Hello surgeons, Slightly + 7 months post primary rhinoplasty; breathing has been severely compromised since. My surgeon said it's "a little pinched"; ENTs have said, "nasal valve collapse." I've recently gone on revision consultations; surgeons believe they can make nose less bulbous while opening up airway. Since I've been burned once--emotionally, financially, aesthetically, and medically, I'd love some opinions if you believe this is possible: a FUNCTIONAL thinner, prettier nose. Thank you!
March 19, 2019
Answer: Nasal valve collapse Your photos, you appear to have some alar collapse as well as some deviation. I would be interested in seeing the operative report from your surgery to see what exactly was done, these issues could be a result of a number of things. The tip does appear to be somewhat bulbous but it is still early, full swelling may last a year and the tip is usually the last part to go down. An in person eval would be best but I would say there is hope for some improvement.
Helpful
March 19, 2019
Answer: Nasal valve collapse Your photos, you appear to have some alar collapse as well as some deviation. I would be interested in seeing the operative report from your surgery to see what exactly was done, these issues could be a result of a number of things. The tip does appear to be somewhat bulbous but it is still early, full swelling may last a year and the tip is usually the last part to go down. An in person eval would be best but I would say there is hope for some improvement.
Helpful
March 22, 2019
Answer: Rhinoplasty May Commonly Inadvertently Compromise the Nasal Valves The internal valves (the sidewall in the middle third) depend on the height and integrity of the bridge. When the bridge is reduced even 2 mm, the internal valves become unstable and can collapse and decrease the airway by 50%. I know this by my published 600 patient rhinomanometric study over 16 years.The external valves (the sidewall in the lower third) depend on the position and strength of the tip cartilages. If the lateral crura (the tip cartilages above your nostrils) are reduced, or if they are anatomically malpositioned by the way your nose naturally is, the airway can again go down by another 50%. Thus a rhinoplasty can theoretically reduce your airway by 75%.You clearly have external valvular collapse, but it is likely that your internal valves are collapsed also. This is readily correctable as long as the surgeon is experienced in this kind of work. It can be done without changing your profile or nasal shape at all, unless you wish other changes there as well. The proven techniques are spreader grafts or dorsal grafts for the internal valves and grafts into the alar walls to strengthen the nostrils. Although other methods are advocated, none have outcome evidence in the literature.Your doctors are right, but there is certainly a cure. Good luck to you
Helpful
March 22, 2019
Answer: Rhinoplasty May Commonly Inadvertently Compromise the Nasal Valves The internal valves (the sidewall in the middle third) depend on the height and integrity of the bridge. When the bridge is reduced even 2 mm, the internal valves become unstable and can collapse and decrease the airway by 50%. I know this by my published 600 patient rhinomanometric study over 16 years.The external valves (the sidewall in the lower third) depend on the position and strength of the tip cartilages. If the lateral crura (the tip cartilages above your nostrils) are reduced, or if they are anatomically malpositioned by the way your nose naturally is, the airway can again go down by another 50%. Thus a rhinoplasty can theoretically reduce your airway by 75%.You clearly have external valvular collapse, but it is likely that your internal valves are collapsed also. This is readily correctable as long as the surgeon is experienced in this kind of work. It can be done without changing your profile or nasal shape at all, unless you wish other changes there as well. The proven techniques are spreader grafts or dorsal grafts for the internal valves and grafts into the alar walls to strengthen the nostrils. Although other methods are advocated, none have outcome evidence in the literature.Your doctors are right, but there is certainly a cure. Good luck to you
Helpful
