Sinus Surgery and Rhinoplasty: Treating Chronic Sinusitis and Nasal Shape in One Operation

3 days ago

3 min read

Key takeaways

Sinusitis is inflammation of the air-filled sinuses around the nose; it is chronic when symptoms last more than 12 weeks.
Most cases improve with medical treatment; surgery is considered when chronic sinusitis persists despite adequate medication.
Functional endoscopic sinus surgery (FESS) and balloon sinuplasty open blocked sinus drainage pathways without external incisions.
When a deviated septum, enlarged turbinates or a nasal deformity also exist, sinus surgery can be combined with septorhinoplasty in one anaesthesia.

What is sinusitis?

The paranasal sinuses are air-filled spaces in the cheek bones, forehead and between the eyes, lined with mucous membrane and draining into the nose through narrow openings. When these openings become blocked by swelling, polyps or anatomical narrowing, mucus is trapped and infection and inflammation follow. Acute sinusitis usually follows a cold and resolves within weeks; chronic sinusitis lasts 12 weeks or more.

What causes sinusitis?

Viral colds and bacterial infections
Allergic rhinitis and chronic inflammation of the nasal lining
Nasal polyps blocking the drainage pathways; see nasal polyps
Deviated septum and enlarged turbinates narrowing the airflow and drainage; see turbinate hypertrophy
Smoking, air pollution and dental infections
Immune deficiencies and conditions such as asthma

Symptoms

Nasal congestion and blocked breathing
Thick, discoloured nasal discharge or post-nasal drip
Facial pain or pressure around the cheeks, eyes or forehead, worse when bending forward
Reduced sense of smell and taste
Headache, bad breath, fatigue and cough

Treatment of chronic sinusitis

Medical treatment first

Saline irrigation, nasal steroid sprays, antihistamines for allergies, and antibiotics when bacterial infection is confirmed form the first line. Many patients improve without surgery.

Surgical options

Functional endoscopic sinus surgery (FESS): through the nostrils, using an endoscope and fine instruments, the surgeon removes the blockage (diseased tissue, polyps, narrow bony partitions) and widens the natural drainage openings while preserving healthy lining. No external incisions are made.
Balloon sinuplasty: a small balloon is placed in the blocked opening and inflated to widen it, suitable for selected cases without extensive disease or polyps.
Septoplasty and turbinate reduction: correct the nasal obstruction that contributes to poor sinus ventilation.

Combining sinus surgery with rhinoplasty

Many patients with chronic sinusitis also have a deviated septum, a crooked nose or a nasal deformity they want corrected. Performing sinus surgery and septorhinoplasty in the same session offers one anaesthesia, one recovery period and a comprehensive solution for breathing and appearance. Planning requires a CT scan of the sinuses and close cooperation with the ENT (ear, nose and throat) team where needed. Prof. Dr. Suleyman Tas evaluates breathing and sinus health in every rhinoplasty consultation. Read about aesthetic and functional rhinoplasty.

Recovery

After FESS, congestion and mild bloody discharge last about one to two weeks; saline rinses help clear crusts. When combined with rhinoplasty, the splint is removed at one week and most patients return to desk work within 7–10 days. Follow-up endoscopic cleaning may be needed to ensure the sinuses heal open.

Frequently asked questions

Does rhinoplasty cure sinusitis?

Cosmetic rhinoplasty alone does not, but correcting a deviated septum or valve problem can improve sinus ventilation. Sinus disease itself requires sinus treatment.

Is endoscopic sinus surgery painful?

Discomfort is usually mild, more like pressure and congestion, controlled with simple painkillers.

Can sinusitis come back after surgery?

Surgery greatly improves drainage, but allergies and polyps may require ongoing medical management.

Do I need a CT scan before surgery?

Yes, a sinus CT scan is essential for planning endoscopic sinus surgery safely.

Next step

Contact Prof. Dr. Suleyman Tas Clinic for a combined assessment of your breathing, sinuses and nasal shape.

About the author

Prof. Dr. Suleyman Tas is a European Board-certified plastic, reconstructive and aesthetic surgeon based in Istanbul with over 20 years of experience, author of Rhinoplasty in Practice (CRC Press) and founder of the Closed Atraumatic Rhinoplasty Course. Read verified patient reviews or book a consultation.

This article is for general information and does not replace an individual medical consultation.