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

B/c I'm looking to get my deviated septum fixed, I watched a video on Youtube w/ a girl talking about her septoplasty. She said her "pinched valve" in the middle of her nose and bulbous tip contributed to her breathing problems. She said these were functional issues; are they? I can see that my nose is the same way, but my ENT doctor never mentioned it. My nose is pinched in the middle with a round tip just like the actress in the pics below. Does a pinched valve or bulbous tip impair breathing?

Doctor Answers 11

A deviated septum is only one component of the nose that can cause blockage

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.

New York Facial Plastic Surgeon
4.9 out of 5 stars 127 reviews

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

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. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Bulbous tip and a deviated septum

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.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

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

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

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Pinched Nasal Valve

A pinched nasal valve does reduce nasal airflow. A bulbous tip should not alter nasal flow.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

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

Many thanks for very interesting question with simulated images. I am not aware if the tip of the nose is connection to internal valve correction or Septoplasty. An ENT surgeon is not conducting an Aesthetic tip plasty for you and therefore what ever you have seen on YouTube does not belong to your problem. I am sure Septoplasty will not change of your tip of nose and will have to do anything any thing will your internal valve. Wish you good luck.

Ashok Govila, FRCS, MCh, MS
Dubai Plastic Surgeon
4.7 out of 5 stars 88 reviews

Pinched Valve Obstructing Nasal Airway

Looking at you in the picture submitted I promise that you have airway obstruction. The hour glass shape of your nose seen externally is consistent with a narrow valve which which will interfere with normal airflow. Your bulbous tip does not cause any functional problems. In addition to straightening your septum, spreader cartilage grafts should be placed to open the valves.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Nasal valve collapse

A pinched valve or more specifically what we call internal nasal valve collapse can negatively the nasal airway.  However, typically a bulbous tip does not.  Surgery for internal nasal valve collapse usually involves placement of spreader grafts which are cartilage grafts placed on along the nasal dorsum in the mid portion of the nose.  This improves the airway but also improves the "dorsal aesthetic lines" of the nose.  A septoplasty corrects a deviated septum and does not specifically address nassal valve collapse. One way to test for nasal collapse is try a breath right strip and see if that dramatically improves nasal airflow.  Also lateral soft tissue traction on the cheek pulling the nose out can also be done to test for nasal valve collapse. 

Perry J. Johnson, MD
Omaha Plastic Surgeon
4.8 out of 5 stars 18 reviews

Internal Nasal Valve Collapse

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.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 64 reviews

Yes and no.....Here is the deal with #breathing and #rhinoplasty

Good question.  Here is the deal:

Obstruction to airflow can come from multiple locations inside and outside the nose.  The septum is only one of the areas and it may be only part of the problem.  A pinched middle vault can cause breathing problems as well as cosmetic problems.  A bulbous tip will not cause breathing problems and its a cosmetic issue but supporting the tip can improve breathing.  Ultimately it sounds like you have not found the right surgeon for your situation.  Look for a great Facial Plastic Surgeon or Plastic Surgeon who specializes in noses.  This is an intricate anatomic and physiologic structure and getting it right the first time gives you the best chance at success.  You want a pretty nose and one that helps you breath. 

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 110 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.