Aesthetic Plastic Surgery

, Volume 39, Issue 2, pp 181–190 | Cite as

Evaluating Current Functional Airway Surgery During Rhinoplasty: A Survey of the American Society of Plastic Surgeons

  • Ahmed M. Afifi
  • Steve J. Kempton
  • Chad R. Gordon
  • Landon Pryor
  • Ashraf A. Khalil
  • Walter M. Sweeney
  • Shashidhar Kusuma
  • Claude-Jean Langevin
  • James E. Zins
Original Article General Reconstruction



Despite numerous reports outlining technical modifications in rhinoplasty, few publications discuss the importance of the perioperative assessment and surgical management of the nasal airway. This study’s objective is to increase awareness regarding the functional aspects of rhinoplasty surgery and to encourage surgeons to incorporate functional airway management into their rhinoplasty practice.


A web-based survey was given to all members of the American Society of Plastic Surgeons (ASPS). Survey results were analysed to determine if surgeons’ experience, annual rhinoplasty volume, or postgraduate training affected their results. The relationship between surgeon satisfaction with the outcome of the airway management and the frequency of performing an inferior turbinate reduction was investigated.


Of the 4,383 listed ASPS members, 671 (21 %) completed the web-based survey. Surgeons who performed a preoperative internal nasal exam were more satisfied with their results (p = 0.016) and report lower rates of postoperative nasal airway obstruction (p = 0.054). Inferior turbinate reduction did correlate to postoperative satisfaction with the nasal airway (p < 0.001). Overall, 85 % of respondents were satisfied with their management of the nasal airway and 87 % of respondents agreed that there is a need for more instructional courses on this topic.


There is considerable variation in the results and techniques of assessment and treatment of the nasal airway. Rhinoplasty volume and inferior turbinate reduction are associated with surgeon satisfaction of management of the nasal airway. Functional airway considerations should be incorporated into routine rhinoplasty training, assessment, and treatment.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Functional airway Rhinoplasty Nose Plastic surgeon 


Conflict of interest

The authors declare that they have no conflicts of interest to disclose.


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Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2015

Authors and Affiliations

  • Ahmed M. Afifi
    • 1
    • 4
  • Steve J. Kempton
    • 1
  • Chad R. Gordon
    • 2
  • Landon Pryor
    • 3
  • Ashraf A. Khalil
    • 4
  • Walter M. Sweeney
    • 5
  • Shashidhar Kusuma
    • 6
  • Claude-Jean Langevin
    • 7
  • James E. Zins
    • 8
  1. 1.Division of Plastic and Reconstructive Surgery, Department of SurgeryUniversity of Wisconsin Hospital and ClinicsMadisonUSA
  2. 2.Johns Hopkins Medicine, Plastic and Reconstructive SurgeryBaltimoreUSA
  3. 3.Private Practice Plastic SurgeryRockfordUSA
  4. 4.Cairo UniversityCairoEgypt
  5. 5.McGaw Medical Center of Northwestern UniversityChicagoUSA
  6. 6.Private Practice Plastic SurgeryPlantationUSA
  7. 7.Cedars-Sinai Plastic and Reconstructive Surgery CenterLos AngelesUSA
  8. 8.Department of Plastic SurgeryCleveland ClinicClevelandUSA

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