After an open rhinoplasty and septoplasty, if middle vault collapse or nasal valve collapse is going to happen, how soon will it happen? Are you ever "out of the woods" so to speak? Are you more likely to have these things happen if a hump was removed? I did not have that, but my bridge was lowered. Will these things always be a possibility? Thanks in advance for your time/info. :) I just want to enjoy my result.
Middle Vault Collapse, and Nasal Valve Collapse
Doctor Answers (6)
Delayed middle vault collapse
if structural techniques to support the middle vault were used, it is unlikely that you would have delayed collapse beyond 1-2 years - when the middle vault is not reconstructed it can happen many years later
The inverted-V deformity and internal nasal valve collapse after rhinoplasty
Patients who have a larger hump reduced, or who have other issues like short nasal bones, are more at risk for the inverted-V deformity and internal nasal valve collapse. This is when the upper lateral cartilages, which form the middle third of the nose, collapse inward. This can present even years after rhinoplasty, but usually there is a suggestion of the deformity much earlier. Contemporary rhinoplasty techniques utilize spreader grafts and other means to avoid this problem, but if you're worried, discuss your concerns with your surgeon. Hope this helps.
Timing of middle vault collapse after rhinoplasty
Narrowing of the middle nasal vault can occur over a wide range of times after the original surgery (from a few months to many years). In some cases it doesn't become evident for 5+ years afterward.
There is a risk of this occuring whenever tissue is removed from the bridge in the area of the cartilagenous middle vault. Mild changes in the bridge in the area are less likely to cause a problem over time. The support and character of the existing nasal framework in the area is also relavent.
In patients that are at risk of this collapse I usually place prophylactic spreader grafts to conservatively support the area and prevent pinching and breathing difficulties down the road.
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Valve collapse after rhinoplasty
I have seen middle vault and nasal valve problem as early as 6 months after surgery to 10 years after surgery. The nasal skin and soft tissue, after open rhinoplasty, continues to contract and remodel over time and changes can occur for the rest of your life. An experienced rhinoplasty surgeon can use techniques and manuvers during your surgery to prevent some of these long term problems. For example after hump reduction, if spreader grafts are placed using the cartilage from the septum, middle vault collapse can be avoided.