Possible Nasal Valve Collapse and Breathing Difficulties After Rhinoplasty/septoplasty/osteotomy? (photo)

Question

I am 5 1/2 post op. Having breathing difficulties through both nostrils. While breathing through right nostril changes during the day (sometimes good sometimes bad), it is constantly bad through the left one especially when I inhale. I am afraid I may have nasal valve collapse as there the “dent” on the left tends to squish in when I deep-breath. I don’t know if the pictures show all.

Toby Mayer, MD · Answer

It Appears that you do have depression in the valve area which can be corrected with cartilage grafts to that area. However it is too soon to say since it takes 6-12 months for the swelling to go down.

Thomas A. Lamperti, MD · Answer

There can be internal nasal swelling at this stage still contributing to nasal blockage, but I do see the area on the left where there is some narrowing.

	Your nose will continue to heal and hopefully as the internal swelling improves your breathing will also improve. If you have persistent problems you may benefit from a spreader graft to open up that narrowed area.

	You can read more about spreader grafts at my web reference link below.

Michael A. Persky, MD · Answer

Hi NG, Best to discuss your concerns with your rhinoplasty surgeon. Examination inside your nose will reveal the cause for your nasal obstruction. We often will treat patients such as yourself with Somnoplasty (radio-frequency volumetric tissue reduction) if the inferior nasal turbinates are reactive. It sounds as if that is the case for your right turbinate. The treatment is non-invasive and performed in the office with no downtime other than a stuffy nose for a few days. Good luck and be well. Dr. P

Kenneth Hughes, MD · Answer

I think your assessment of the situation is probably correct based upon the pictures and your description.  I would have to examine you to be more certain. 

	 

	 

	 

	Kenneth Hughes, MD Los Angeles, CA

Garrett A. Wirth, MD, MS, FACS · Answer

Thank you for the description and pictures.  Based on those, I believe you may, in fact have some valves collapse issues.  This would need to be evaluated further with a formal consultation and diagnosis should also include external, internal or combination of valve restrictions, if that is the final issue.  As far as changes in breathing during the course of the day, please keep in mind there are normal variations for all nasal airflow that adjust each day for all noses normally.  Would need to asses if yours is normal or too restrictive.Garrett A. Wirth, MD, MS, FACSWirth Plastic Surgery

Possible Nasal Valve Collapse and Breathing Difficulties After Rhinoplasty/septoplasty/osteotomy? (photo)

Answers (5)