Aesthetic Rhinoplasty and Nasal Obstruction: Presentation of Results of a 100-Patient Study by Using NOSE Inventory

Kotzampasakis D, Delistathi T, Kotzampasakis S, Mantalos P.

What this paper says

Among 100 patients who had purely cosmetic rhinoplasty through the nostrils with no septum or turbinate work, 77 percent reported improved breathing, 10 percent were unchanged and 13 percent were worse.

Overview

Most rhinoplasty literature addresses technique, complications, appearance and psychology, but little examines what a purely cosmetic operation does to breathing. This prospective study used a validated obstruction questionnaire in patients operated by surgeons in both public and private practice.

Sections of note

Prospective study using the validated NOSE questionnaire in 100 patients operated between 2009 and 2016.
Surgery was classical aesthetic rhinoplasty by the intranasal approach, without functional intervention on the septum or turbinates.
Patients were operated by surgeons in both the public and private sectors; analysis used SPSS.
77 percent of patients improved in nasal obstruction symptoms.
10 percent were unchanged and 13 percent reported worsening.
The functional outcome was generally stable over time, with a slight tendency to deteriorate in later years.
Both genders improved, with females improving more than males; smoking and allergic rhinitis did not appear to be important determinants. Level of evidence IV.

What it means for a patient

A cosmetic-only rhinoplasty improved breathing for roughly three quarters of patients, but made it worse for about one in eight.
No septum or turbinate surgery was performed, so the breathing change came from reshaping the external nose alone.
Results held over the following years with a slight decline.
Limits: 100 patients, multiple surgeons across two sectors, self-reported outcome only, and no objective airflow measurement.

Why this paper matters

Whether cosmetic rhinoplasty helps or harms breathing is a routine question in consultation and rarely answered with data. This gives figures for both directions. Without objective airflow measurement or a comparison group, the mechanism behind the 13 percent who worsened is unidentified.

Terms

NOSE inventory: The Nasal Obstruction Symptom Evaluation, a validated blockage questionnaire.
Intranasal approach: Surgery done through incisions inside the nostrils.
Functional intervention: Surgery on the septum or turbinates aimed at breathing.
Turbinate: A shelf of tissue on the inner side wall of the nose.
Allergic rhinitis: Nasal inflammation caused by an allergic reaction.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“The current prospective study is evaluating the nasal symptoms of patients who underwent aesthetic rhinoplasty with the intranasal approach, in a long-term setting. Setting: There is a large amount of the literature about the technique, the possible comorbidities, the aesthetic result, the patient's psychosocial…”

Excerpt; the full abstract is on PubMed.