The Different Types of Nasal Valve Collapse Surgery: Which One is Right for You

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The Different Types of Nasal Valve Collapse Surgery: Which One is Right for You

The Different Types of Nasal Valve Collapse Surgery: Which One is Right for You

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The nasal valves are the narrow most part of the nasal airway and play a key role in ensuring that your breathing is normal and regular. It regulates the nasal airway and nasal resistance (70% of total respiratory resistance). Even a small issue in the nasal valve can compromise normal breathing during physical efforts and even during sleep. The nasal valve is delicate and mostly made of cartilage and since its natural structure is very narrow, a defect can cause the airflow to become restricted and even blocked at times. There are many techniques that can be used to correct the nasal valve blockage and collapse and top doctors for rhinoplasty counsel a patient about which technique is most suitable.

When there is a refers to a structural abnormality or dysfunction of the nasal valve it is called nasal valve collapse. The nasal passage becomes narrowed or obstructed, leading to various symptoms and potential dangers.

There are two main components to the nasal valve, the internal and external nasal valves. The internal valve is made of the septum, lateral nasal wall, and nasal floor, while the external valve is created by the nostrils and the surrounding soft tissues. Any compromise in the structure or function of these components can result in nasal valve collapse. The dangers associated with nasal valve collapse are primarily related to the obstruction of airflow and subsequent respiratory difficulties. Individuals with nasal valve collapse often experience

  • Chronic nasal congestion
  • Difficult in breathing through the nose
  • Sensation of restricted airflow

And can cause

  • Mouth breathing
  • Snoring
  • Sleep apnea
  • Sleep-related disorders
  • Sleep disturbances

It affects the quality of life of the patient and they often have to deal with reduced physical performance, decreased exercise tolerance, and fatigue due to the increased effort required to breathe adequately. The persistent nasal congestion can also affect their ability to taste and smell properly, leading to a decreased appetite and enjoyment of food. Nasal valve collapse also affects mental wellbeing causing frustration, irritability, and difficulty concentrating, which may affect work or school performance. Sleep disturbances and associated daytime fatigue can also contribute to mood disorders such as depression or anxiety in men and women.

Nasal valve collapse can also cause the asthma to worse and trigger more asthma attacks. If the patient has an issue of chronic sinusitis or nasal polyps then nasal valve compromise can aggravate the condition and lead to increased sinus infections and inflammation.

What causes nasal valve collapse?

There can be many reasons for nasal valve deformity including

  • Birth defect in which the children are born with flawed nasal valves.
  • Ageing and gravity in adults
  • Previous nasal surgery in which excess cartilage is removed
  • Fracture or trauma to the nose
  • Congenital weakness

This collapse can happen on both sides of the nose and can cause partial or complete restriction of the airflow leading to problems. The temporary solution for improving the breathing flow include nasal sprays, allergy medications, steroids and the use of nasal strips to improve air intake. But these are not permanent solutions and don’t often work well.  They can also increase the complications and side effects.

Nasal valve repair treatment

Many people suffering from chronic headaches, congestion, sinus pressure, snoring, sleep apnea etc. often don’t realize that it can be because of an issue with the health of the nasal valve. Nasal valve repair can be a crucial solution for individuals who experience these symptoms. Often, these issues stem from a weakness in the nasal valves, which can significantly impact one’s quality of life. Many individuals resort to using over-the-counter remedies like Breath-Right Strips or nasal stents in an attempt to alleviate their breathing difficulties caused by this condition but they don’t often work so well in improving the airflow.

Types of nasal valve collapse

Internal and external valve collapse are the most common types of nasal wall repair.

Internal wall collapse, also known as internal nasal valve collapse, occurs when the internal components of the nasal valve, such as the septum, lateral nasal wall, and nasal floor, become weak or collapse inward. This leads to a narrowing of the nasal airway, obstructing the flow of air through the nose. Individuals with internal wall collapse may experience symptoms such as chronic nasal congestion, difficulty breathing through the nose, and a sensation of restricted airflow.

External wall collapse, also known as external nasal valve collapse, refers to the collapse or weakening of the external components of the nasal valve. The external nasal valve is formed by the nostrils and the surrounding soft tissues. When these structures lose their support or become lax, the nasal airway can narrow, resulting in symptoms similar to internal wall collapses, such as nasal congestion and difficulty breathing.

Nasal valve repair surgery is the solution to treat both external and internal valve repair. Nasal valve collapse surgery before and after aims to widen the nasal airway and restore the airflow thus improving the shape of the nose and helping the patient breathe better. Nasal valve collapse surgery strengthens and supports the weakened nasal valve structures, widens the nasal airway, and restores normal airflow.

Symptoms of nasal valve collapse

The surgeon will recommend having a nasal valve collapse rhinoplasty if

  • The patient is having difficulty breathing through the nose
  • The patient has nasal congestion
  • There is an obstruction in the nasal passage
  • There is nasal bleeding
  • There is crusting around the nostrils
  • The patient snores a lot

Nasal valve surgery

This is a surgical procedure that aims to strengthen the cartilage of the nose and fleshy sides of the nostril. This type of rhinoplasty can be done via both open and closed rhinoplasty procedures.

