How to fix internal nasal valve collapse when I already have spreader grafts and batten grafts?

Question

I’m 6 months out of revision rhinoplasty and have had trouble breathing so I visited a rhinologist who told me my internal nasal valves are collapsed and too narrow. He wants me to meet with a plastic surgeon abut I already have spreader grafts and batten grafts that usually help with internal valve collapse. I don’t know what else to do.

Nima Shemirani, MD · Answer

Hi @mmark07.  I recommend seeing an expert revision rhinoplasty specialist for an in person examination. There are options for you that can be determined after examination.

Best of luck,

Dr. Nima

Jeffrey Lisiecki, MD · Answer

See your surgeon and discuss your problems with them, or else see a plastic surgeon who specializes in rhinoplasty for a diagnosis. There are still a number of things that can contribute to internal valve dysfunction. The spreader grafts may not be in the best place. Batten grafts can sometimes obstruct the airway. Your septum may still be deviated or have spurs. Your turbinates may be too large. Your upper lateral cartilages may not be tensioned enough so that they can still collapse. Scar tissue from your prior surgery may be obstructing the airways. You also may have a medial cause of airway obstruction. Examination can help elucidate which of these is causing the problem.

How to fix internal nasal valve collapse when I already have spreader grafts and batten grafts?

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