What is mid vault collapse?

Dear rosiecon11 in Beverly Hills, CA:
The word “collapse” is a bit scary. It is not a collapse like when a roof
collapses under 10 feet of snow or collapses during a fire. While this is analogous to the roof of the
nose, the reference to collapse is that there is a little bit of weakness and
sometimes a structural “dip” between the nasal bones and the cartilage called
the upper lateral cartilage that occupies the upper third of the nose. Sometimes it can come from injuries,
sometimes it comes from surgery, and sometimes people are just born with weaker
cartilages. In itself it is a cosmetic
issue, but when the cartilages are very, very weak, if the patient has a
particular type of nasal obstruction, one may see these cartilages move inward
with deep inspiration. If the problem is
a cosmetic nuisance and not impinging on the breathing or worsening it, then it
can be corrected either with surgery or by a non-surgical technique including
temporary or permanent fillers.
The best advice is to have consultation with a surgeon
who majors in rhinoplasty and has a long run of experience and a high degree of
specialization. Check out the websites,
look at the patient reviews on review sites such a RealSelf and the others, and
look at the doctors’ before-and-after photos and see how similar cases have
been managed. When you do go for
consultation, be sure to have computer imaging and ask about whether if a
weakness of the middle third of your face is indeed a problem that can be
corrected using a temporary or permanent filler.
Best wishes,
Robert
Kotler, MD, FACS

Over
4,500 nasal procedures performed

Mid vault collapse usually is related to previous surgery or other trauma.  This refers to the cartilaginous dorsum .  The collapse refers to a weakening and narrowing between the upper lateral cartilage and septum known as the "internal nasal valve" .  Patients will usually complain of nasal obstruction and may have an inverted V shape/deformity  seen on frontal view.This is corrected with "spreader grafts" of cartilage placed between the upper lateral cartilage and septum to open the internal valve.  This usually rectifies any esthetic issues also. These grafts are typically harvested from the septum but if not enough is  available on account of previous nasal surgery,  auricular (ear) cartilage can be used.