Minimally invasive treatment for nasal valve collapse?

Question

I just had revision Rhino a month ago. Preop I had some dif. in how open each nostril was, but the dif. in intake was not noticeable unless I occluded 1 nare at a time. Only my tip was addressed in this revision (graft and straightening a twisted tip/ fixing bossae), but now functionally my valve collapse on one side is worse, with feeling of pinching/occlusion most of the time (clear air flow if I pull on the cheek). I don't want another Rhinoplasty, is there a less invasive fix?? Thanks!

Daniel J. Givens, MD · Answer

A new minimally-invasive procedure to treat nasal valve collapse is now possible.  The Latera Implant is available in some markets, and we have had great success using the devices.  It can be used in some cases of post-rhinoplasty nasal valve collapse as well.  The implant can be placed either in the operating room or in the clinic under local anesthesia with just a few injections.  It is inserted through a needle near the rim of the nostril, and the implant sits just over the top of the nasal bones and the upper and lower lateral cartilages of the nose.  These structures, which can collapse if weakened by over-resection during rhinoplasty, are supported by the implant preventing collapse.  The implant lasts 18 months before it dissolves, and is replaced by helpful scar tissue.  2 year research data suggests the improvement in nasal breathing may be permanent.  Side effects and potential complications are minimal.I recommend you seek consultation with a facial plastic surgeon, Otolaryngologist, or general plastic surgeon who specializes in rhinoplasty to help determine what treatment is appropriate for your nose.Best Wishes.

Bounmany Kyle Keojampa, MD, FACS · Answer

Nasal valve collapse after rhinoplasty is common.  If it is because of internal valve collapse due to discontinuity of the scroll area, this can be easily fixed in the office with a minor 15 minute procedure under local anesthesia.  The overhanging cartilage causing the internal nasal valve collapse  is shaved and sutures are placed to reconstitute the scroll region between the upper and lower lateral cartilages.  Patients notice a dramatic improvment in nasal breathing immediately after the procedure.We perform this in office procedure frequently for patients who have internal nasal valve collapse after rhinoplasty.

Steven Wallach, MD · Answer

Unfortunately, an internal nasal valve problem cannot be treated non-surgically.  Often a spreader graft is required.

Robert H. Hunsaker, MD · Answer

If it persists after you are fully recovered, NO, I do not know of any nonsurgical method that would be recommended.

R. Stephen Mulholland, MD (retired) · Answer

Dear canuckgirl810,

Thank you for your clinical post and
I’m sorry to hear of the change in the functional status of your airway.

Following resolution of edema and stiffening
of the cartilages that we use to repair and restore your nasal tip you may find
that the interim nasal valve collapse improves. 
I’ve been performing both open and closed rhinoplasty surgery for over
25 years and I’m also well-known for injection rhinoplasties.  Unbeknownst to most physicians, injection
rhinoplasty particularly and specifically selective injection into the region
of the nasal valve between the upper lateral cartilage and the
mucoperichondrium with the septum can act as a Juvederm or Restylane spreader
graft.  I’ve had actually excellent
success at temporarily improving the symptoms of physiologic condition of nasal
valve collapse with this simple injection technique.  I’ve perform it with a nasal speculum and a
headlight, identify the collapsed valve and do a trans mucoperichondrial
injection of Restylane or Juvederm to improve the collapse.

I hope this information is of some
assistance and best of luck.

To find out more, please visit the
link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto

Minimally invasive treatment for nasal valve collapse?

Answers (5)

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