What Can Be Done if my Nose Seems Too Narrow and I Have Trouble Breathing Thru It?

Question

I have not had any cosmetic work done on my nose. It has always been like this. An ENT doctor said my septum and turbinates do not seem to be causing the problem. Breathe-rights and decongestants don't help. I don't have any allergies (tested twice). Nose sprays prescribed by my doctor did not help.

Matthew Richardson, MD · Answer

Many patients with very thin noses and weak structural nasal support have trouble breathing through the nose due to nasal valve collapse. Repair of nasal valve stenosis or nasal valve collapse is a technically challenging procedure and should be customized to the individual patient. A thorough history and physical exam would be needed to determine the proper diagnosis and treatment, but if the septum is straight, the turbinates are small, other causes of nasal obstruction are ruled out, and the nasal valve area is clearly incompetent on exam, then surgical repair of the nasal valve area is likely warranted.
This is something that I commonly see and correct in my practice. This is also something that is not commonly performed by ENT surgeons or by plastic surgeons who perform very few rhinoplasty procedures.
Be sure to see an expert such as a facial plastic surgeon to review all the options.
Best,

Aaron Stone, MD · Answer

It is impossible to say what can be done to improve airflow through your nose without a face to face physical examination. If as you say the septum and turbinates are not the reason for the decreased airflow and in the absence of prior surgery or trauma the most likely cause is collapse of the nasal valves when breathing. The treatment then would depend on which valve is involved.

	You can test this for youself closing off/collapsing one nostril with your index finger. Lift your chin up and look in the mirror as you inhale and exhale through the nose. If you see the open side collapsing during the breathing the cycle that is a problem with a nasal valve. The treatment is placement of cartilage grafts inside the nose to prevent the collapse. The position of the graft will depend on which valve is involved.

	I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

	My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Emily Hrisomalos, MD · Answer

Thank you for this inquiry and I am sorry to hear you are dealing with this problem. The nasal septum and turbinates are common causes of nasal obstruction, but there are also other causes which must be considered. If the cartilages are weak or flimsy, as you would imagine, the force of inspiration (breathing in) will easily collapse them leading to airflow blockage. This can happen congenitally or can be a result of reducing the size or integrity of the cartilages with surgery. This problem can be corrected with rhinoplasty using grafts to stabilize the nasal sidewalls and prevent collapse. This would also allow for straightening the septum if it is deviated somewhere that may not have been initially visualized that may also be contributing. There is a relatively new device(small absorbable implant)  called Latera, that can be used as an alternative or adjunct to grafting that may also help with this problem.
In any case, a consultation with a rhinoplasty expert such as a facial plastic surgeon or plastic surgeon will allow for thorough assessment and discussion of corrective options.

Michael M. Omidi, MD, FACS · Answer

Difficulty breathing most commonly occurs form one of the followings:1.  Enlarged turbinates -- sausage like structures that humidify the air that can enlarge from allergies.2.  Narrowed Internal or external valves,  structures in your nose can collapse when breathing in reducing air flow.  Correction requires cartilage grafts to help open the nose at the areas of collapse.3.  Deviated Septum4.  PolypsAn examination and/or CT scan can help with the diagnosis.  Best of Luck, An in-person exam with a
board-certified plastic surgeon is the best way to assess your needs and
provide true medical advice.  Best of
luck. Dr. Michael Omidi

Travis T. Tollefson, MD, MPH · Answer

Dear Mrs Stuffy

	Breathing through your nose may feel stuffy at different times of the day.  From your description, you may have collapse of the sides of your nose (but usually Breath rite would help this).  You may have other airway obstruction sites that could be identified by a nasal endoscopic examination.  If you havent' had a scope placed in your nose, then schedule another consult for an airway examination.  

	It may be that fixing your narrow nose can make it look better, but not help you breath.  This is good to discover before surgery so that you are not disappointed.  Best Wishes.

What Can Be Done if my Nose Seems Too Narrow and I Have Trouble Breathing Thru It?

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What Can Be Done if my Nose Seems Too Narrow and I Have Trouble Breathing Thru It?

Answers (7)

Answer: Narrow nose and difficulty breathing

Answer: Narrow nose and difficulty breathing

Answer: Narrow nose and breathing problems

Answer: Narrow nose and breathing problems

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Everything you need to know about Rhinoplasty

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