What does nasal valve collapse feel like?

Nasal valve collapse symptoms vary depending on the severity of the collapse and whether the internal nasal valve, external nasal valve, or both are affected. Common nasal valve collapse symptoms include:

• A persistent sensation of a blocked nose, even when there is no congestion present
• Difficulty breathing through the nose, particularly during sleep or physical activity
• Noticeable narrowing or collapse of one or both nostrils when inhaling
• The need to gently pull the cheek skin outward to allow normal airflow, which is a recognised self-test for internal collapse
• Snoring or disrupted sleep caused by reduced nasal breathing
• Fatigue related to poor sleep quality or the effort required to breathe

Symptoms worsen during deep inspiration and physical exertion because increased airflow demand places greater pressure on already weakened nasal structures. Many people living with nasal valve collapse initially attribute their symptoms to allergies or a chronic blocked nose, which means the underlying structural cause can go unidentified for some time.

How do you know if your nasal valve has collapsed?

Accurate diagnosis of a collapsed nasal valve requires assessment by a consultant ENT surgeon with experience in functional nasal conditions. A proper assessment will include both an external examination and an internal nasal examination, along with a dynamic assessment of how the nasal structures behave during breathing.

One commonly used diagnostic tool is the Cottle test, in which the cheek skin is gently pulled outward toward the ear. If this movement improves airflow noticeably, it indicates that the internal nasal valve is contributing to the nasal obstruction. A physical exam will also allow the surgeon to assess the nasal sidewall, the integrity of the cartilage and whether external valve collapse is visible on inhalation.

Proper assessment prior to any nasal surgery is equally important. Where a surgeon fails to carry out a thorough pre-operative evaluation of nasal valve function, there is a risk that the surgery itself may either cause or worsen valve collapse. This is one of the key ways in which nasal valve collapse can become a medical negligence issue.

How serious is nasal valve collapse?

Nasal valve collapse is a serious structural breathing problem that can significantly affect daily life. Persistent nasal obstruction of this kind can lead to breathing difficulties, disrupted sleep, reduced tolerance for physical activity, and in some cases broader health and wellbeing impacts associated with chronic poor sleep. It is not a cosmetic issue; it is a functional one, and it should be treated with appropriate clinical seriousness.

For people who have experienced nasal valve collapse as a result of a surgical procedure, the impact can extend beyond the physical. There is often considerable distress associated with undergoing a procedure, expecting an improvement, and being left in a worse condition than before. The psychological toll of that experience is a legitimate part of any compensation assessment.

When does nasal valve collapse occur after surgery?

Nasal valve collapse can occur after previous rhinoplasty surgeries, and it is one of the known complications associated with nasal procedures more broadly. However, there is an important distinction between a complication that arises despite appropriate surgical care and one that arises because the required standard of care was not met.

Rhinoplasty and nasal valve collapse

Rhinoplasty, also known as nose reshaping or nose job surgery, involves altering the structure of the nose, including its cartilage framework. Overly aggressive removal of cartilage during rhinoplasty can weaken the structural support of the nasal valve, leaving the nasal sidewall without the internal support it needs to remain open during inhalation. When a surgeon removes too much of the upper lateral cartilages or lower lateral cartilages without taking appropriate steps to preserve or rebuild the nasal valve, external valve collapse or internal nasal valve collapse can follow.

This risk is well recognised in surgical practice, and a surgeon operating to the expected standard of care should assess nasal valve function prior to operating, plan the procedure in a way that preserves structural support, and use surgical techniques such as cartilage grafts or spreader grafts where necessary to maintain the integrity of the nasal airway. Failure to do so may constitute a breach of duty of care.

If you have experienced breathing difficulties following rhinoplasty surgery, it is worth exploring whether the procedure met the required standard of care.

Septoplasty and nasal valve collapse

Septoplasty is a procedure carried out to correct a deviated septum, typically to improve nasal airflow. While septoplasty can be an effective and appropriate treatment for septal deviation, external nasal valve collapse is a recognised complication of septoplasty procedures, particularly where pre-operative assessment has not adequately evaluated nasal valve function.

When a surgeon proceeds with septoplasty without identifying an existing tendency toward valve collapse, or without taking steps to protect the nasal valve during the procedure, the surgery can worsen nasal obstruction rather than resolve it. The septum plays a structural role in supporting the internal nasal valve, and its alteration without proper assessment of the wider nasal airway can destabilise the nasal valve and lead to collapse.

