Do I have nasal valve collapse? (Photos)

Question

I had a rhinoplasty 4 years ago and a year later after surgery i became severly congested my side walls and nasal bones seem like they have collapsed inward i have to sleep with nasal dilators if not i cant sleep .i feel like airflow is not flowing freely up the nose including the upper nasal passages.

Gianfranco Frojo, MD · Answer

Can you please provide more photos of the nose including prior to surgery if possible? It is challenging to assess any situation with a single zoomed in photo.

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question.

Although an exam in person is ideal, from your story alone it appears that you have internal nasal valve collapse which may be due to either a deviated septum or collapse of your "side cartilages".   In such an instance you can likely benefit from a septoplasty where the deviated septum is revised, excised, and re-set as necessary.  Moreover, any further breathing difficulty can also be improved with spreader grafting -- most PPO health insurance plans can cover all this at minimal cost to you☝️

If you have any cosmetic concerns, the cost of a revision rhinoplasty may also be reduced if your PPO health plan will cover your nasal breathing difficulty.

The next step for you is to pursue the right plastic surgeon for your septoplasty, with or without a rhinoplasty.  In your consultation, be sure your surgeon addresses all your functional (and aesthetic) goals and concerns specifically, IN PERSON, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course.  I also think a key component of your consultation is to establish a good connection with your plastic surgeon.  This is difficulty to do without seeing your surgeon in the office, in person.  It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on septoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Eric M. Joseph, MD · Answer

When patients have collapse of their nasal side walls after rhinoplasty surgery, we typically repair these with lateral crural extension grafts. These are small pieces of cartilage that are implanted into the nasal tip to add structural support, and to open the nasal passage, and to prevent the nostrils from collapsing in with breathing. If somebody has adequate nasal septal cartilage remaining, that would be our number one choice for procuring these grafts. If the cartilage is not available in somebody's nasal septum, we purchase it from a tissue bank, and we have had an excellent experience with MTF profile sheets. I wish you well moving forward. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It is difficult to fully evaluate your internal valve from this picture alone. If you do have a collapsed internal  nasal valve, placement of spreader grafts can help this.   One thing I would definitely recommend is not wearing nostril retainers. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Do I have nasal valve collapse? (Photos)

Answers (4)

Answer: Breathing evaluation

Answer: Breathing evaluation

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Do I have nasal valve collapse? (Photos)

Answers (4)

Answer: Breathing evaluation

Answer: Breathing evaluation

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.