Rhinoplasty is a surgical procedure of reshaping or reconstructing the nose, either for aesthetic and/or functional reasons, to correct congenital problems, traumatic injuries, diseases, or even tumours. Common goals are cosmetic enhancement and the restoration of breathing functions. Other than the modification in look and/or function, patients are usually curious to know if rhinoplasty impairs their sense of smell. In the current review on rhinoplasty and the olfactory function, the anatomy of the nose, possible influences emanating from rhinoplasty with respect to olfactory performance, and its role in enhancing or deteriorating this sensory function are discussed.
Understanding the Anatomy of the Nose
The nose is a highly crucial respiratory and olfactory organ used to detect odours. The olfactory epithelium, containing the sensory cells grossly responsible for scent identification, is located on the roof of the nasal cavity. Air should pass that area so that the signals interpreted by the brain as odour can be computed. The internal nasal structures comprising the septum and turbinates may modify airflow and olfactory perception. Grossly distorted or obstructive nasal structures impede airflow to olfactory receptors, resulting in reduced sensation of smell. Functional rhinoplasty for correction of these obstructions can improve olfactory ability.
Rhinoplasty and Loss of Smell
Rhinoplasty may eventually affect olfaction due to the variable nature of this kind of surgery and also because of individual anatomy.
Suppose the procedure corrects functional issues, such as a deviated septum or reduces enlarged turbinates. In that case, airflow through the nasal passages may improve, offering olfactory receptors a better chance at detecting odours. However, rhinoplasty does come with the risk of temporary or permanent damage to nerves of smell or delicate mucous membrane lining. Oedema after surgery may obstruct airflow, leading to transient loss or reduction of smell.
The sense of smell usually returns to normal or improves as the swelling goes down if the surgery has solved functional problems.
Functional Rhinoplasty to Improve the Sense of Smell
Functional rhinoplasty treats structural defects of the nose that cause impairment of breathing and, in certain cases, loss of the sense of smell. This surgery improves nasal airways by figuring out possible obstructions: a deviated septum, nasal polyps, or enlarged turbinates. In this way, by readjusting the passages and taking out blockages, functional rhinoplasty can restore airflow and may improve one's sense of smell. Interestingly enough, patients with nasal obstructions may experience a significant increase in their sense of smell following the surgery, assuming, of course, that their olfactory impairment was chronic and related to congestion or restriction of airflow.
Temporary Loss of Smell After Surgery
On the other hand, rhinoplasty may sometimes cause a temporary loss of smell in patients, which would be particularly frequent during the postoperative period because of swelling and scarring. This would impede air passage to the olfactory receptors, reducing the detection of scent. Sometimes, after weeks or months, most can recover their smell. However, possible overdevelopment of scar tissue or even neuropathy due to surgical manipulation may lead to an extended impairment of olfaction.
Can rhinoplasty permanently improve the sense of smell?
Opened airways may achieve a better sense of smell. Cosmetic rhinoplasty, however, may not necessarily change anything to the sense of smell of an individual since surgeons maintain the functional features of the anatomy of the nose, including the olfactory system, as any other average person. Generally, individuals do not experience long-term changes in their smelling senses after the event.
Rhinoplasty can improve or impair one's sense of smell, depending on the purpose of the surgery and the techniques used. Functional rhinoplasty will help patients with nasal obstructions or difficulties breathing by increasing airflow and improving olfaction. The healing process may cause temporary diminution of smell, and permanent alteration may result in rare situations due to complications. These are some of the possible outcomes that the surgeon needs to discuss with patients.
