A nose that feels blocked when you breathe in, particularly when the sides of the nostrils seem to draw inwards, is a common reason for seeking an ENT opinion. The cause is often not mucus or swelling but a lack of support in the side wall of the nose, a condition known as nasal valve collapse. Because the symptoms resemble those of allergy or a deviated septum, it can go unrecognised for years while sprays and tablets bring little relief.
For some patients, nasal valve collapse treatment can be a short procedure in clinic using a small absorbable implant. At Hillser Clinic on Harley Street in London, we begin with your symptoms and an examination of which part of the nose is responsible, and only then discuss treatment. The research on the LATERA nasal implant is encouraging for selected patients, but suitability is decided on examination, not on symptoms alone.
A short in-clinic procedure may relieve blockage without changing how the nose looks, and a consultation establishes whether the side wall is the cause.
What nasal valve collapse feels like
The nasal valve is the narrowest part of the airway, just inside the nostril, where the side wall of the nose meets the septum. When the side wall is weak or unsupported, it can be drawn inwards as you breathe in, narrowing the airway at the moment you need it open. The typical sensation is of being unable to draw air through the nose, even when it does not feel congested.
Symptoms often include:
Blockage on breathing in: the nostrils may seem to pinch or collapse inwards, sometimes on one side more than the other.
Worse on exertion: breathing through the nose becomes harder during exercise, when airflow demand increases.
Worse at night: disturbed sleep, a dry mouth on waking and a tendency to mouth-breathe.
Limited response to medication: sprays and antihistamines make little difference.
That last point matters. If your nose remains blocked despite treatment for allergy, our article on why your nose may still be blocked despite antihistamines explains the other structural causes worth investigating, of which valve collapse is one.
How it is diagnosed
Diagnosis starts with a detailed history: which side is affected, when the blockage is worst, what you have already tried and how much it affects sleep, exercise and daily life. Examination at our rhinology service includes looking at the shape and strength of the nose from the outside, and watching the side walls as you breathe in.
A simple bedside test, the Cottle manoeuvre, adds useful information. The cheek is gently drawn outwards to open the valve area while you breathe in. If breathing improves, it suggests the valve is contributing to your symptoms, and a nasal strip that lifts the side wall can give a similar clue.
Nasal valve collapse often coexists with other causes of blockage. A deviated septum, enlarged turbinates, chronic rhinitis or sinus disease may each play a part, and treating the wrong one is a common reason for disappointing results.
Who may be a good candidate for nasal valve collapse treatment
A LATERA implant is most likely to be considered if several of the following apply:
Persistent blockage on breathing in: symptoms that are present most days rather than only during a cold or hay fever season.
A weak side wall on examination: the side of the nose visibly or demonstrably moves inwards on breathing.
Improvement with support: breathing that improves with the Cottle manoeuvre or a nasal strip.
Inadequate relief from medical treatment: you have tried appropriate sprays or other medication without enough benefit.
Other causes of blockage must be assessed alongside the valve. If the septum or turbinates are also contributing, the order and combination of treatment needs careful thought. If your blockage is driven mainly by inflammation, a different approach may suit you better, such as ClariFix cryotherapy for chronic rhinitis.
Ultimately, suitability is decided on examination. If your symptoms sound familiar, a consultation will establish whether the side wall is the cause and whether a minimally invasive option is appropriate for you.
What the implant is and what the procedure involves
LATERA is a small, absorbable implant that supports the side wall of the nose, known as the lateral nasal cartilage. It is shaped to sit within the tissue of the nostril and hold the wall in a more open position, so that it is less likely to draw inwards when you breathe in. The material is absorbed over time.
The implant is placed in clinic under local anaesthetic, so a general anaesthetic and an operating theatre are not needed. The area is numbed, the implant is positioned through a small opening, and the position is checked before you leave.
If this sounds like a possibility for you, a consultation is the way to find out. Our team can arrange it, and you do not need to have settled on treatment beforehand.
What the research shows
The evidence on LATERA comes from two main sources. The first is a published randomised trial (Bikhazi et al, Facial Plastic Surgery 2021), which included 137 patients.
At 3 months, 82.5% of patients who received the implant reported a meaningful improvement in symptoms.
The second source is a systematic review and meta-analysis (Kim et al, International Forum of Allergy and Rhinology 2020), which pooled 5 studies and 396 patients. It found that implants reduced movement of the nasal side wall and improved disease-specific quality of life.
These figures describe groups of selected patients, not individuals, and they cannot tell you how your own nose will respond. That is why the assessment matters as much as the treatment.
What to expect afterwards
Most people go home shortly after the procedure. Mild bruising, swelling and some tenderness around the nostril are expected and temporary. Some patients are aware of the implant for a while, and mild discomfort can occur. Our team will give you written aftercare instructions, including guidance on activities to avoid while the area settles, and will arrange a follow-up to check your progress.
Improvement can take time to appreciate, so judgement is best made after the initial swelling has settled, not in the first days.
Other options
Not everyone with nasal valve collapse is suited to an implant, and not everyone wants one. Conservative measures include nasal strips or internal dilators, which support the side wall temporarily and can also be useful as a test of how much benefit support might give. Where the collapse is more marked or other structural problems are present, surgery may be the more appropriate option.
Functional rhinoplasty reconstructs or reinforces the side wall, often using cartilage grafts, and can address the septum at the same time. It involves more recovery than an in-clinic procedure, and our article on rhinoplasty from consultation to recovery describes what that journey involves. The right choice depends on the cause, the severity, your priorities and your preference, and it is one we make together after examination.
Frequently asked questions about nasal valve collapse treatment
How do I know if I have nasal valve collapse?
The typical sign is a nose that feels blocked when you breathe in, sometimes with the nostrils drawing inwards, even when the nose does not feel congested. It is often worse during exercise and at night, and sprays or antihistamines make little difference. Only an examination can confirm whether the side wall of the nose is the cause, which is why assessment comes before any treatment.
How is nasal valve collapse treated?
Options range from nasal strips or internal dilators, through an absorbable LATERA implant placed in clinic under local anaesthetic, to functional rhinoplasty where the collapse is more marked or other structural problems are present. The right choice depends on the cause, the severity and your own priorities. We agree it with you after examination.
Will it change how my nose looks?
The implant is designed to support the side wall from within, and the aim is to improve breathing without changing the shape of the nose. Mild swelling in the early days can be visible, but it settles. If you also want a change in appearance, that is a separate discussion about rhinoplasty.
Is it painful?
The area is numbed with local anaesthetic, so most patients describe pressure rather than pain during the procedure. Mild discomfort, tenderness or an awareness of the implant can follow and is usually temporary. Simple pain relief is normally sufficient, and we advise on this at your appointment.
Could nasal valve collapse be affecting my snoring or CPAP?
It can contribute. A narrowed nasal airway increases resistance, which may encourage mouth-breathing and snoring, and it can make a CPAP mask harder to tolerate. If you snore or use CPAP and your nose feels blocked, it is worth having the nose examined as part of your assessment.
Do I need a GP referral?
You can book a private consultation directly with Hillser Clinic. If you have previous scans, reports or details of past nasal treatment, bringing them helps the assessment.
Book a nasal valve collapse consultation at Hillser Clinic
We offer expert evaluation of nasal valve collapse and other causes of nasal blockage at Hillser Clinic, with a full range of options from medical treatment to a LATERA implant and functional rhinoplasty. To arrange a consultation, please contact our team.
