2023;383:e075445. DOI: 10.1136/bmj-2023-075445
Multicentre clinical trial comparing septoplasty with medical management in adults with nasal obstruction associated with a deviated septum.
The selected references cover evidence relevant to assessing nasal obstruction, septoplasty, endoscopic sinus surgery and the use of navigation in selected situations. The decision to recommend surgery must always be based on the patient’s anatomy, symptoms and individual clinical assessment.