Nasal Valve Collapse – The Hidden Cause of a Blocked Nose

mrtimbiggs4
Nov 16
2 min read

Many patients come to clinic saying they’ve “tried every spray” but still can’t breathe properly through their nose. When medical treatment doesn’t work, the cause is often structural, not allergic. One of the most common, and least recognised, structural problems is nasal valve collapse.

At Adnova Clinic in Fareham, near Portsmouth and Winchester, I see many patients whose breathing problems are due to narrowing or weakness of the nasal valves. Fortunately, this can be effectively treated with functional rhinoplasty or functional septorhinoplasty.

What Is the Nasal Valve?

The nasal valve is the narrowest part of the nasal airway, located just inside the nostrils, where the lower cartilage meets the septum and sidewall. It acts like a pressure gate, controlling airflow into the nose.

When the valve area is narrow, weak, or collapses inward as you breathe, airflow becomes restricted, even if the rest of the nasal passage is normal.

Symptoms of Nasal Valve Collapse

Patients with nasal valve collapse often describe:

A feeling of nasal blockage, especially when inhaling deeply
The nose “collapsing inwards” when breathing, which can often be seen from the outside, blocking the nostril
Better airflow when pulling the cheek sideways (the “Cottle manoeuvre”)
Difficulty exercising or sleeping due to restricted airflow
Minimal improvement with sprays or allergy treatment

If these sound familiar, nasal valve collapse may be the underlying cause.

Why Does It Happen?

Nasal valve collapse can occur for several reasons:

Natural weakness in the sidewall cartilage
Over-resection during previous nasal surgery
Trauma or injury
Age-related tissue softening
Post-septoplasty or post-rhinoplasty loss of support

When valve support is lost, airflow becomes turbulent and restricted, often worse on deep inhalation.

How We Fix It – Functional Rhinoplasty

At Adnova Clinic, I repair nasal valve collapse using a functional rhinoplasty approach. This involves strengthening or widening the valve area with cartilage grafts, straightening the septum, and restoring the external framework to maintain both function and appearance.

I use Piezo ultrasonic instrumentation for precision bone work and a dorsal preservation philosophy to minimise trauma and maintain a natural profile.

Patients can breathe through the nose straight away after surgery, there is no nasal packing, and recovery is typically comfortable.

When to Seek Help

If your nose feels constantly blocked, especially during exercise, and medical treatments haven’t helped, you may have structural valve collapse rather than allergy or inflammation. An experienced ENT and rhinology surgeon can diagnose this easily with a nasal examination and airflow assessment.

If patients find benefit from breathe right strips, which pull open the internal nasal valve area, then you are likely to benefit from functional rhinoplasty.

Summary

Nasal valve collapse is a hidden but common cause of persistent nasal obstruction. With modern functional rhinoplasty and septorhinoplasty, both the internal support and external shape of the nose can be restored — improving breathing and confidence.

Consultations are available with Mr Tim Biggs, Consultant ENT & Rhinology Surgeon, at Adnova Clinic, Fareham, serving patients from Portsmouth, Hampshire, and the south coast.