Is moderate dynamic (upon breathing) inspiratory nasal collapse considered normal? I am 9 months past primary rhinoplasty.

I can't remember exactly how this was before surgery (could it have been pre-existent?), but if I breathe in hard enough I can get my nostril to completely collapse. If I'm breathing normal you can kind of see it move (it can be seen in the upper cartridges as well). Also, if I blow out of my nose I can inflate the cartilages quite a bit, like a balloon. Upon resting nostrils seem normal.

Doctor Answers 3

Valve weakness

This may be due to internal or external nasal valve weakness.  It can be quite bothersome and can be corrected with cartilage grafting to reinforce these areas.  Best wishes, Dr. T. 

Dynamic collapse

You may have had a tendency to have this preop and if you have had a reduction rhinoplasty it could have been made worse - it is not really a normal situation and may impair your breathing - both nostrils or external valves should be fairly stable and resist collapse on deep inspiration 

Is moderate dynamic (upon breathing) inspiratory nasal collapse considered normal? I am 9 months past primary rhinoplasty.

Your nose is naturally equipped with nasal valves, both internal and external, that can dynamically alter the flow of air through them, both for the better or worse, in the affected individual. In the majority of people, the internal nasal valve is designed to collapse with intense inspiration, which explains why individuals often switch to oral breathing during strenuous exercise. The collapsibility of the nose is due to the makeup of the internal nasal valve, which consists nearly entirely of cartilagenous tissue and the internal lining of the nose (mucosa). How easily the valve collapses toward complete obstruction is the variable here that can mean whether this natural occurrence is a problem or not. For example, in individuals with uncontrolled nasal allergies, the internal lining of the nose (including, especially, the inferior turbinates) can swell up drastically. An enlarged inferior turbinate severely reduces the cross-area of the internal nasal valve. In turn, this means that the affected individual will notice a much more immediate collapse to total obstruction early on in breathing, and will experience difficult breathing through the nose even at rest. Similar dynamics are seen in every person with a cold, or anyone who has undergone recent nasal surgery. Nasal swelling, for the most part, limits nasal flow by increasing nasal resistance due to decreased room for air flow, which causes the internal nasal valve to collapse more readily due to greater negative nasal pressures required for breathing. Even sitting here answering your question, if I occlude one nasal passage, and breathe forcefully and rapidly enough through the other, I will see that nasal side wall collapse nearly completely. In the end, whether such collapse is normal, abnormal, or harmful and in need of an intervention, depends largely on whether this creates any symptoms of nasal obstruction at rest or with minimal exercise. If the answer is no, then congratulations, you can be considered "normal" from this very-specific nasal breathing standpoint. 

Danny Soares, MD
Clermont Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

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