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Shifting Nasal Obstruction Post Rhinoplasty

asked 1 year ago by Fergi999 in NY
Latest answer by Michael A. Jazayeri, MD
Question viewed 585 times
Tags: female, blockage, graft, inverted v deformity, pressure, scar tissue

I have difficulty breathing post rhinoplasty. There's scar tissue in my nasal passages+ edges of the upper laterals have pierced the skin (can be seen)+ there's a slight open roof def. My doctor says it's not a valve collapse but inverted V, yet it's barely visible. He wants to use grafts to widen that area. The blockage shifts rather quickly from nostril to another depending on the position of my head, and it's severity changes. I also feel an ache and pressure. Is grafting the only way?

13 answers to Shifting Nasal Obstruction Post Rhinoplasty

Shifting nasal obstruction and rhinoplasty.

It is normal for the nose to have shifting obstruction especially lying down. I would get another opinion since this may not require surgery. See an experienced revision rhinoplasty surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Best Treatment for Shifting Nasal Obstruction Post Rhinoplasty...Somnoplasty

Hi Fergi, Love your work with the Black Eyed Peas! If your breathing is shifting dependant on head position, then your inferior nasal turbinates are a large factor in your nasal obstruction. I would recommend radiofrequency volumetric tissue reduction of your inferior nasal turbinates with a treatment called Somnoplasty by Gyrus. The treatment is in the office with topical and local anesthesia, takes a few minutes, and is rather painless. There is no nasal packing,... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

The use of spreader grafts in rhinoplasty

It is very difficult to answer your concerns accurately without an examination. However, in my opinion, spreader grafts are the best solution for mid-vault collapse (inverted V and internal valve narrowing as you have alluded to). Other causes of difficulty breathing may be smoking (if you smoke, you may NEVER have your subjective feelings of obstruction resolved), inferior turbinate hypertrophy, and, the one most surgeons miss, excess or deviated vomer bone (the vomer sits behind the... more

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Post rhinoplasty shifting blockage

You mentioned a number of technical terms ,inverted V deformity, nasal valve collapsee, opem roof , upper lateral infringement, etc. Without detailed photos or hands on examination it is diffivult to give an intelligent opinion. Shifting nasal obstruction may simply be due to inferior turbiante swelling when dependent, but you should be seen by an experienced revision rhinopalsty surgeon. Good luck

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

facedr.com

Nasal Congestion after Rhinoplasty Surgery

Hi Fergi999, Nasal congestion is common immediately after rhinoplasty surgery, which is commonly due to internal swelling, crusting, or mucous. Chronic nasal congestion after rhinoplasty may be due multiple factors such as scarring, cartilage collapse, deviated septum, or swollen turbinates. Nasal congestion that alternates between sides suggest that enlarged turbinates may play a role in your symptoms. In addition, an "inverted V" deformity suggests possible cartilage... more

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon

Nasal airway obstruction treated with spreader grafts

I do like spreader grafts for both the inverted V-deformity and for widening of the internal valve so that your breathing is improved. However, you may not need surgery if it is more airway complaints. It could be the turbinates that need shrinking or that the mucosa is reactive and you need an inhaled nasal steroid. I would see a revision rhinoplasty specialist in your area to be sure.

Jay Calvert, MD
Beverly Hills Plastic Surgeon

Nasal Obstruction Post Rhinoplasty

There is compromise of the internal valve with an inverted V defromity, which will cause nasal obstruction - spreader grafts are usually the most reliable treatment. You need to be evaluated by an experiewnced nasal surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Nasal Obstruction After Rhinoplasty

Inverted V deformity is the sign of collapse of the upper lateral cartilages causing nasal obstruction. This can be corrected by variety of techniques including spreader graft which is insertion of a small piece of cartilage between the upper lateral cartilage and dorsal septum for support and widening of internal nasal angle leading to better airways. Your obstruction may be complicated with existing deviated septum as well as intranasal scars or enlarged turbinates. Your surgeon should be... more

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon

Inverted v deformity

An inverted "V" deformity is often due to midvault collapse. This is best treated with spreader grafts wit wident he middle vault and improve the airway.

Steven Wallach, MD
Manhattan Plastic Surgeon

Grafts and rhinoplasty

Dear Fergi999, The treatment of an inverted V deformity is usually spreader grafts. This will also open up the nasal valve area which is the narrowest portion of your nasal airway, about an inch inside your nose. -Not only will spreader grafts help correct the cosmetic problem, it will treat the breathing problems as well -It switches sides due to a couple of things: -the nasal cycle, where each side of the nose swells at different times as blood flow... more

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon

Inverted V Deformity needs Revision Rhinoplasty

Revision Rhinoplasty is more difficult than primary rhinoplasty so it is good that your original surgeon feels qualified to undertake this procedure. An inverted V deformity can only be repaired by inserting spreader grafts to support the collapsing cartilage. This cartilage can be harvested from the nasal septum, the ear, or rib cartilage.

Kristin Egan, MD
Manhattan Beach Facial Plastic Surgeon

Will need grafts...

If you have a true inverted V deformity then the upper lateral cartilage attachment to the septum and/or nasal bones is weak and collapsing. You will likely need to have this reconstructed with spreader grafts and maybe another composite cartilage and skin graft from your ear to open the scar tissue inside your nose. Hard to say for sure without pictures, but that's what it sounds like to me.

Colin Pero, MD
Dallas Facial Plastic Surgeon

www.drpero.com

Nasal Valve Collapse

Hi, It certainly sounds like a nasal valve collapse. If you use your fingers to spread your cheeks just by the nostrils ( known as the cottle maneuver) and you can breath better, then its probably a nasal valve collapse. Nasal valve collapse is usually fixed using spreader or butterfly grafts which widen the internal valve at the area of the collapse. Best, Dr.S.