Many people mistakenly believe that nose reshaping is done for cosmetic reasons only. In fact, many people who would benefit from a functional revision rhinoplasty would also get the side effect of a more balanced nose. This is because the septum, which lies at the root of many upper airway breathing difficulties also happens to form a very important structural component of the nose that impacts enormously on the external appearance of the nose. Deviation of the septum can cause significant breathing difficulties – a problem of much more import than the external appearance of the nose. Addressing this lopsided culprit, which by the way is often covered by most insurance carriers, will greatly aid nasal airflow, and fortunately, also improve nasal shape. In addition, in some cases of trauma, where the nasal bones have been misplaced, nasal airflow is also significantly compromised. Resetting the displaced bones will usually take care of the problem, and again, improve nasal shape. How is this done? Depending on the complexity of the problem, and the surgeon’s preference, the surgery may be performed through an open or closed approach. From a simplified perspective the only thing that separates the two approaches with respect to the final appearance is the presence of a small, usually imperceptible (except to the dog or the lover of the patient) scar at the top of cupid’s bow. From the surgeon’s standpoint, however, the addition of that small opening can greatly facilitate exposure, and help precise matching of one side to the other in the more involved case. To conclude, form is function and function is also form when it comes to nose surgery, fix your breathing, fix your nose.