Nasal Valve Collapse Surgery?

Hi. Sorry to hear about your functional problem. If your internal nasal valve has collapsed, you'll need cartilage grafts called spreader grafts to fix it. If your external nasal valve collapses when you breath in you'll need lateral crural strut grafts. Either way, you'll need a revisionary surgery. Standard time to wait in between nasal surgeries is a year to allow swelling to resolve, scarring to mature and tissues to soften. Hope this helps and best of luck! Dr Shifrin

There are two nasal valves, the internal and external.  Internal valve collapse typically requires a spreader graft to restore the valve angle.  This involves disassembly of the nasal dorsum and insertion alongside the septum.  Another solution can involve advancement of the medial edge of the upper lateral cartilage (a spreader flap).  Both of these maneuvers require an extensive amount of surgery relative to the original rhinoplasty.  In the case of external valve collapse, simpler approaches such as a small rim graft can often alleviate the problem.  I recommend that you see an experienced surgeon to discuss your problem, get an accurate diagnosis, and figure out the optimal timing for your correction.  Unfortunately, no one can guarantee that any surgery will be successful, but at least someone with experience in this area will give you the best shot at success.

Hi O,

Nasal valve collapse surgery should be less involved that your original rhinoplasty.  Grafts are used to open the valve.  In some patients, the inferior nasal turbinate can be reduced with radiofrequency (Somnoplasty) in a non-surgical in office treatment that can improve breathing and open the nasal valve.  The surgery or treatment may be performed at any time now that you are 3 months post-rhinoplasty.  Good luck and be well.

Dr. P

Opening the nasal valve after prior rhinoplasty involves recognizing what level of the nasal valve is involved and what caused the valve collapse.  Typically, if the area of collapse is diagnosed properly, and if the appropriate technique/grafts are used to open the valve, then nasal valve reconstruction in the hands of an experienced revision rhinoplasty surgeon is very straightforward and has a very low risk of needing further surgery.  Good luck!

Nasal valve surgery can be tricky. However if done by a well trained surgeon, it can be your last rhinoplasty. I notice that you are in Philadelphia. Dr Daniel Becker is excellent with nasal valve surgery. You should certainly see him.                                                      Regards                                                                                                                             Dr. J                                                                                                                        Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

              Spreader grafts can be used to correct internal valve collapse in closed or open fashion.   This does tend to make the dorsum appear wider.  There are other techniques as well.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Nasal valve collapse is a complication of rhinoplasty surgery.  Fortunately, it is a treatable condition that can be improved with revision rhinoplasty surgery.  We allow patients to heal for up to one year before undergoing any revision rhinoplasty.  This is because resolution of swelling, scar tissue formation, and overall healing take up to 12 months.  At that time your airway can be more accurately assessed.  The type of treatment you require will depend on the type of valve collapse present.  The nose two valvular structure of the nose are the internal and external nasal valves.  Valvular collapse can occurr at either of these locations if cartilage support weakened from prior rhinoplasty surgery.  In both cases cartilage grafting is the usual treatment.  Small pieces of cartilage are usually taken from the nasal septum or ear.  They are then placed into the nose in specific areas to support the areas of collapse.  This surgery is very helpful at improving symptoms.  First, you should follow up with a board certified surgeon with expertise in nasal surgery to have your problem accurately diagnosed and then treated.  Good Luck! 

Dear Ohiou,

Thank you for your post.  Nasal valve correction is quite common.  Cartilage is used to reinforce the internal or external valve and thus decrease the amount of collapse, and improve breathing.  There are some consequences of this, such as making your nose a bit wider, in the case of a 'spreader' or 'auto spreader' grafts, and possible cartilage visibility in rim grafts.  Discuss all these issues with a surgeon who is very comfortable with these surgeries.

Best Wishes,

Pablo Prichard, MD

Hello, I want to reassure you that the Nasal Valve Surgery is well known and works well in the hands of Board Certified Plastic Surgeons or Facial Plastic Surgeons.  The usual time for the surgery is 6 to  12 months after the initial Rhinoplasty to ensure that the pos-op swelling has improved maximally.  However, if your surgeon feels that the edema has adequately resolved and your symptoms need intervention, then 3 months is reasonable.  Internal Valve correction requires Spreader grafts.  External Valves need Lateral Crural Grafts.  Sometimes reduction of Inferior Turbinates may be necessary with or without the valve surgery.  Be sure to consult with your surgeon.  The more information you have, the more comfort you will gain.  I sincerely wish you the best!

It is possible that you are experiencing a collapse of the internal nasal valve.  This is a dynamic problem and requires an examination by a plastic surgeon or ENT.  It can be corrected with spreader grafts.