One of the most common reasons for continued nasal congestion despite allergic medications and even nasal surgery is due to fragile nostrils. Your nose has various shapes and sizes, but having naturally thin nostrils or weakened nostrils after rhinoplasty can lead to fragile nostrils that collapse during inspiration even silent.
Unfortunately, many people undergo a number of different medical treatments using allergy sprays or even surgery before this condition is even considered.
There are three easy ways to know if you have brittle nostrils:
1. Look in the mirror and take a deep breath through your nose. Do the sides of your nostrils penetrate as you breathe in?
2. place your index finger right next to the nostrils on both sides. While gently pushing on each side, pull the skin of the cheek up and away from the nose, towards the outer corners of the eyes. Inhale and see how you feel.
3. Remove the cotton ends from two Q-Tips and place the thin end inside the nostril and lift it sideways. Take a deep breath. Has your breathing improved much?
A very important point to point out here is that how closed your nose is inside can also determine how much your nostrils will collapse. Think about sucking through a fragile straw. If you pinch the center slowly, the end will collapse as the air flow increases. The same thing happens with your nostrils. In many cases, properly addressing intranasal allergies or a deviated septum and enlarged turbinates will prevent the collapse of the nostrils.
If you use over-the-counter decongestants like Afrin or Sudafed and are able to breathe much better, you must first turn inside the nose. But if you still have nasal congestion and it is obvious that your nostrils are failing, then you have brittle nostrils or the collapse of the nasal valve. Lifting the nostrils by peeling off the cheeks or using Q-Tips is a good test to see if you have this condition.
If the treatment of allergies or deviated septum or swollen turbinates does not help, there are two main ways to treat this problem:
1. Nasal dilator devices.
These are available in two varieties: external and internal.
External devices are primarily bench top adhesive strips that attach to the outside nostrils that separate the nostrils. This works for most people, but for some people with thick or oily skin, it may not work as well.
Internal nasal dilator clip. Numerous devices exist, including Nozovent, Sinus Cones, Breathewitheez and Brez. You can find one of these devices online.
The most common way to manage it surgically is through a functional nasal reconstruction procedure, using rhinoplasty techniques. Small strips of cartilage (collected from the nasal septum or from the ear) are positioned under the skin of the nostrils and between the septum and cartilage of the lower part of the nose. There may be a slight enlargement of the nose due to the added support structures.
A newer and easier way to deal with brittle nostrils is to make a small incision under the lower eyelid and apply a thin suture to the bone. The suture is then inserted under the skin towards the area of the flaccid nostril, twisted around the nostril and returned to the incision of the eyelid and tied under a slight degree of tension. This suspends the nostril so that it does not fall inside. This procedure can be performed under local anesthesia and can literally take around 30 minutes and recovery is very rapid. Unlike the more formal procedure, your nose is less likely to enlarge, since you are only suspending or “hanging” your nostrils on the bone above.