Collapse After Revision Rhinoplasty?

I have had a 3rd rhinoplasty, requiring a rib graft, 5 weeks ago. The surgery was supposed to correct, among other things, areas of collapse however I now notice that this was not fully achieved. I believe I have external valve collapse on both sides and internal valve collapse on one side. This is impeding my breathing since when I pull my cheeks away from my nose, air flows much better. Should I notify my doctor immediately? Also, how difficult is it to correct these issues in general?

Doctor Answers 6

What to expect after revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Swelling after revision rhinoplasty can take twice as long to resolve vs. primary rhinoplasty. I would do the following.

  1. This maybe normal swelling: follow up, non urgently with your surgeon for re evaluation.
  2. There maybe internal valve collapse.  Without photos, examination, and further healing it is too soon to tell.
  3. There maybe external valve collapse: Same.  Have to wait and see. Going in too soon can only cause harm and reverse a potentially normal result.

Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 156 reviews

Give Your Nose Time to Heal

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

5 weeks is still very soon after your surgery, and the majority of your swelling is still present.  It can take up to a year before you see the final result of your surgery, but the amount of time the swelling lingers may be influenced by the following things:

1) Whether or not tip work was performed
2) The thickness of the patient's skin
3) If the procedure was open or closed

I would give it some time, as you are still early in the healing process.  I would recommend speaking with your surgeon regarding any concerns you have at this time.

Fixing external and internal nasal valve collapse can be challenging during a revision rhinoplasty.  For that reason, it is important to see a surgeon who specializes in these procedures.


Thanks and I hope this helps!

Breathing issues and rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Lycee123,

  • You should contact your surgeon with any questions or concerns after surgery
  • He/she is best equipped to handle those answers
  • I think it is still very early to get worried, and let him know so you can be examined

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Revision Rhinoplasty Collapse

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In instances such as this, it's very important to notify your doctor because your breathing is in jeopardy. This is a difficult thing to correct, but it can be done. You may want to consider waiting a bit before undergoing corrective surgery again. Waiting up to two years may be the most beneficial. 

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Fixing a collapsed nose with revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello, and sorry to hear about your breathing issues following surgery. Five weeks is still very soon after your procedure, and I would give it some time before you jump to any conclusions. You are still quite swollen at the 5 week mark, and swelling may interfere with your breathing being perfect. In general, if those issues were present, surgery would be necessary. To correct a valve collapse, cartilage grafts would be used during an open procedure. It is best if this type of surgery is performed by a specialist. For the grafts, I wold use septal cartilage as a first choice. If there is not enough septal cartilage available, or if the cartilage from the septum is compromised, using a PDS plate with ear cartilage is now a good choice. It can be a second option after septal cartilage. Rib cartilage is also a great choice. It is very strong, and much more rigid than ear cartilage. At this point, I would recommend speaking with your surgeon regarding any concerns. He/she knows the extent of your surgery and exactly what was performed. Thank you and I hope this helps!

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Revision rhinoplasty and breathing issues

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

At five weeks post revision rhinoplasty, you may still be swollen. You have to give it several months for things to settle down before considering further surgery.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.