Can a collapsed nasal valve corrective surgery also be included within a cosmetic Rhinoplasty?

Both aesthetic and reconstructive rhinoplasty can occur at the same time. In fact this is very common. Lateral wall reconstruction isn't as commonly combined as septoplasty with cosmetic rhinoplasty, but is needed at times. Reconstructive surgery means creating normal function and appearance starting from an abnormality or deformity, while aesthetics surgery means starting from average or normal and improving it. They are two ends of a spectrum. 

Absolutely, nasal valve surgery can be (and often should be) included in cosmetic rhinoplasty. In fact, aesthetics and functionality of the nose go hand in hand and I frequently perform nasal valve surgery in cosmetic rhinoplasty to improve nasal breathing while improving the nose aesthetically. Just because the indication of a rhinoplasty might be cosmetic does not and should not mean that the nasal valve area can be ignored. In fact, reductive rhinoplasty techniques with overly aggressive cephalic trimming can lead to supra-alar pinching with subsequent nasal obstruction over time. It is hence important to anticipate healing over the long-term and stabilize the nasal valve area in select patients, even if the surgery was 100% cosmetic. With regards to the cost, repair of nasal vestibular stenosis is usually covered by most insurance plans if the patient has documented nasal obstruction, the nasal obstruction does not improve with medications such as nasal steroids, and the nasal obstruction improves with the so-called "Cottle maneuver" where the cheeks are pulled sideways next to the nasal valve area or the inside of the nostrils are supported with Q-tips during inspiration. If these criteria are not met, nasal valve surgery (repair of nasal vestibular stenosis) is typically not covered. 

Nasal valve repair can be done simultaneously with a rhinoplasty. The valve repair however can make the valve area look swollen and you need to be aware of that. RegardsDr. J

There are many surgeons that will regularly perform this repair if needed during a cosmetic rhinoplasty.  Sometimes all that is involved for internal valve collapse is rotating cartilage in the area and placing some sutures.  Other times grafts may be needed to widen the valve area.  If it is an external valve collapse then supporting grafts along the nostril can be used to support the rim.  Consult a physician who regularly performs rhinoplasty surgery who can discuss the details further with you in person. 

Yes we commonly fix both functional and aesthetic nasal issues at the same time. Sometimes however opening the nasal valve may make the nose appear wider which may not be part of the aesthetic goals. It's important to discuss these issues with an experienced rhinoplasty surgeon. Cost is variable in Toronto may vary from $5000-$14000 for rhinoplasty. 

In general, reconstructive procedures may be done concurrently with cosmetic ones.  Patients commonly will have an approval for a reconstructive surgery and then pay for the additional OR, anesthesia, and surgical time required for the cosmetic portion of the surgery.  That makes it a good deal for both surgeon and patient.  With an open approach rhinoplasty, spreader grafts for nasal valve collapse are easier to place.  Cartilage may be harvested from the septum which basically is a septoplasty.  These reconstructive maneuvers may result in a straighter nose, an aesthetic benefit.

Quite often a cosmetic rhinoplasty requires some functional treatment as well. I commonly repair nasal valve issues at the same time.

 There are many different treatments for collapsed nasal  valve, depending upon whether it's an internal  or external collapse.   The treatment also depends upon whether or not the valve collapse is static or dynamic. Treatment usually involves structural cartilage grafting  such as a spreader graft, an alar batten graft, or an alar rim graft. All  types of functional surgery can be performed at the same time as cosmetic nasal surgery. For many examples and more information and our  price list, please see  the link and the video below

Dear
astevens25,

When
performing a cosmetic rhinoplasty procedure, the aesthetic balance both of the
bridge and the tip in relation to the rest of the facial structure needs to be
taken into account and addressed expertly and in a very aesthetically pleasing
fashion. Equally important is the
functional aspects of the nose, specifically breathing and airway exchange.
Having trained in both plastic surgery and ear/nose/throat-head/neck oncology,
I have been performing cosmetic rhinoplasty for over 20 years. When performing cosmetic rhinoplasty, a
surgical procedure on the airway – a septoplasty – and any support required by
the internal/external valves is included.
These procedures are functional and are covered by the Ontario Health
Insurance Plan and therefore I don’t charge for these and they are included as
part of the cosmetic rhinoplasty.

I
have found over the last 20 years that performing computer imaging with my
rhinoplasty patients allows them a good chance to see the kind of outcomes that
can be achieved and reassures them that the overall aesthetic outcome in
nasal-facial balance and proportion will be very pleasing. The functional aspects of your airway,
septum, any turbinate surgery, internal/external valve support would be
addressed at the same time and included in the cost. I believe most rhinoplasty surgeons would
have the same view and same approach.

Seek
the advice of two or three rhinoplasty surgeons with significant medical
experience and you will find one, I think, that you will feel comfortable with
and you will get an excellent result.

For
more information, please review the link below.

Best
of luck.

Sincerely,

R.
Stephen Mulholland, M.D.

Certified
Plastic Surgeon

Yorkville,
Toronto