Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Functional rhinoplasty addresses structural problems inside the nose that restrict breathing. It’s a different conversation from cosmetic rhinoplasty — the concern isn’t how the nose looks but how it works, though the two are frequently combined when a patient has both aesthetic and functional concerns at the same time.
Dr Scott J Turner is a Fellow of the Royal Australasian College of Surgeons (FRACS) with specific training in both functional and cosmetic nasal surgery. He consults at his Sydney clinics in Bondi Junction and Manly, with surgery performed at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
What Is Functional Rhinoplasty?
Functional rhinoplasty corrects internal structural abnormalities that impair nasal breathing. The goal is physiological — restoring airflow through one or both nasal passages. The external appearance of the nose may not change at all, where only internal structures are addressed.
The most common structural problems treated with functional rhinoplasty are:
Deviated septum. The nasal septum is the wall of cartilage and bone that divides the two nasal passages. Where it is significantly off-centre, it narrows one or both passages and restricts airflow. Correcting this surgically is called septoplasty. For an in-depth guide to septoplasty specifically, see septoplasty and deviated septum surgery.
Nasal valve collapse. The nasal valves are the narrowest functional points of the nasal airway. Where the internal or external nasal valve is weak or collapses during inhalation, airflow is significantly restricted. Spreader grafts or batten grafts are placed to reinforce and widen the valve, restoring an adequate airway.
Inferior turbinate hypertrophy. The turbinates are bony structures inside the nose that humidify and filter inhaled air. When they become chronically enlarged — often in response to allergies or chronic inflammation — they can cause persistent nasal obstruction. Turbinate reduction may be performed alongside septal correction, where both are contributing to the problem.
Functional Rhinoplasty vs Cosmetic Rhinoplasty
The distinction between functional and cosmetic rhinoplasty matters for several practical reasons.
What is being addressed. Functional rhinoplasty works inside the nasal passages and addresses structural problems causing breathing obstruction. It may leave no visible external change to the nose at all. Cosmetic rhinoplasty addresses the external shape, size, and proportions of the nose for aesthetic purposes.
Medicare eligibility. Functional rhinoplasty may attract a Medicare rebate where clinical criteria are met. Cosmetic rhinoplasty does not.
Regulatory requirements. Standalone functional rhinoplasty — where no cosmetic component is involved — follows a different regulatory pathway from cosmetic surgery. Where both are being addressed together, the cosmetic requirements apply to the cosmetic component.
For a full comparison of both procedures, see cosmetic vs functional rhinoplasty.
When Both Are Present: Septorhinoplasty
Many patients have both functional and cosmetic concerns. They have breathing problems caused by a structural issue and they also want to address how their nose looks. In most cases, combining both in a single septorhinoplasty is the recommended approach.
The key reason is septal cartilage preservation. Performing septoplasty first removes cartilage that is the most important grafting material in rhinoplasty — for tip support, spreader grafts, and structural reinforcement. Combining both operations preserves that resource. One anaesthetic, one recovery period, and better intraoperative planning are additional advantages.
For a full guide to combined surgery, see what is septorhinoplasty.
Does Functional Rhinoplasty Change the Appearance of the Nose?
Isolated functional rhinoplasty — where only internal structures are addressed — does not typically change the external appearance of the nose. Where spreader grafts are placed for nasal valve repair, there may be a subtle widening at the mid-vault, but this is generally minor and often imperceptible.
Where functional rhinoplasty is combined with cosmetic rhinoplasty as septorhinoplasty, external changes are part of the surgical plan and are discussed at consultation.
Medicare and Functional Rhinoplasty
A Medicare rebate may apply where functional rhinoplasty is performed to address a documented structural problem causing meaningful nasal obstruction. The relevant item numbers include 41671 (septoplasty), 45635 (partial rhinoplasty of the bony vault), and 45641 (total functional rhinoplasty).
What is required for Medicare eligibility:
- A GP referral confirming the functional indication
- Clinical documentation of the structural problem
- Photographic evidence and/or NOSE Scale scoring demonstrating the degree of obstruction
- Conservative treatment (nasal corticosteroid sprays, antihistamines) tried and found inadequate
Where Medicare criteria are met and you hold appropriate private hospital cover, the hospital facility fees may also be covered by your insurer — often the most financially significant component.
For full detail on all relevant item numbers, documentation requirements, and what remains out-of-pocket, see the Medicare rhinoplasty guide.
The Surgical Procedure
Functional rhinoplasty is performed under general anaesthetic in a fully accredited private hospital. Operating time typically ranges from 1.5 to 4 hours, depending on what the procedure involves and whether cosmetic work is being combined.
Where septal deviation is the primary concern, the septoplasty component is performed through the inside of the nose. The mucosa covering the septum is lifted, the deviated cartilage and bone is reshaped or repositioned, and the mucosa is closed with absorbable sutures. Where nasal valve issues are also present, spreader or batten grafts are placed through the same approach.
