Severe Nasal Collapse

6-7 years ago I had rynoplasty and tubinectomy surgery, please excuse my spelling on those two procedures. The surgery was in attempt to fix a deviated septum, crooked nose, and hump on the front of my nose. below is a link to a video of my nose, you can see when i try to breath in, the side walls collapse severely, NO air comes in. This is how my nose is everyday, I’m not sick or stuffed up. The smallest bit of mucus in my nose feels huge. please help!

http://www.youtube.com/watch?v=aYG97upEing

Doctor Answers (9)

Nasal Collapse with Inspiration

+3

The video demonstrates your problem quite clearly, and the issue is how much does that impact your daily life.  If quite a bit then look to surgical options. You would need strong, structural cartilage grafting of your nose from likely a rib (assuming the nasal septal cartilage was removed during the first surgery).  This will help give your "internal valve" more strength with a forcible inspiration. However, there is the risk that your nose could look wider as a result. The nose that "breathes" the best is a wide one, but most people want to maintain an aesthetic appearance of the nose as well. There is always a balance with form and function in any rhinoplasty.  See someone experienced with revision rhinoplasty.

Best of luck

Vince Marin, MD, FACS
San Diego Plastic Surgeon


San Diego Plastic Surgeon
5.0 out of 5 stars 26 reviews

Nasal Valve Collapse

+2

I have reviewed your video, and although it does show a degree of internal nasal valve collapse, it would be prudent to examine your valve under conditions in which you were not taking such forceful inspirations.  That being said, you seem to continue to display a twist to the nose.  This is most likely secondary to continued septal deviation.  I suggest you follow up with a skilled revision rhinoplasty surgeon for a detailed examination of the nose.  You will require structural cartilage grafting to support the nasal valve and airway.  I would suggest rib grafting as a means to provide excellent graft strength.  Good Luck.... Dr. Corrado

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Airway problems

+2

You seem to answer your question yourself. Even after turbinectomy and correction of a deviated septum, some people still have airway breathing problems. I'll bet even with midvault collapse and then surgery to provide support( spreader grafts), you may still have some breathing issues that can be related to your sinuses or allergies.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

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Pinched Nose From Nasal Valve Collapsed

+2

With what appears to be moderate inspiration in your video, there is notable collapse of the nasal valve area. Most people, as indicated by Dr. Tavoussi, do not breathing in through their nose with that amount of force. That being said, you certainly might benefit from reconstructive rhinoplasty surgery to strengthen the valve area. This would require cartilage grafting to the nose to help improve your nasal breathing. I have included a quick link to one of our rhinoplasty tutorial pages discussing evaluation and management of the pinched nose. Hopefully this helps.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
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Severe Nasal Collapse

+2

What you are doing is taking a hard and fast breath which will lead to collapse of upper cartilages but they bounce back. You don't usually breathe like that do you? I have not had rhinoplasty but the same thing happens when breathe really hard. Having said that, you do have continued deviation of nasal septum and nasal structure which may be contributing to airway compromise.

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

Severe Nasal Valve Collapse after rhinoplasty surgery

+1

Your nasal valve collapse is severe, and most likely a combination of previous surgery and predisposing anatomy. It can be addressed with functional reconstruction, rebuilding the structural support of your nose using cartilaginous grafts.  You're extremely weak in the internal and external valves, and also in the bony pyramid.  We would have to examine you to see what septal cartilage if any is left in your nose, and what we would have to use (septal, ear, rib, cadaver rib, etc).

Ramtin Kassir, MD, NY, NJ Facial Plastic Surgeon

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.5 out of 5 stars 26 reviews

Classic valve collapse--there is a reliable treatment

+1

This is a common problem--sometimes due to previous surgery, sometimes just genetic.  The treatment is functional rhinoplasty to add support to the areas of collapse and weakness.  Alar batten grafts, lateral crural strut grafts, lateral crural grafts--these are all structural techniques which may help you.  The selection of technique and the nuances of how the grafts are places would depend on your goals and your unique anatomy which would have to be determined with a detailed nasal examination.  But overall, you do not need to live with the problem you have--nasal valve surgery has been shown repeatedly in medical studies to effectively treat valve problems like the one you have.

David W. Kim, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Nasal valve collapse after rhinoplasty

+1

Although everyone will have some degree of inward movement of their nose with deep inspiration your video does show quite significant weakness of the nasal valves (internal more so than external valves).

A full nasal exam would point to the best method of correction but I suspect structural grafting using spreader grafts and possibly alar batten grafts would help supprt your nasal sidewall. An internal exam to check on the position of your septum is also in order.

A question in your case would be where to obtain enough cartilage since you've had a prior septoplasty. There may be some septal cartilage to harvest, but rib cartilage may be needed to provide enough material.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Nasal valve collapse after rhinoplasty

+1

Your video clearly demonstrates collapse of the nasal valves.  You may have had anatomy that predisposed you to this problem.  There is a way to improve this with structural grafting using your own cartilage.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 136 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.