Nose Collapse After Rhinoplasty: Causes and Prevention

Rhinoplasty is a popular procedure of choice to correct structural defects, improve breathing or achieve the desired aesthetic result. However, a potential complication that can occur after this surgery is nasal collapse. Although this condition is rare, it can have significant functional and aesthetic consequences for patients.

Nasal collapse often manifests as a deformity where the nasal bridge or sidewalls give way, leading to a sunken appearance and possibly compromising nasal function. It is typically the result of weakened cartilage or incorrect surgical technique, where the support structures of the nose are damaged or overly reduced. Patients need to be aware of the possibility of this complication and the importance of choosing an experienced surgeon to minimize the risk.

In the event of nasal collapse following rhinoplasty, corrective measures may be necessary to restore both the nose’s form and function. Treatment can involve revision surgery, where grafts are used to rebuild the nasal framework and provide adequate support to the affected areas. Understanding the causes, risks, and treatment options for nasal collapse is crucial for anyone considering or having undergone a rhinoplasty procedure.

Risks and Complications of Rhinoplasty

Rhinoplasty, while a common plastic surgery, carries potential risks and complications that patients should be aware of before undergoing the procedure. Meticulous surgical planning and technique are vital to minimize these postoperative concerns.

Potential Risks of Nasal Surgery

Nasal surgery can present several risks, such as bleeding, infection, or adverse reactions to anesthesia. Other concerns include:

  • Complications related to the reshaping of the nose, potentially leading to asymmetry or the need for revision surgery.
  • Difficulty in breathing (nasal obstruction), which may persist or arise post-surgery.
  • Possibility of skin discoloration, particularly around the tip of the nose and nostrils, often linked to blood vessel damage.

Understanding Nasal Valve Collapse

A nasal valve collapse is a significant complication that may occur if too much cartilage is removed, weakening the nasal structure. This can result in:

  • A feeling of nasal obstruction and difficulty breathing through the nose.
  • The necessity for cartilage grafting to rebuild the nasal structure and restore function.

Recognizing Infection Symptoms

Postoperative infection is a potential risk of any surgery, including rhinoplasty. Symptoms to look out for include:

  • Unusual redness or swelling that persists or worsens over time.
  • Fever or an increase in pain, which could indicate an underlying infection that might require antibiotic treatment.

Anatomy of the Nose

The anatomy of the nose is intricate and plays a critical role in both appearance and respiratory function. Understanding its structure is essential in grasping how rhinoplasty can affect nasal integrity and airflow.

Nasal Structure and Airflow

The nasal cavity is the internal chamber where airflow occurs as one breathes. It’s divided by the septum, a barrier separating the two nostrils. On the sidewalls of the nasal cavity, there are three pairs of nasal conchae or turbinates, which help to warm, humidify, and filter the air before it reaches the lungs.

The internal nasal valve is the narrowest part of the nasal airway and is critical for proper breathing. It consists of the septum, the upper lateral cartilages, and the floor of the nose. The angle of the internal nasal valve is typically between 10 to 15 degrees, which allows for optimal airflow resistance.

Internal and External Nasal Valves

The external nasal valve includes the nostrils and the soft tissues of the nasal ala, which are the outer walls of the nostrils. This area is less rigid and can be influenced by both congenital factors and traumatic events, such as surgery. Proper function of these valves is crucial as they regulate the airflow entering the nasal passages.

Both valves can be compromised after a procedure like rhinoplasty. A collapse of the nasal valve can occur, impairing airflow and causing difficulty with breathing. This collapse is often due to alterations in the structural support of the nasal cavity during surgery, which then impairs the normal function and structure of both the internal and external nasal valves.

nose collapse

What Does a Collapsed Nose Mean?

A collapsed nose, often occurring after rhinoplasty surgery, refers to a condition where the nasal structure is compromised leading to an indentation or depression on the nose. Commonly characterized by a sunken appearance, the collapse is frequently associated with a condition known as Saddle Nose Deformity, where the nasal bridge has a noticeable inward curve.

Key Characteristics of a Collapsed Nose:

  • The external appearance may show a scooped out look, particularly along the nasal bridge.
  • Functionally, there can be an obstruction in the nasal passages, leading to difficulty in breathing.
  • A collapse may negatively influence both aesthetic outcomes and respiratory function.

It is important to distinguish between the types of collapse:

  • Internal Nasal Valve Collapse: Affects the sidewalls of the nose, creating obstruction and difficulty breathing.
  • External Nasal Valve Collapse: Involves the outer part of the nose, which can lead to a pinched look and may worsen with inspiration.

Contributing Factors:

  • Over-resection of cartilage during the initial rhinoplasty.
  • Weakening of the nasal framework.
  • Trauma to the nose post-surgery.

Patients experiencing these symptoms should consult with a specialist. In some cases, a corrective procedure called revision rhinoplasty could be considered to reinforce the nasal structure and improve the nasal appearance.

Nose Collapse After Rhinoplasty

Nose collapse, also known as saddle nose, is a condition that can occur following rhinoplasty. It involves the depression of the nasal bridge, leading to both cosmetic and functional issues.

Causes of Nasal Collapse

The integrity of the nasal structure depends on its cartilage and bones. A nasal collapse may occur if the cartilage or bony structures are compromised during or after the surgery. The removal of excess tissue or an inadvertent impact can lead to a weakened nasal framework. Inflammation and improper healing processes may exacerbate the situation, further contributing to the collapse.

Diagnosing Nasal Valve Collapse

The diagnosis of nasal valve collapse is essential for formulating an appropriate treatment plan. It begins with a physical examination and patient history. Medical imaging or endoscopic evaluations provide a detailed view of the internal nasal structure. If they identify a deviation or collapse of the nasal bridge, it confirms the presence of nasal valve collapse.

Treatment and Correction

When addressing nasal collapse after rhinoplasty, patients typically have a choice between surgical and non-surgical options to correct the structure and improve airway function. The chosen treatment hinges on the severity of the collapse and the underlying causes.

Surgical and Non-Surgical Options

Non-Surgical Treatments: These may include the use of a nasal valve dilator, a device designed to help keep the nasal valve open, thus improving airflow. They provide temporary support and can alleviate symptoms, especially during sleep or exercise.

Surgical Treatments: Surgical intervention is often required for permanent correction of nasal collapse. An otolaryngologist or a facial plastic surgeon will assess the patient’s condition and may recommend surgery to restore both form and function of the nose, ensuring long-term support and improved airway.

Cartilage Grafting Techniques

Autologous Cartilage Grafting: This technique involves harvesting the patient’s own cartilage, usually from the septum, ear, or ribs, to reinforce the nasal structure. It is considered the standard for reconstruction, providing stability and longevity to the nasal framework.

Alloplastic Grafts: In cases where sufficient autologous cartilage is unavailable, synthetic materials may be used. However, these come with an increased risk of infection and extrusion, and thus, they are generally considered less favorable compared to autologous grafting.

Preventing Complications

When considering rhinoplasty, minimizing post-surgical complications such as infection, swelling, pain, or even nose collapse is essential. A stringent focus on selecting an expert plastic surgeon and adhering to thoughtful preoperative considerations can greatly reduce the risks associated with the procedure.

Choosing the Right Surgeon

Selecting an experienced plastic surgeon with a specialized background in facial surgery is critical. Patients should seek a surgeon who is board-certified and has a portfolio of successful procedures. During the initial consultation, clear communication about the patient’s goals and concerns allows the surgeon to tailor the approach to individual needs, thus enhancing the outcome and reducing the possibility of complications.