How do you know if your Nasal Valve Collapse is bad enough to get surgery.

This question is probably best addressed in person. However, if you are having to pull on your cheeks or elevate your nostrils in order to improve your breathing, then it is likely that you still have at least some degree of nasal airway collapse or valve obstruction. I would discuss this with your previous surgeon or seek another rhinoplasty expert in your area.

     I would recommend an examination in person to help determine what may be done to help resolve your issues.Kenneth Hughes, MDLos Angeles, CA

I would recommend a consultation with a facial plastic surgeon or plastic surgeon for an in person evaluation.  During that evaluation, you should bring your surgical records so that the surgeon can evaluate exactly what was done in the initial surgery.  There are numerous surgical maneuvers used to correct nasal valve collapse, but without seeing you, it's impossible to make any further recommendations.  I wish you well!

A very helpful test done in the office is the modified Cottle maneuver. This is similar to pulling on your cheek. Your surgeon will lift up on the nasal valve area simulating changes that might be created by surgery and you can determine whether this creates significant improvement in your nasal breathing. This is typically a very accurate estimation regarding whether or not additional surgery could improve your airway. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

A functional rhinoplasty can mean many different things.  Perhaps septum and turbinates were addressed but if the side walls are collapsing to the point that it affects your breathing then this should be looked at by a plastic surgeon.  There are more than one cause for this potential collapse.  The most commonly treated is the valve mechanism as the cartilage on the side walls meet the septum--the valve of Minx.A cartilage graft will widen this area.  However, often overlooked is the valve fomed where the tip cartilages overlap as they connect to the sidewall cartilages (lower lateral and upper lateral junction).  this coupling is referred to as the scroll and is almost always resected when the tip size is reduced.  This scroll is like an I-beam that stiffens the side wall and while it cannot be easily replaced or mimicked,  a stiffer piece of cartilage in this region will resist caving inward on inspiration.  I hope this makes your next consultation more valuable

Its normal for the nose to collapse a little when you breathe inward. If you are having a hard time breathing or sleeping then you should have your nose checked out again. 

If you are having breathing issues, you should see your Plastic Surgeon for an in person evaluation.  Alar grafts may be needed to correct the nostrils.  Best wishes!