Middle-vault Collapse and Detached Lateral Cartilage Due To Trauma, What Can I Do To Fix This?

Question

Due to trauma in which my nasal tip was hit very hard it seems this has caused its detachment from essential areas for support and has made the bridge/middle vault cartilage collapse. How can this be fixed? Its made for not only breathing obstruction but also a great deformity as its become very disharmonious with my face. Is it possible to build the bridge up with grafts while also reattaching/refining the tip to how it was before? Thank you.

Mark B. Constantian, MD, FACS (retired) · Answer

It is very hard to detach upper lateral cartilages from bone.  That mechanism for middle vault collapse is still given yet is incorrect.

	When the bridge is lowered for any reason (dorsal resection, hump removal, septal trauma), the upper laterals sink toward the midline, producing the collapse that you see. In your case the septum has been  damaged, which has also shortened your nose.

	The reverse also works: a significant dorsal graft will pull the upper laterals out, open your airway (doubling your airflow, a shown by my research in 600 patients like you), and correct the contour problem.

	 

	See an experienced surgeon whom you trust--these techniques sound easy but require skill.

Francis R. Palmer, III, MD (retired) · Answer

The nose does appear different in the two pictures after the nasal trauma and IMHO, you should have a few consultations with experienced Rhinoplasty surgeons to examine and evaluste your nose for corrective Rhinoplasty and possible Septoplasty.

Middle-vault Collapse and Detached Lateral Cartilage Due To Trauma, What Can I Do To Fix This?

Answers (2)