I Have Obstructed Breathing, Do I Have Nasal Valve Collapse or Inverted V Deformity?

I had a rhinoplasty 2 yrs ago for a droopy tip/hump/long nose. I accepted the results however I feel he overresected the hump. My breathing has gradually gotten worse and after the swelling resolved, I'm noticing the cartilage is retracted from the bone. Do I have nasal valve collapse and would insurance pay for graft solely to improve the breathing and not for cosmetic change? I'm frustrated that my doctor didnt anticipate this since I've heard other docs put in grafts during initial surgery.

Doctor Answers 5

Spreader grafts?

Both of these problems are functional problems and an examination is needed.  If you pull the sides of your face at the junction of the nose to the cheek and your breathing is better then you may have a collapse of the internal nasal valve.  This can be corrected by a spreader graft.  If this deformity is present prior to surgery then you are correct it should be addressed at the time of the initial surgery.  

Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

I Have Obstructed Breathing, Do I Have Nasal Valve Collapse or Inverted V Deformity?

You may have both. Discuss using spreader grafts with your surgeon or get a second opinion on how to improve this. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

Nasal obstruction and inverted V deformity

Your photos do seem to show the so-called "inverted V deformity" and nasal deviation. This is often associated with nasal valve compromise and consequently, nasal airway obstruction. I would recommend seeing a local surgeon for an evaluation as there can also be a dynamic component to nasal valve collapse which cannot really be detected by photos alone. A revision rhinoplasty could definitely address your airway and cosmetic concerns. Whether or not insurance would cover any further procedures will be dependent on the individual insurance provider and your policy. Best of luck!

Sachin S. Pawar, MD
Milwaukee Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

Obstructed breathing

You do appear to have a deviated nose with inverted V and probable internal valve collapse. Whether or not insurance would help you is something you need to investigate yourself with your carrier or company HR person. Some policies will not cover any treatment even purely functional if the problem was caused by previous cosmetic surgery. Good luck!

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Inverted V after rhinoplasty

Your photo does show an inverted V of the nasal bone with a shift on the cartilages of the dorsum up against the septum. It is likely that the internal valve has become constricted as well and a revision with spreader grafts can solve both problems.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

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