Rhinoplasty not only a matter of aesthetics

There are more and more studies that demonstrate how important nasal respiration is for health, therefore, it is very important that before carrying out any intervention, properly explore the nostrils through an endoscopic study that allows us to assess whether there is a septal deviation, a hypertrophy of the lower turbinates, nasal polyposis, or chronic sinusitis. The importance of the previous exploration of the nostrils lies in the fact that the techniques used by most plastic surgeons tend to collapse the area of ​​the nasal valve and if in a patient who previously already had a deviation at this level, although preoperatively, he was asymptomatic and does not report any respiratory difficulties, it will probably worsen after rhinoplasty. Good nasal breathing is essential for health. Normal human breathing is through the nose, mouth breathing is either an aid or an alternative but it is not how efficient nasal breathing is. When the air passes adequately through the nose it is conditioned to adequately reach the pulmonary alveoli in the adequate humidity and temperature conditions. When we breathe without difficulty through the nose, the air correctly reaches the lungs even though we are at 30º or 30º below zero, because by rubbing against the nasal mucosa especially at the level of the lower turbinates and also the middle turbinates, it is heated or cooled as necessary. The cilia of the nasal mucosa also help to clean the air breathed of the pollution, impurities or allergens that it can transport so that if we breathe well we may have rhinitis but we will probably avoid bronchitis that is much more serious. We must consider that the nasal mucosa and the mucosa of the lower airways are very similar from the pathological point of view. 

Nasal breathing allows the inspired air to reach the pulmonary alveoli in the right conditions, however, when we breathe through the mouth, most of the air is blocked in what is called the “dead space” between the trachea and the bronchi but without reaching to the distal alveoli, which does not produce an adequate gas exchange with the blood.  Nasal respiration creates the resistance necessary for the diaphragm to work properly so that it descends, increases the ventilatory capacity of the lung, and at the same time facilitates and increases the air reaching the distal alveoli. A person with good nasal breathing can reach 70% of their maximum aerobic capacity, that is, when we make an aerobic effort such as running, a person with good nasal breathing can reach 70% of their maximum effort using only this route. In other words, athletic and / or sports capacity is greatly increased. In rhinoplasties, in addition to improving aesthetics, we must be very careful to improve nasal breathing and always use surgical techniques for resection of wing cartilages and osteotomies that prevent the collapse of the airway. In my experience there are also certain disorders such as anxiety and even certain slight depressions that improve considerably when we improve nasal breathing after rhinoplasty, which is logical because most methods of meditation and / or relaxation are based on nasal repiration. Some of my patients after years of mild anxiety and depression have improved considerably by being able to breathe normally through the nose because it has a very beneficial relaxing effect. Nasal breathing is essential for health because it facilitates the physical and emotional wellbeing that is so necessary in the times that we have had to live, that’s why at Rinopastia Barcelona we not only value aesthetic improvement but we also consider it as very necessary to improve nasal breathing to contribute to the quality of life of the patient. 

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