ENT has said I have long term nasal inflammation causing internal valve collapse. Surgery or implant?

Thanks for your post. By far the best option with regard to correction for external alar valve collapse or internal upper lateral cartilage collapse is with nasal septal cartilage from your own nose via a repair vestibular stenosis procedure. This option can be performed either via an open or closed approach, under general anesthesia on an outpatient basis. This option offer a high degree of success with few risks in the hands of an experienced surgeon. I would avoid insertion of foreign body for nasal valves, when standard cartilage repair is so beneficial. You may want to consult with a surgeon who regularly performs valve repair for a second opinion. I am not aware of any significant nerve damage or dryness risks associated with nasal valve repair using cartilage. Best wishes. 

Rhinoplasty with spreader graft is the best option. I perform this operation multiple times per week and it is 95-99% effective in the right patients...those who have true internal nasal valve collapse. Implants and foreign bodies always carry a risk of extrusion. Of course, this is only an opinion. I'm sure you will find a few surgeons who use it frequently with success. But cartilage is the standard. Implant when there is nothing else available for grafting (like septal or ear cartilage).