All about nasal valve collapse.

For correcting collapsed alae, blunt dissection of the septal mucoperichondrium through the transfixion incision is extended on both sides up to the vault of the upper lateral cartilages, which are severed from their insertion. I remodel the lower lateral cartilage and secure the lateral crus together with the upper alar groove in a less concave position with mattress sutures in cases of anterior valvular disturbance. The upper lateral cartilages are also fixed in a more convex position, particularly in cases of posterior valvular disturbance. In both anomalies a slightly convex septal or auricular slice cartilage graft placed over the concerned cartilage helps to keep the valve more open and the lateral wall in proper position. If necessary, in extreme secondary cases, one needs the help of bilateral cartilaginous or bony supports embedded subperiostally at the nasal bones.