Allergies. Colds. Sinus infections. These are several reasons why you may have difficulty breathing at night.  They can be caused by something in the environment—like pollen---to a problem with the structure of the nose—such as a deviated septum. Structural problems often require nose plastic surgery to correct. 

However, another common cause is nasal valve collapse. There are multiple ways it can develop, but its main symptoms are nasal obstruction, congestion and difficulty breathing through the nose. It can be treated with nose plastic surgery, but in many cases, non-surgical help is all that is needed.

What causes nasal valve collapse?

The most common causes are:

  • Trauma to the nose
  • Inflammation
  • Aging
  • Scar tissue
  • Weak nasal cartilage
  • Enlarged tissue
  • Complications following nose plastic surgery. 

In some cases, nasal valve collapse may be hereditary. It is much more common in those who have narrow nostrils or an over-projecting nose, according to information from Brigham and Women’s Hospital

Where is the nasal valve located?

It’s located at the narrow tip of your nose. The nasal valve is a very complex structure that consists of several parts. It’s made up of the septum and cartilages. Because the area is small, even the most minor issues can cause significant blockage and difficulty breathing. 

What are the symptoms of nasal valve collapse?

The symptoms of nasal valve collapse are the same as those seen in many other conditions, such as chronic sinusitis or the common cold. These symptoms include congestion, nasal obstruction and difficulty breathing through the nose. 

How can I determine if I have nasal valve collapse?

Actually, you can make a fairly accurate assessment. If you breathe better by using nasal strips (such as Breathe Right), or you notice improvement when you pull your cheek skin toward your ear, then it’s very possible that you have nasal valve collapse.  

If you notice any of the above, contact one of our expert ENTs who can confirm a diagnosis. Sometimes, an accurate assessment may be needed through a nasal endoscopy

This procedure allows us to more closely examine your nasal passages. It will also help us determine if there is another cause for your chronic congestion, such as a deviated septum or polyps

How is nasal valve collapse treated?

First, we’ll determine if this condition can be treated without surgery. Many patients recover through antihistamines, steroid nasal sprays or products such as Breathe Right strips. However, sometimes surgery is needed. 

During surgery, we reconstruct the cartilages in your nose in order to improve your airway. This surgery is minimally invasive---it’s performed through one small incision at the nose’s base. If needed, we can use ear cartilage for reconstruction. 

In addition, there are two new minimally invasive surgical treatments for this problem. While these treatments do not work for every patient with nasal valve collapse, they are geared toward stiffening the sidewalls of the nose to decrease collapse and improve breathing.

What are other common nasal abnormalities?

Some of the most common structural abnormalities of the nose may have to be corrected using nose plastic surgery. These include:

A Deviated Septum

The septum is the center of the nose that divides it into the left and right sides. When the septum leans toward the left or the right, this can cause chronic congestion and other problems. Roughly 80 percent of the general population has some type of septal deviation

Nasal polyps

These are common, affecting roughly 30 percent of all Americans. These grape-shaped growths tend to occur more frequently in those with allergies and asthma.

Like nasal valve collapse, this condition seems to run in families. Fortunately, these growths are benign. In some cases, these polyps don’t cause any symptoms, and if they don’t bother you, then no treatment is needed. Problems only occur when they block the nasal passages.

Enlarged Turbinates 

Turbinates are small layers of bone and mucous on the walls of your internal nasal cavities. They warm the air we breathe. However, when these are abnormally enlarged, the result can be nasal congestion, drainage, facial pain and reduced airflow.

See Why We Are the Practice of Choice in the Triangle

For decades, Raleigh Capitol ENT has been recognized as one of the region’s best ear, nose and throat medical practices. Our comprehensive approach to medicine means we can offer an extensive variety of services, whether your child needs tubes in the ears or if you’re struggling with the inconvenience of sleep apnea.  We invite you to explore the wide range of treatments available at our Sinus Center

We’re also experts as facial and nose plastic surgery.

If you have chronic nasal congestion, we encourage you to contact us so we can provide the care and expertise you need.


Raleigh Capitol Ear, Nose, and Throat is the area's premiere physician-owned ENT practice with seven convenient locations throughout Wake County. Our board-certified physicians have extensive experience in treating both common and complex cases to help adults and children alike. For more information or to schedule an appointment, contact us.


Brigham and Women’s Hospital. “Nasal Valve Collapse.” 

Wittkopf, Mariaa; Wittkopf, Justinb; Ries, W Russell. “Current Opinion in Otolaryngology & Head and Neck 

Surgery”: February 2008 - Volume 16 - Issue 1 - p 10–13. Online.