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27 years
Hi.i have a problem sleeping on my left side or even tilting my head to the nose becomes obstructed and i cnt breathe.its been a while now.did rhinoplasty 8 yrs ago.thx
Aug 19, 2014

Dr. Zakia Dimassi Pediatrics
Postrhinoplasty (after rhinoplasty) nasal obstruction can be caused by a number of factors, but is primarily the result of the interplay between 2 factors:
- Unidentified preexisting nasal conditions (eg, deviated nasal septum, turbinate ( a long, narrow and curled bone shelf (shaped like an elongated sea-shell) that protrudes into the breathing passage of the nose) hypertrophy, mucosal disease) and
- Cutting too much cartilage with subsequent reduction in the nasal valve area (the soft oart maded up of cartilage) after rhinoplasty.
1. The nasal valve is responsible for regulating the flow or air through the nares (nostrils). Disturbance of the nasal valve area can impair normal nasal breathing.
Nasal valve inappropriate function (dysfunction) can be internal, which results from:
-static dysfunction, i.e. secondary to continuous obstruction at the level of the nasal valve because of things like a deviated septum, inferior turbinate enlargement (you could see this if you shine a light into your nose: you would observe a bulge pushing against the septum), or the upper portion of the cartilage pushed down and towards the septum.
-Dynamic dysfucntion, it varies in severity with respiration and is usually due to poor support by the structures that supposedly hold the valves up on the sides of the nose, including the cartilage and muscular components.
2. External nasal valve collapse is another important cause of nasal blockage. It involves collapse of the margins of the nares at the opening of the nose. This phenomenon is especially common in patients with narrow slit-like nares, a projecting nasal tip, and nare sidewalls.

If there is an underlying medical condition such as allergic rhinitis, infectious rhinitis, vasomotor rhinitis (you get a runny nose and obstruction upon exposure to heat or cold), and rhinitis medicamentosa (you abuse nasal sprays like Otrivin and you cannot have patent nasal passage without them), you should seek treatment for those.
Once these have been adequately treated, structural defects of the internal and external nasal valves can be considered for surgical repair. The possible sites and types of abnormalities include the septum, upper and lower lateral cartilage, floor of the nose, head of the inferior turbinate, or a combination of these. Postrhinoplasty valve narrowing is best managed by directly dealing with the cause of the pathology. In most instances, te recover full nasal valve function, reconstruction of the nasal valve with an implant is needed.