Inadequate pre-operative evaluation is one of the most common factors in nasal valve collapse cases that arise following septoplasty. A consultant ENT surgeon carrying out this procedure has a duty to identify risk factors in advance and to plan accordingly.

What are the risk factors for post-surgical nasal valve collapse?

Understanding the risk factors for nasal valve collapse is relevant both to surgeons planning procedures and to people trying to understand why breathing problems have developed after their surgery. Risk factors include:

• Prior surgery on the nose, including previous rhinoplasty or septoplasty, which can weaken or reduce existing cartilage support
• A pre-existing deviated septum or narrow nostrils that may make the nasal valve more vulnerable to collapse
• Weak or thin lower lateral cartilages or upper lateral cartilages that offer reduced structural support
• Aggressive cartilage removal during surgery without compensatory reconstruction
• Inadequate pre-operative assessment that fails to identify the above risk factors

Where other risk factors were present and were not identified or accounted for, that failure may form part of a negligence claim.

How do they fix a collapsed nasal valve?

Treatment for nasal valve collapse depends on the severity of the condition and whether surgical correction is appropriate. Non-surgical treatments offer temporary relief for some people, while others require surgical correction to address the underlying structural problem.

Non-surgical treatments

Non-surgical treatments for nasal valve collapse include nasal dilators, which widen the internal nasal airway and improve airflow by holding the nasal valve open. Breathing strips applied to the outside of the nose provide similar temporary support by gently lifting the nasal sidewall. These approaches can provide meaningful relief for mild nasal valve collapse but do not address the underlying structural deficit. An injectable implant may also be considered in some cases as a minimally invasive option to provide structural support without open surgery.

Surgical correction

Nasal valve collapse surgery aims to rebuild the structural support of the nose and prevent collapse during inhalation. Surgical techniques used to treat valve collapse include:

• Spreader grafts or batten grafts: cartilage grafts are placed alongside or beneath the nasal sidewall to provide internal support and widen the nasal airway at the site of collapse
• Functional rhinoplasty: a surgical option specifically designed to correct nasal valve collapse, functional rhinoplasty addresses the structural causes of nasal obstruction while preserving or restoring the shape of the nose
• Septorhinoplasty: this approach addresses both internal and external nasal valve collapse alongside any underlying deviated septum or septal deviation
• Alarplasty: used to strengthen the alar base and prevent external valve collapse
• Revision rhinoplasty: where nasal valve collapse has occurred as a result of a previous rhinoplasty, revision rhinoplasty may be required to correct the damage caused by the prior surgery

For people who have experienced nasal valve collapse as a result of negligent surgical care, the cost of corrective nasal valve collapse surgery may form part of a compensation claim, alongside other financial and personal losses.

When does nasal valve collapse become a medical negligence issue?

Not every case of nasal valve collapse following surgery constitutes medical negligence. Surgery carries inherent risks, and some complications can arise even where the surgeon has acted with appropriate skill and care. The question that matters legally is whether the surgeon met the standard of care expected of a reasonably competent practitioner in their field.

A breach of duty may exist where:

• A proper assessment of nasal valve function was not carried out prior to surgery
• Known risk factors, including prior surgery or narrow nostrils, were not identified or addressed in the surgical plan
• Cartilage was removed aggressively without steps being taken to maintain or rebuild structural support
• Septoplasty was performed without appropriate evaluation of the nasal valve, leaving a pre-existing tendency toward external valve collapse undetected and unaddressed
• Informed consent was not properly obtained, meaning the risk of nasal valve collapse was not explained in advance
• Post-operative complaints about breathing difficulties were not taken seriously or investigated promptly

Where a surgeon's failure to meet these standards has resulted in nasal valve collapse, and that collapse has caused persistent nasal obstruction, breathing difficulties, or the need for further surgical correction, there may be grounds for a compensation claim.

What can compensation cover?

Where nasal valve collapse has been caused by medical negligence, a compensation claim can account for a range of losses and impacts. Every claim is assessed individually, but compensation may cover:

• The cost of revision surgery or nasal valve collapse surgery to correct the damage
• Further medical treatment and ongoing management
• Psychological support for distress, anxiety, or the broader impact of living with chronic breathing difficulties
• Loss of earnings where the condition has affected your ability to work
• Travel and treatment costs
• Pain, suffering, and loss of amenity
• Long-term care costs where applicable