If my nose collapses on deep inspiration, is this internal or external nasal valve collapse? (Photo)

Question

2 years post-septorhinoplasty. Should my nose be collapsing to this degree upon deep inspiration? I don't think that it should be, but I've been told things like, "you're just breathing in too hard." Is this "normal"? Is this external collapse? I also believe I have some degree of internal collapse on both sides. Thank you!

Lexie Wang, MD · Answer

This is an example of external nasal collapse. Internal collapse is located at a different area. You may have that as well but I can't tell from this photo alone. Now I don't know how hard exactly you're breathing when doing this, but even if you're breathing in a little harder, it should not be collapsing to this degree, in my opinion (as an ENT-trained plastic surgeon!).  You can tell if it's "normal" or not based on whether you truly experience the sensation as if you are obstructed and if it is different when you take your fingers and pull your cheeks to the side (simulates keeping the valve open).

Raj Dedhia, MD · Answer

The photo you are showing demonstrates external valve collapse, the right side worse than the left side. However, the internal valve cannot be evaluated on this image alone, and may be contributing to nasal obstruction as well. The "dynamic" collapse during deep inspiration is a physical occurrence (Bernoulli's principle - as air flows through your nose, the pressure decreases relative to the atmospheric pressure and will cause some collapse). It also depends on how some of your nasal musculature supports the nostrils during breathing which is different for everyone. Rhinoplasty techniques typically will not eliminate the collapse completely, but can stiffen the nostrils to decrease the degree of collapse.

Ronald J. Edelson, MD · Answer

It is not unusual for nostrils to collapse like that on deep inspiration. Mine do and I’ve never had rhinoplasty. It’s hard to tell from a static photo whether this is normal or not. I suggest getting other opinions

Eric M. Joseph, MD · Answer

Some people that are able to dilate their nostrils are less sensitive than others to weakness of the external nasal valves. If you are experiencing significant nasal obstruction after surgery, repair of your external nasal valves with lateral crural strut grafts may be considered. Thank you for your question I hope this is helpful. Sincerely, Dr Joseph

Shabnam Ghazizadeh, MD · Answer

Hi. Excellent question. This is called external valve collapse. If it is causing issues with breathing a rhinoplasty can help support the nasal sidewall and improve breathing. I recommend a consultation with a rhinoplasty specialist. Best of luck, Dr. Ghazizadeh

If my nose collapses on deep inspiration, is this internal or external nasal valve collapse? (Photo)

Answers (5)

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