Abstract
Functional and aesthetic rhinoplasty in patients with septal deviation is an essential surgical intervention to restore respiratory function, harmonize nasal aesthetics, and improve patients' quality of life. This article aimed to conduct an integrative review of contemporary techniques, functional and aesthetic outcomes, and patient perceptions. Using a rigorous methodology, the review covered studies published over the last ten years, identifying significant advancements such as the introduction of structural preservation techniques and ultrasonic rhinoplasty, which optimize results and minimize complications. The findings indicate that integrating functional and aesthetic approaches is critical for surgical success but emphasize the importance of proper expectation management and the evaluation of psychological conditions such as body dysmorphic disorder. It is concluded that rhinoplasty requires a multidimensional and personalized approach, highlighting the need for further research to refine surgical practices and consolidate its clinical application.
References
Avashia YJ, Glener AD, Marcus JR. Functional Nasal Surgery. Plast Reconstr Surg. 2022 Aug 1;150(2):439e-454e. doi: 10.1097/PRS.0000000000009290. Epub 2022 Jul 27. PMID: 35895523.
Öztürk G. New Suturing Approaches for Patients with Nasal Hump and Septal Deviation. Ann Plast Surg. 2022 Mar 1;88(3):254-261. doi: 10.1097/SAP.0000000000003035. PMID: 35130203.
Tremp M, Schneider J, Raghu RBN, Goksel A, Saban Y. A Systematic Analysis of the Nasal Septum in Crooked Noses and Suggested Treatment Algorithm According to Preservation Rhinoplasty (PR) Principles. Aesthetic Plast Surg. 2023 Aug;47(4):1499-1507. doi: 10.1007/s00266-023-03293-3. Epub 2023 Feb 24. PMID: 36826521; PMCID: PMC10390351.
Ishii LE, Tollefson TT, Basura GJ, Rosenfeld RM, Abramson PJ, Chaiet SR, Davis KS, Doghramji K, Farrior EH, Finestone SA, Ishman SL, Murphy RX Jr, Park JG, Setzen M, Strike DJ, Walsh SA, Warner JP, Nnacheta LC. Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty. Otolaryngol Head Neck Surg. 2017 Feb;156(2_suppl):S1-S30. doi: 10.1177/0194599816683153. PMID: 28145823.
Wo LM, Al Bayati M, Weber LE, Habal MB, Thaller SR. Future Direction in Rhinoplasty: Functional Improvements for a Better Outcome. J Craniofac Surg. 2020 May/Jun;31(3):750-754. doi: 10.1097/SCS.0000000000006444. PMID: 32209944.
Avashia YJ, Glener AD, Marcus JR. Functional Nasal Surgery. Plast Reconstr Surg. 2022 Aug 1;150(2):439e-454e. doi: 10.1097/PRS.0000000000009290. Epub 2022 Jul 27. PMID: 35895523.
Ghosh A, Friedman O. Surgical Treatment of Nasal Obstruction in Rhinoplasty. Clin Plast Surg. 2016 Jan;43(1):29-40. doi: 10.1016/j.cps.2015.09.007. PMID: 26616692.
Palma P, Khodaei I. Surgical management of the distorted caudal septum. Curr Opin Otolaryngol Head Neck Surg. 2014 Feb;22(1):52-7. doi: 10.1097/MOO.0000000000000019. PMID: 24366268.
de Lima Ramos S, Hochman B, Gomes HC, Abla LEF, Veiga DF, Juliano Y, Dini GM, Ferreira LM. Effect of nasal deviation on quality of life. Plast Reconstr Surg. 2011 Jul;128(1):132-136. doi: 10.1097/PRS.0b013e3182173d51. PMID: 21399564.
Erdivanli OC, Coskun ZO, Ozgur A, Ogurlu M, Demirci M, Dursun E. Comparison of Quality of Life Before and After Septoplasty With Short Form-36. J Craniofac Surg. 2020 May/Jun;31(3):832-835. doi: 10.1097/SCS.0000000000006358. PMID: 32102030.
Hytönen ML, Lilja M, Mäkitie AA, Sintonen H, Roine RP. Does septoplasty enhance the quality of life in patients? Eur Arch Otorhinolaryngol. 2012 Dec;269(12):2497-503. doi: 10.1007/s00405-012-1931-9. Epub 2012 Jan 25. PMID: 22274692.
Patel PN, Kandathil CK, Most SP. Outcomes of Combined Anterior Septal Reconstruction and Dorsal Hump Reduction. Laryngoscope. 2020 Dec;130(12):E803-E810. doi: 10.1002/lary.28611. Epub 2020 Mar 12. PMID: 32163185.
Simsek T, Erdoğan MM, Özçetinkaya Erdoğan S, Kazaz H, Tezcan E, Seyhan S. Assessment of functional and aesthetic outcomes in septorhinoplasty. Eur Arch Otorhinolaryngol. 2021 Apr;278(4):1089-1097. doi: 10.1007/s00405-020-06387-9. Epub 2020 Sep 29. PMID: 32995911.
Choi JE, Noh YS, Koh SM, Shin JB, Lee KE, Jung YG, Hong SD, Chung SK, Kim HY. The Potential Esthetic Effect of Endonasal Septoplasty on the Cartilaginous Dorsum in Asian Population. Facial Plast Surg Aesthet Med. 2021 Jan-Feb;23(1):42-48. doi: 10.1089/fpsam.2020.0039. Epub 2020 Jun 4. PMID: 32498571.