The surgeon will place the crafted cartilage between the midline septum and upper lateral cartilage away from the septum to increase the area in the internal valves. Even an improvement of just 1 mm can make a lot of difference. There are different surgical techniques used for nasal valve repair, and the specific approach depends on the underlying cause and severity of the nasal valve collapse. Here are some commonly employed surgical procedures:

  • Nasal Valve Reconstruction: This procedure involves strengthening and supporting the nasal valve using various techniques. Cartilage grafts may be harvested from the ribs, ear or the patient’s own septum or harvested from an organ donor and used to reinforce the weakened nasal valve structures, thereby widening the nasal airway.
  • Spreader Grafts: Spreader grafts are small pieces of cartilage inserted between the upper lateral cartilage and the septum. These grafts help to stabilize and open the nasal valve, preventing its collapse during inspiration.
  • Alar Batten Grafts: Alar batten grafts are used to address the collapse or narrowing of the external nasal valve. They are inserted into the lateral wall of the nose to provide support and improve the patency of the nasal airway.
  • Turbinate Reduction: Enlarged turbinates, structures located inside the nasal passages, can contribute to nasal congestion and airflow obstruction. Turbinate reduction procedures, such as turbinate cautery or turbinate reduction surgery, may be performed in conjunction with nasal valve repair to further optimize breathing.


When the nasal valve collapse is caused because of weak or lax nasal tissues, the plastic surgeon might recommend the use of radiofrequency energy to tighten and stiffen the tissues to improve nasal airflow.

Nasal valve repair surgery is typically performed under local or general anaesthesia, depending on the complexity of the procedure. Recovery time varies, but most individuals can expect some swelling, congestion, and discomfort for a few weeks following surgery. Nasal packing or splints may be placed temporarily to support the nasal structures during the healing process.

Other treatment procedures to fix the valves include

  • a tip plasty to correct the droopy nose tip which opens up the external and internal valves
  • deviated septum rhinoplasty to increase the airflow thus improving nasal valve function

The type of surgery that will work for you will largely depend on your skin’s anatomy, the criticality of the collapse and the patient’s age. It is quite often combined with septoplasty to

Before the nasal valve surgical repair procedure

The surgeon will evaluate your skin and the condition of the nose to make a specifically tailor-made custom care plan to suit the patient’s exact needs. The plastic surgeon will also guide you through the procedure and all the necessary information to make sure you know what changes nasal valve collapse surgery before and after will bring to your nose and face.

Recovery post nasal valve repair surgery

The recovery post nasal valve repair is quite simple. Once the effect of the anaesthesia wears off, the patient can go home and let the normal recovery take its course. There is very low risk of infection and bleeding.

Some patients who have some underlying medical conditions might see some scarring but that is also very rare. There will be some pain and numbness and change in sensation in the nose for the healing period. During the recovery period

  • make sure you don’t miss the post-surgery appointments
  • follow the aftercare appointments
  • call your doctor if you notice much bleeding and crusting
  • don’t blow your nose
  • avoid contact sports and strenuous work
  • don’t take unprescribed medications

Nasal valve surgery

The cost of nasal valve surgery can vary depending on various factors such as the geographical location, the specific surgical technique used, the complexity of the case, the surgeon’s experience, and the facility where the procedure is performed. Additionally, the cost may also include fees for anaesthesia, pre-operative tests, post-operative care, and any necessary follow-up appointments.

It is important to note that health insurance coverage may vary, and some insurance plans may cover a portion of the cost of nasal valve surgery if it is deemed medically necessary. It is recommended to contact your insurance provider and discuss the specific details of your plan to understand the coverage and any potential out-of-pocket expenses.

Additionally, it is advisable to consult with a qualified specialist who can evaluate your condition, provide a proper diagnosis, and discuss the potential treatment options and associated costs. They will be able to provide you with a more accurate estimate based on your specific case.

It is crucial to consider not only the cost but also the expertise and reputation of the surgeon and the quality of care provided when making a decision about nasal valve surgery.

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About Dr. Debraj Shome

Dr. Debraj Shome- Facial Plastic Surgeon in Mumbai, India

Dr. Debraj Shome – Founder, The Esthetic Clinics, is a top facial plastic surgeon. Dr. Shome is currently a Consultant at the best Mumbai hospitals like Saifee Hospital, Breach Candy Hospital, Nanavati Hospital & Apollo Spectra Hospital in Mumbai, India. He has 40+ research papers in the best international journals, numerous presentations at conferences & many awards such as “Best Plastic Surgeon in Mumbai”, “Best Plastic Surgeon in India”, Best Cosmetic Surgeon in India”, “Best Cosmetic Surgeon in Mumbai”, “Breakthrough Innovator in Facial Plastic Surgery” etc. A celebrity plastic surgeon, Dr. Shome believes plastic, reconstructive & cosmetic face surgery can allow you to lead a more fulfilled life….Read more

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