Titanium Breathe Implants are small, carefully fashioned sheets made of the metal titanium, which are used to improve breathing through the nose in people with narrow noses, a narrow nasal valve or nasal valve collapse.
What is nasal valve collapse?
The nasal valve is the space just inside the nose, just over 1cm beyond the front of the nose. In everyone, it is the narrowest point of the inside of the nose. Because of this, it is the most important area in regulating the flow of air through the nose into the lungs. Even small changes in the size or aperture of the nasal valve can affect the flow of air through the nose significantly.
The size of the nasal valve itself does vary from person to person. In fact it is not necessarily the case that someone with a big nose will have a big nasal valve and vice versa. It is possible to have a reasonable sized nose but for the lower half to be ‘pinched’, causing a narrowing at the valve area, which in turn will give a tendency towards having a slightly blocked nose.
Alternatively, the size of the nasal valve may be perfectly adequate, but the strength of the side walls of the nose (usually made up of skin, fat and cartilage) may be weaker than normal. This can happen due to the normal ageing process, after an injury or accident or following previous nasal surgery. A weak side wall will be less able to resist the tendency of the nose to collapse inwards, particularly when breathing hard such as during exertion.
Why should I consider having a Titanium Breathe Implant?
This is a relatively new technique which has been developed specifically for people with nasal valve problems. It is likely that you will be suffering with a blocked nose, which can either occur all of the time or after exertion such as exercise. There are of course many other possible causes of a blocked nose and it is important for your GP and/or ENT specialist to examine you in order to rule out some of the other possibilities such as allergy, deviated nasal septum, sinusitis or nasal polyps.
If your specialist feels that your blocked nose is due to a narrow nasal valve, a titanium breathe implant may be beneficial for you. Being many times stronger than stainless steel, the titanium strengthens up the side walls of the nose such that it resists collapse, even during exertion. This will mean that the nasal valve should stay open thereby allowing you to breathe. In addition, because of its remarkable strength, the implant can be made to be extremely thin, which means that it should not be visible externally.
What are the alternatives to a Titanium Breathe Implant?
One alternative is to try an external nasal splint such as a ‘Breathe Right strip’ which is placed on the outside of the nose and has the effect of springing the side walls of the nose outwards, thereby resisting the tendency of the nose to collapse on breathing in. Some people find them quite effective, in some cases sufficiently so that surgery is not required. However the benefit is only realised whilst using the strips, which can cause a problem to some patients who cannot, for work or other reasons, wear them during the day. If the breathing problem is only at night then they are certainly worth a try. Even if surgery is being considered, your surgeon may suggest that you have a trial of the strips. If the strips are not effective then you will be more convinced that surgery is the only way forward. If the strips are effective but you do not like the idea of wearing them all of the time, then again surgery remains a viable way forward.
Traditionally, surgery to correct a narrow nasal valve or valve collapse is complex and not always successful. It involves strengthening the side walls of the nose with cartilage obtained from the patient’s own nasal septum or ear. Harvesting this cartilage requires another incision to be made and the length of the operation is therefore increased. There are also complications that can occur from taking this cartilage from these sites, including a scar and infection. The main problem however with using cartilage is that it is not much stronger than the patient’s own nasal side wall. Also cartilage has the tendency to weaken with time. This means that the operation to strengthen the nasal side wall may not be successful.
These shortcomings are avoided with the use of titanium. Its inherent strength means that it resists collapse far better than cartilage does, allowing the nasal valve to stay open without the need for other incisions and minimising postoperative complications as a result.
Titanium Breathe Implant – the operation
Titanium Breathe Implants are inserted with the patient asleep under a general anaesthetic (GA). An external incision is required in the skin of the tip of the nose, which allows the skin to be carefully raised in order to expose the cartilaginous framework of the nose. In particular, the nasal valve area is meticulously dissected free in order to demonstrate the weak area. At this point, the size of the valve is assessed and the correct titanium implant selected from a range of possible sizes. The titanium implant is then securely sutured in place using non-absorbable material so that there is no movement or slippage of the implant. Any other problems that need to be corrected can now be addressed (eg. Septoplasty, tip refinement) before the external skin incision is closed with fine sutures and a plaster placed on the nose for protection. It is unusual to require any internal nasal dressing unless a septoplasty or sinus surgery has also be conducted simultaneously.
What to expect after insertion of a Titanium Breathe Implant
Once the operation has finished, you will be moved into the recovery area where you will wake up. There should be little if any discomfort, although you may feel that your nose is slightly congested and sore, particularly if you accidentally knock it. You will be able to eat and drink soon after you wake up, and you should then be able to go home on the same day.
As with any form of nasal surgery, it is important to minimise the amount of heavy lifting and/or straining in the first few days after the operation otherwise there will be an increased likelihood of a nose bleed. Also it is important to try not to sustain any injury to the nose as this could displace the titanium implant.
What can go wrong after a Titanium Breathe Implant?
Inserting a Titanium Breathe Implant is generally extremely safe, but there are some risks and complications that can occur as after any operation. There may be some bleeding from your nose which is usually limited but can on rare occasions be more severe than usual. This can happen within the first few hours after surgery or up to 10 days later.
Published research and unpublished communications have shown that the Titanium Implant rarely becomes infected. The risk of infection appears if anything to be lower than if the patient’s own cartilage is harvested and implanted. If you suspect an infection such as skin redness or tenderness or a foul smelling discharge from the nose, you are advised to see a doctor as you may require a course of antibiotics.
One other concern that many people have is whether the titanium implant will be visible from the outside. Whilst this remains a theoretical possibility, it does not seem to occur at all. This may be because the titanium implant is designed to be extremely thin, which is possible on account of its remarkable strength. Also, once the implant is sutured in place, it is overlapped by the existing nasal valve cartilages which protect and cover the titanium implant. These two reasons may therefore account for the lack of visibility of the implant.
Further information about Titanium Breathe Implant
This can be obtained from the manufacturer’s website