Where cosmetic work is also planned, an open rhinoplasty approach via a small columellar incision gives simultaneous access to both the internal septum and the external nasal framework.
Internal silicone splints may be placed to support the septum during healing. These are removed at the one-week post-operative appointment.
Recovery
Isolated functional rhinoplasty recovery is shorter and less visually confronting than rhinoplasty recovery, because the external nose is not operated on.
- Week 1 — internal splints in place, nasal breathing blocked, mouth breathing expected
- Splint removal at approximately one week — breathing improvement typically noticeable immediately
- Weeks 2 to 4 — most patients return to desk work within one to two weeks
- Months 2 to 3 — full functional improvement in airflow as internal swelling completely resolves
Where functional rhinoplasty was combined with cosmetic rhinoplasty, the recovery follows the longer rhinoplasty timeline — external splint for one week, visible bruising for two to three weeks, final cosmetic result at 12 months.
For the full week-by-week breakdown, see the rhinoplasty recovery guide.
Cost
| Component | All-inclusive cost |
|---|---|
| Functional rhinoplasty / septoplasty | $11,500–$18,000 |
| Combined septorhinoplasty (cosmetic + functional) | Functional fee plus cosmetic fee |
| Consultation | $450 |
Where Medicare and private health insurance criteria are met, the effective out-of-pocket cost may be lower than the figures above. A formal itemised quote with expected rebates and gap payments is provided after consultation.
For full pricing detail, see the rhinoplasty cost guide.
AHPRA Regulatory Requirements
Standalone functional rhinoplasty — where no cosmetic component is involved — follows a different regulatory pathway from cosmetic surgery. Where functional rhinoplasty is combined with cosmetic rhinoplasty, the cosmetic component is subject to the full AHPRA cosmetic surgery requirements effective 1 July 2023:
- A referral from your GP or a specialist physician
- A minimum of two consultations with Dr Turner before surgery is booked
- A psychological evaluation to confirm suitability
- A mandatory cooling-off period before formal consent is given
Dr Turner’s team will confirm which requirements apply to your specific situation at the consultation.
Frequently Asked Questions
Can rhinoplasty fix breathing problems?
Yes, where the breathing problem has a structural cause. Rhinoplasty that addresses internal structural problems — such as a deviated septum, nasal valve collapse, or enlarged turbinates — may substantially improve nasal airflow. Not all breathing problems are structural, and a proper clinical assessment is needed to determine whether surgery is appropriate. Where the obstruction is caused by allergies or chronic inflammation, medical management may be a more appropriate starting point.
What is the difference between functional and cosmetic rhinoplasty?
Functional rhinoplasty addresses internal structural problems that impair nasal breathing. It may leave no visible external change to the nose. Cosmetic rhinoplasty addresses the external shape, size, and proportions of the nose for aesthetic purposes. The two can be combined in a single operation called septorhinoplasty. Functional rhinoplasty may attract a Medicare rebate where clinical criteria are met. Cosmetic rhinoplasty does not.
Does functional rhinoplasty change how my nose looks?
Isolated functional rhinoplasty, addressing only internal structures, does not typically change the external appearance of the nose. Where spreader grafts are placed for nasal valve repair there may be a subtle widening at the mid-vault, but this is generally minor. Where functional rhinoplasty is combined with cosmetic rhinoplasty as septorhinoplasty, external changes are part of the surgical plan.
Does Medicare cover functional rhinoplasty?
A Medicare rebate may apply where functional rhinoplasty is performed to address a documented structural problem causing meaningful nasal obstruction. A GP referral is required and clinical documentation including photographic evidence or NOSE Scale scoring must support the claim. The rebate covers the surgical component only. Anaesthesia and hospital fees remain out-of-pocket regardless of Medicare eligibility, though private health insurance may cover hospital fees where criteria are met. For full detail on item numbers and eligibility, see the Medicare rhinoplasty guide.
Can functional and cosmetic rhinoplasty be done at the same time?
Yes, and where both concerns are present, combining them in a single septorhinoplasty is generally the recommended approach. It means one anaesthetic, one recovery period, and preserves the septal cartilage intact as grafting material for the cosmetic component. The Medicare rebate may apply to the functional component of a combined procedure where clinical criteria are met.
Consult with Dr Scott J Turner
Where the functional issue follows previous rhinoplasty rather than presenting at primary consultation, see breathing problems after rhinoplasty for the post-operative-specific framework.
Dr Turner consults for functional rhinoplasty in Sydney at Bondi Junction and Manly. He also sees patients in Brisbane and Canberra. Surgery is performed in Sydney at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
Contact the practice to arrange a consultation, or read more about Dr Turner’s background and training.
