Internal nasal valve collapse? Do I have any options after two revisions?

Question

I had a rhinoplasty that caused my nose to collapse externally and internally. A revision surgery used cartilage from my ear to support the tip, but after a month, my nose became even narrower. Another surgery used septal cartilage, which stabilized the tip perfectly, but the inside remains narrow. Internal cartilage placement wasn’t possible due to significant scarring, which is pressing on the internal structure. Does this mean I have no further options?

Eric M. Joseph, MD · Answer

Internal nasal valve collapse may cause both a visible indentation in the bridge of the nose, and nasal obstruction. If you are just looking to fill the indentation, microdroplet Silikon-1000 nasal injections may be considered for a permanent non-surgical nose job treatment. If you cannot breathe through your nose, you may benefit from Consulting with a reputable rhinoplasty specialist so you can see what might be best for you moving forward. I hope this helps! Sincerely, Dr Joseph

Ali Sajjadian, MD, FACS · Answer

Thanks Fearless574724 for your question! Your rhinoplasty revisions seem to have been a difficult experience for you. It's normal to be anxious and to consider your alternatives.
Given your description of the internal constriction and breathing difficulties, internal nasal valve collapse is a possibility. This happens when the nose's internal structures constrict and impede airflow, particularly the angle formed by the upper and lower lateral cartilages.
It is true that scarring can make revision procedures more challenging and make it more challenging to successfully implant cartilage transplants.
It's crucial to remember that you could still have choices. You can talk about the following options with a highly skilled rhinoplasty surgeon:
Specialized grafting techniques: A competent surgeon may be able to open the internal nasal valve using cartilage grafts (from your rib or ear or septum) even if there is scarring. Methods such as spreader grafts or alar batten grafts may be taken into consideration.
Options without surgery: Airflow may occasionally be improved by minimally invasive techniques including radiofrequency ablation or the insertion of absorbable implants, such as the LATERA implant or external valve opening devices placed on the area of nasal valve such as breath right strips.
Emphasis on function: If more structural alterations are deemed too dangerous, attention may be directed on enhancing airflow in alternative ways, such as treating any turbinate hypertrophy (enlarged nasal structures).
Look for an expert: Speak with a rhinoplasty surgeon who specializes in treating nasal valve collapse and revision situations. Seek out an individual who holds dual board certifications in otolaryngology (ENT) and face plastic surgery.
Compile thorough documentation: To provide to the new surgeon, gather all of your prior surgery data and operating notes.
Free exchange of ideas: Give the surgeon a thorough explanation of your symptoms, worries, and objectives.
Keep in mind that each case is different, and the best course of action will be determined by a knowledgeable professional conducting a complete review. Keep looking into your possibilities until you discover one that suits you, and don't give up.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian

Lexie Wang, MD · Answer

I don't understand what you mean by the internal cartilage placement was not possible due to "significant scarring" - this doesn't make sense. But to answer your question, yes you do have options but you will need to get cartilage from somewhere to open up the valves.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. This can likely be improved with a revision rhinoplasty. Placement of spreader grafts will likely help correct your internal nasal valve collapse with appropriate tensioning of the tip. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Internal nasal valve collapse? Do I have any options after two revisions?

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Answer: Revision rhinoplasty

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Internal nasal valve collapse? Do I have any options after two revisions?

Answers (4)

Answer: Revision rhinoplasty

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