I Have Breathing Issues from a Septoplasty and Cosmetic Issues from a Rhinoplasty? What would you recommend? (photo)

My nose was over resected / nasal valve collapse. I was told I needed nasal reconstruction (spreader graft’s taken from my rib cartilage). I have tried breath right strips positioned on the top front of my nose with a 100% improvement in breathing. A friend of mine (ENT facial plastic surgeon) has recommended against complete nasal reconstruction and is suggesting removal of scar tissue and repair of the nasal valve. I would like recommendations on revision rhinoplasty surgeons.(Manhattan)

Doctor Answers 3

Valve problems

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From you photo the problem seems to be the external valve, especially on the right.  Spreader grafts help the internal valves, higher up in the nose.  You may need strut or batten grafts.  If you want someone in NYC, I would see Steve Pearlman.

Revision septorhinoplasty

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 There are multiple issues that can cause breathing difficulties out of the nose which include a deviated septum, turbinate hypertrophy, valve collapse, and even allergies. Examination of the external and internal portion of the nose is required to make any judgment calls on what may need to be performed especially for revision nasal surgery. A deviated septum is repaired with a septoplasty procedure,  while valve collapse is addressed with cartilage grafting such as spreader grafts and alar rim grafts. The turbinates can also be reduced in size on the internal portion of the nose to improve air flow.

Sometimes breathing can be worse after rhinoplasty, this can hopefully avoided or treated with grafts

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There are a number of causes for airway blockage and breathing issues following rhinoplasty. Repair is very specific and depends on a personal exam. Sometimes its scar tissue and other times collapse. The latter may require cartilage grafts from the nasal septum, ear or rib depending on the extent and what was done prior.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 134 reviews

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