Han JK, Stringer SP, Rosenfeld RM, Archer SM, Baker DP, Brown SM, Edelstein DR, Gray ST, Lian TS, Ross EJ, Seiden AM, Setzen M, Tollefson TT, Ward PD, Welch KC, Wise SK, Nnacheta LC. Clinical Consensus Statement: Septoplasty with or without Inferior Turbinate Reduction. Otolaryngol Head Neck Surg. 2015 Nov;153(5):708-20. doi: 10.1177/0194599815606435. PMID: 26527752.
Saleh AM, Younes A, Friedman O. Cosmetics and function: quality-of-life changes after rhinoplasty surgery. Laryngoscope. 2012 Feb;122(2):254-9. doi: 10.1002/lary.22390. Epub 2012 Jan 17. PMID: 22252921.
Alan MA, Kahraman ME, Yüksel F, Yücel A. Comparison of Dorsal Preservation and Dorsal Reduction Rhinoplasty: Analysis of Nasal Patency and Aesthetic Outcomes by Rhinomanometry, NOSE and SCHNOS Scales. Aesthetic Plast Surg. 2023 Apr;47(2):728-734. doi: 10.1007/s00266-022-03151-8. Epub 2022 Oct 27. PMID: 36302983.
Verkest V, Pingnet L, Van Hout G, Fransen E, Declau F. Comparison in Patient Satisfaction Between Structural Component and Hybrid T-bar Preservation Rhinoplasty: A Retrospective Propensity Score Matched Cohort Study. Aesthetic Plast Surg. 2023 Dec;47(6):2598-2608. doi: 10.1007/s00266-023-03347-6. Epub 2023 Apr 17. PMID: 37069352.
Saleh AM, Younes A, Friedman O. Cosmetics and function: quality-of-life changes after rhinoplasty surgery. Laryngoscope. 2012 Feb;122(2):254-9. doi: 10.1002/lary.22390. Epub 2012 Jan 17. PMID: 22252921.
Simsek T, Erdoğan MM, Özçetinkaya Erdoğan S, Kazaz H, Tezcan E, Seyhan S. Assessment of functional and aesthetic outcomes in septorhinoplasty. Eur Arch Otorhinolaryngol. 2021 Apr;278(4):1089-1097. doi: 10.1007/s00405-020-06387-9. Epub 2020 Sep 29. PMID: 32995911.
Stergiou G, Schweigler A, Finocchi V, Fortuny CG, Saban Y, Tremp M. Quality of Life (QoL) and Outcome After Preservation Rhinoplasty (PR) Using the Rhinoplasty Outcome Evaluation (ROE) Questionnaire-A Prospective Observational Single-Centre Study. Aesthetic Plast Surg. 2022 Aug;46(4):1773-1779. doi: 10.1007/s00266-022-02773-2. Epub 2022 Feb 15. PMID: 35169915.
Haddady Abianeh S, Moradi Bajestani S, Rahmati J, Shahrbaf MA, Fatehi Meybodi A. Evaluation of Aesthetic and Functional Outcomes After Open Rhinoplasty: A Quasi-experimental Study by the Aid of ROE and RHINO Questionnaires. Aesthetic Plast Surg. 2021 Apr;45(2):663-669. doi: 10.1007/s00266-020-01905-w. Epub 2020 Aug 3. PMID: 32747985.
Luong KP, Slijper HP, Stubenitsky B, Hummelink S, Ulrich DJO. Changes in patient-reported satisfaction and quality-of-life 6 months after rhinoplasty. J Plast Reconstr Aesthet Surg. 2024 Apr;91:325-334. doi: 10.1016/j.bjps.2024.02.038. Epub 2024 Feb 9. PMID: 38442513.
Ishii LE, Tollefson TT, Basura GJ, Rosenfeld RM, Abramson PJ, Chaiet SR, Davis KS, Doghramji K, Farrior EH, Finestone SA, Ishman SL, Murphy RX Jr, Park JG, Setzen M, Strike DJ, Walsh SA, Warner JP, Nnacheta LC. Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty. Otolaryngol Head Neck Surg. 2017 Feb;156(2_suppl):S1-S30. doi: 10.1177/0194599816683153. PMID: 28145823.
Tasman AJ. The psychological aspects of rhinoplasty. Curr Opin Otolaryngol Head Neck Surg. 2010 Aug;18(4):290-4. doi: 10.1097/MOO.0b013e32833b51e6. PMID: 20543695.
Heiming M, Savvas E, Rudack C, Stenner M, Spiekermann C. Discrepancy of the subjective perception of the nasal appearance between independent individuals and patients undergoing functional rhinoplasty (fRPL). Eur Arch Otorhinolaryngol. 2023 Jan;280(1):191-197. doi: 10.1007/s00405-022-07504-6. Epub 2022 Jun 28. PMID: 35763081; PMCID: PMC9813204.
Luong KP, Slijper HP, Stubenitsky B, Hummelink S, Ulrich DJO. Changes in patient-reported satisfaction and quality-of-life 6 months after rhinoplasty. J Plast Reconstr Aesthet Surg. 2024 Apr;91:325-334. doi: 10.1016/j.bjps.2024.02.038. Epub 2024 Feb 9. PMID: 38442513.

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