Is a nose job permissible if one can't breathe?

So the general principle is any purely cosmetic and permanent change wouldn't be permissible according to the majority of scholars because it would be considered changing the creation of Allah. However, there are certain exceptions to this. One being, let's say, if there's a specific need. Let's say in this situation, doctors have said you're unable to breathe properly. That would be permissible for that specific need. If it's something which a body part is out of the ordinary, out of the norm, then also that would be permissible. But the general principle however would be if it's a purely cosmetic change that wouldn't be allowed if it's a permanent one.