How nasal valves affect rhinoplasty

How nasal valves affect rhinoplasty

The causes of respiratory trouble that are most commonly seen in rhinoplasty patients are those related to the septum and the turbinates. The air we breathe enters through two holes, known as nostrils, which are extremely important for the first phase of breathing (inspiration). In this area, there are two structures known as nasal valves that act essentially as airflow restrictors. Alterations in these valves are often the cause of respiratory difficulties and even aesthetic abnormalities that lead people to consider rhinoplasty.

Nasal valves

If we look inside the nostrils we can visualize two structures: the internal and the external valve.

    • The external valve is formed by the area bordered by the lateral arms of the alar cartilage, the internal arms of the alar cartilages (the columella), the septum, and the floor of the nasal fossae.
    • The internal valve is formed by the area bordered by the upper lateral cartilage (also known as triangular cartilage), the nasal septum, the head of the inferior turbinates, and the floor of the nasal fossae.

Both regulate the amount and direction of air that penetrates the nostrils. These valves are manipulated during most Michigan rhinoplasty procedures so it is essential to know their structure and functioning, not only to not alter them, but to improve or rebuild them if they are defective.

Causes of malfunction of the nasal valves

Primary alterations can arise due to aging, congenital malformations or abnormal development. Secondary alterations can arise from surgeries or traumatisms.

The components that form the nasal valves can have an inadequate structure leading to insufficient resistance as they have to withstand negative pressures during inhalation. They may also present an anomalous position, inadequate size, or scars that alter their functioning.

Note, having nasal deformities such as a deviated septum may affect the cost of plastic surgery. Such breathing obstructions may also increase the chances of your procedure being covered by health insurance.

Diagnosis of a malfunctioning nasal valve.

Alterations of the functioning of the nasal valves are diagnosed by means of exploration and by means of dynamic tests that will be performed by your rhinoplasty michigan surgeon.


  • In primary cases, in which there is no history of surgery or trauma, an examination should be made to evaluate the size, position, and stability of the nasal valves.
  • In secondary cases, in which there have been rhinoplasties and/or previous trauma the doctor will also evaluate if there are retractions or scars that limit or hinder the functioning of the nasal valves.
  • Externally, the nose may present a characteristic configuration consisting of the presence of depressions in the walls of the nasal wings and lengthening of the nostrils. 

Dynamic tests

  • A simple maneuver such as a strong inhalation, keeping one of the two nostrils plugged, will give your Michigan plastic surgeon a general idea of whether these mechanisms are working properly. By strongly inhaling the affected valve, it collapses due to the excessive negative pressure. When the inhalation is complete and the nostrils are uncovered, the affected valve returns to its position.
  • Some patients also report relief of symptoms when they push against their cheek on the affected side or when they use nasal bands.


Primary rhinoplasty with normal valves: In this case, the changes made in the cartilage should preserve the function and structure of the valves. Normally it enough to remold the cartilage, being conservative in reducing their size.

Primary rhinoplasty with defective valves: In these cases, the alar cartilages are usually short and/or poorly placed. The treatment is usually aimed at:

  • Reinforcing them, folding them or placing hidden grafts that provide the appropriate support.
  • Relocating them in the proper position without the need for grafts.
  • Reinforcing and relocating them simultaneously.

Secondary rhinoplasty with defective valves: In these cases, there may also be scarring or excessive fibrosis that cause stiffness and obstruct the flow of air. In addition to the above maneuvers, the removal of scar tissue can return flexibility and functionality to the valves.

In these cases, the use of grafts is common since the size of the residual cartilages or their position is usually defective. In any of the mentioned cases, the mucosa that covers the interior of these valves must be preserved or, in secondary cases, freed from the scars and fibrosis that are distorting them.

To think that the nose allows us to breathe normally may be a no-brainer but it must be taken into account when performing Rhinoplasty in Michigan. Fortunately, rhinoplasty, as a surgical technique, has evolved enormously in the last two decades, allowing effective control of factors that influence the improvement of both aesthetic and functional results.

Final words

If you are looking for an extremely experienced and professional rhinoplasty surgeon or you are on the hunt for the best plastic surgery in Michigan, request a consultation and a top rhinoplasty surgeon will reach out to you shortly. 

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About Author: Luke Yaldo

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I founded SurgeonGate to help patients learn about cosmetic medicine and reach the most experienced and specialized surgeons in the state of Michigan. I hope that by reading our content, you can become a more confident patient and make informed decisions about your body. Thank you for working with us!