The external nose (the part you can see easily on the outside) can also play an important role in nasal obstruction. The nostrils and area directly above them form what is called the nasal valve (see illustration below). This area is somewhat prone to collapse but can be particularly narrowed or easily collapsible due to a number of reasons, including congenital (at birth) factors or previous trauma or surgery. Rhinoplasty and nasal valve surgery are commonly used to treat nasal obstruction that originates at the external nose.

Rhinoplasty procedures are highly individualized, so your doctor should discuss the nature of the procedure as well as the risks and postoperative instructions.

Nasal valve surgery is often performed in conjunction with septoplasty and carries a similar set of risks and postoperative instructions. The procedure typically involves use of the septal cartilage that was removed during septoplasty, although occasionally additional cartilage is needed and taken from one of the ear cartilages. A pocket is created on each sidewall of the nose through an incision inside the nose. On each affected side, a piece of cartilage designed to support the sidewall of the nose is placed into the pocket to support an area of narrowing or collapse. The incisions are then closed with stitches. In addition to the potential for bruising and a minor risk of infection, the major risk associated with the procedure is a slightly wider appearance to the mid portion of the nose. Although the general appearance of the nose is primarily related to the nasal tip and the shadows at the tip (not affected by this procedure), there will a change in appearance. Because the cartilage graft is typically only 2-3 mm thick, this change in appearance may or may not be noticed by others. Other risks and postoperative instructions are outlined in the Septoplasty page, although your surgeon may choose to have you apply some antibiotic ointment to the incisions inside your nose as well.

Frontal view of the external nose

Frontal view of the external nose, showing bone and cartilage