My nose collapses when I suck air from my nostrils. How would surgery fix that?

Question

I will be having a Rhin/Septo/Endoscopic Inferior turbinoplasties. I have a deviated septum, so my surgeon said he was going to get the excess septum and use it to add support above my nostrils. When I breathe in air my nose sucks in the skin above my nostrils, so it seems like it's making contact with my septum which restricts my breathing. Is this procured common? Can someone please tell me how this will be performed? Is there a name for it?

William Portuese, MD · Answer

There are 3 types of cartilage grafts  that are used to help with the collapsing nose with inspiration.1. Spreader grafts are composed of the patient's own septal cartilage and are inserted along the dorsal septum to push the upper lateral cartilage outward. They help with valve collapse and vestibular stenosis. This also opened up the nasal angle and internal nasal valve to improve air flow and help  the nose with collapse 2.  Alar Batten grafts are also composed of cartilage from the internal portion of the nose and are inserted at an approximately 45° angle,  placed underneath the lower lateral cartilages and inserted underneath  the pyriform aperture to hold open the collapsing lower lateral cartilages.3, Alar rim grafts are thinner cartilage grafts also harvested from internal nasal septal cartilage and are inserted right along the alar rim as a stiffening graft to prevent the alar rim from collapsing inward with inspiration. For many examples, diagrams of all the above grafting techniques, and our rhinoplasty photo  gallery, please see the link below

John J. Minoli, MD, FACS · Answer

Without
further historical information the cause of the septal deviation and the
associated nostril collapse cannot be determined. Perhaps the condition arose
as part of your natural development, perhaps from an acquired circumstance such
as trauma. Without a full physical examination of both your external nose and
your internal nasal anatomy the root of your collapsing nostrils also cannot be
determined. That said, the mid vault of the nose houses the internal nasal
valves which when deficient can definitely lead to “nostril” collapse on
inspiration. The use of septal cartilage, fashioned into the form of mid-vault
spreader grafts effectively addresses this problem.

Your
description details your nose sucking in the skin above your nostrils, so I
must also consider that you may be referring to the lower portion of your nose which houses the
lateral alar cartilages. If collapse occurs at this level, septal cartilage may
be used in a variety of ways to support the lower wings of the nose (i.e.,
alae).

Ask
your surgeon whether mid-vault spreader grafts or lower-alar support grafts are
needed. The internet has pictorial examples of each of the aforementioned grafts. Best of luck to the you, new scientist!

Stephen Weber MD, FACS · Answer

What you're describing is a septorhinoplasty. A small amount of deviated cartilage from the septum is placed either in the middle or lower third of the nose to prevent the collapse that you describe. This technique can be very effective in properly selected patients. This is a very common procedure. I hope this information is helpful.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Jeffrey Ditesheim, MD, FACS · Answer

When the nose side wall (the nostril ) collapses with deep inspiration, it means that the pressure it is taking to get air in is greater than the ability of the nostril to stay open.  There are many reasons for this.  There is likely obstruction to air flowing through your nose.  This could be because of a deviated septum or an old injury  or could be because the nose needs more structure.  The reason for this should be clear before surgery as the plan will be different depending on what needs to be fixed, good luck

Donald Nunn, MD (retired) · Answer

Your surgeon will use cartilage harvested with you septoplasty to provide support to your nostrils when breathing.  It is placed underneath the skin and internal nasal lining.  Good luck.  Donald R. Nunn MD Atlanta Plastic Surgeon.

Ashok Govila, FRCS, MCh, MS - Account Suspended · Answer

Thanks for the question.From the description it seems you had surgery to nose earlier and this sometimes results into a nasal valve collapse by removing too much of alar cartilage.In which case on inspiration the nose that holds the nostrils open, can not keep it open and the alae collapses.If no surgery has been done in the past still such a picture is possible in some patients with week cartilages.The solution to your problem is cartilage graft and this is what it seems your PS is planning.

Robert E. Zaworski, MD (retired) · Answer

You said you are having nasal surgery.  Prior to your surgery, ask your Plastic Surgeon to explain the procedure to you so that you have a clear understanding of what he is going to do.  Based on what you have said, it sound like he is going to add cartilage to your alar base(alarplasty) to correct your nostrils, which will help with your breathing.

My nose collapses when I suck air from my nostrils. How would surgery fix that?

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