Hi Doctor. Can you tell me what procedure a doctor might consider with upper valve damage and sunken lateral cartilage due to impact ? Can the lateral walls be realigned if they're still intact but moved from their original position and sunken in ?
The upper walls of your nose are usually made out of bone and can be realigned by making cuts in the bones(osteotomies). The middle portion of the nose may need spreader grafts to help support internal nasal valve. In addition we also use lateral (alar batan) grafts to give additional support to the nasal valve. Hope that helps.
@@josephshvidlermd-seattle Thanks for the info Doc. I recently visited one of the top ent's in Ireland that does alot of nose work. He wouldn't work on it, said it'd be a complicated job and could end up looking bony.. which sucks. Maybe at some point in the future ill get a second opinion, possible outside of Ireland. Cheers Doc.
I had a botched surgery 2 years ago : external and internal valve collapse. I had a revision 5 months ago. Surgeon did an amazing aesthetic job. He put alar strut graft and extended spreader graft but I still have problem with the internal valve 😔. What Can he do more ? Allar batten ?
It depends on the placement of the grafts, and placing more grafts may not be the answer. Alar strut grafts are placed under the native lower lateral cartilages. While they are a very powerful graft, sometimes the graft can prolapse internally and narrow the internal nasal valve. In some situations you can go back and shave and thin out the graft from the inside. In other situations, the graft is not long enough and may need to be replaced with a stronger or longer graft. I would encourage you to follow up with your surgeon and have them examine your nose to determine exact etiology.
Sometimes but not always, run grafts can serve a cosmetic purpose but also can support external nasal valve, sometimes a stronger graft is required to help support the nasal valve.
Hi doctor that my problem I am 18 months after a rhinoplasty in turkey i can’t breathe well it’s traumatizing me iam in paris I went to the ent he said what tou said I needed I blame the fucking surgeon in turkey I was breathing well before the operation he did even want to give me a receipt for my 25OO euros I feel terrified now I have to focus on solution I am waiting for a consultation with a ent plastic surgeon to do the grafts
Hi Doctor. Can you tell me what procedure a doctor might consider with upper valve damage and sunken lateral cartilage due to impact ? Can the lateral walls be realigned if they're still intact but moved from their original position and sunken in ?
The upper walls of your nose are usually made out of bone and can be realigned by making cuts in the bones(osteotomies). The middle portion of the nose may need spreader grafts to help support internal nasal valve. In addition we also use lateral (alar batan) grafts to give additional support to the nasal valve. Hope that helps.
@@josephshvidlermd-seattle Thanks for the info Doc. I recently visited one of the top ent's in Ireland that does alot of nose work. He wouldn't work on it, said it'd be a complicated job and could end up looking bony.. which sucks. Maybe at some point in the future ill get a second opinion, possible outside of Ireland. Cheers Doc.
I had a botched surgery 2 years ago : external and internal valve collapse. I had a revision 5 months ago. Surgeon did an amazing aesthetic job. He put alar strut graft and extended spreader graft but I still have problem with the internal valve 😔. What Can he do more ? Allar batten ?
It depends on the placement of the grafts, and placing more grafts may not be the answer. Alar strut grafts are placed under the native lower lateral cartilages. While they are a very powerful graft, sometimes the graft can prolapse internally and narrow the internal nasal valve. In some situations you can go back and shave and thin out the graft from the inside. In other situations, the graft is not long enough and may need to be replaced with a stronger or longer graft. I would encourage you to follow up with your surgeon and have them examine your nose to determine exact etiology.
Did you manage to fix the issue? I have exactly to the same issue
Do you use ear or rib cartilage doc?
Thinking rib, it is stronger. Small incision
How much for septoplasty + valve repair
Are rim grafts sufficient to prevent External nasal valve collapse?
Sometimes but not always, run grafts can serve a cosmetic purpose but also can support external nasal valve, sometimes a stronger graft is required to help support the nasal valve.
@@josephshvidlermd-seattle Cool. Thanks. Do you offer video consults?
Hi doctor that my problem I am 18 months after a rhinoplasty in turkey i can’t breathe well it’s traumatizing me iam in paris I went to the ent he said what tou said I needed I blame the fucking surgeon in turkey I was breathing well before the operation he did even want to give me a receipt for my 25OO euros I feel terrified now I have to focus on solution I am waiting for a consultation with a ent plastic surgeon to do the grafts
Did you fix it Natalie