Does a Pinched Valve/narrow Mid Vault and Bulbous Tip Obstruct Airflow, and Can This Be Fixed by a Septoplasty? (photo)

A deviated septum can block your breathing. So can large turbinates and/or a narrow external nose called the nasal valve. It's not always easy to determine what is the specific cause. If there is any doubt, I suggest a second opinion from a nose specialist. If your nasal valve needs to be strengthened it should be done at the same time as a septoplasty since the best graft material we use to strengthen your nasal valve is from the nasal septum. A photo doesn't always show the answer. A personal exam is very important for such subtle findings.

If one has a pinched mid-vault from previous nasal surgery this does cause internal nasal valve collapse and can be corrected with an open approach and use of spreader grafts from the septum. This can significantly improve breathing.

A pinched nasal valve does typically contribute to nasal obstruction while a bulbous nasal tip is strictly a cosmetic issue. A septoplasty alone will change neither the tip nor the nasal valve region. If you do have a deviated septum it will likely improve your breathing but will not improve the nasal valve region. Cartilage grafts are typically required in that area to add structure and prevent collapse. This can be performed with a septoplasty and is usually referred to as a septorhinoplasty procedure. I hope this information is helpful.Stephen Weber MD, FACS
Lone Tree Facial Plastic Surgeon

We can discuss the causes of anatomic airway obstruction at length. But ONLY intra nasal IN PERSON examination allows definitive diagnosis. Best to see a boarded surgeon in your city. BTW bulbous tip does not add to air way obstruction. 

There are multiple issues that can cause nasal obstruction  from the internal portion of the nose, and these include a deviated nasal septum, unilateral or bilateral valve collapse, turbinate hypertrophy  and a nasal fracture.  A bulbous tip does not  impair breathing and is only reduced for cosmetic purposes.  When an hourglass nose is present, many times there is a valve collapse issue and spreader grafts are required to open up the nasal valve. Spreader grafts are usually composed of the patient's own cartilage harvested from inside the nose. Virtual rhinoplasty software is available on our website for you to try.