Aesth Plast Surg (2011) 35:211–215 Fig. 6 In the Cottle test, the force of the examining ﬁngers to open the nose is at the cheek level only. On the other hand, the nasal strip expands the actual side walls of the nose, showing why it may be not only a more speciﬁc test of valvular function but also a stronger test The external nasal dilator strip is helpful when the clinician is not certain whether the valve is the cause of airway obstruction. In effect, it is a mock surgery. Conﬂict of interest None. Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which per- mits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. References 1. Constantian MB (1994) The incompetent external nasal valve: pathophysiology and treatment in primary and secondary rhino- plasty. Plast Reconstr Surg 93:919–931 2. Guyuron B, Michelow BJ, Englebardt C (1998) Upper lateral splay graft. Plast Reconstr Surg 102:2169–2177 3. Howard BK, Rohrich RJ (2002) Understanding the nasal airway: principles and practice. Plast Reconstr Surg 109:1128–1146 4. Park SS (1998) The ﬂaring suture to augment the repair of the dysfunctional nasal valve. Plast Reconstr Surg 101:1120–1122 5. Seyhan A (1997) Method for middle vault reconstruction in pri- mary rhinoplasty: upper lateral cartilage bending. Plast Reconstr Surg 100:1941–1943 6. Teichgraeber JF, Wainwright DJ (1994) The treatment of nasal valve obstruction. Plast Reconstr Surg 93:1174–1182 7. Toriumi DM, Josen J, Weinberger M, Tardy ME Jr (1997) Use of alar batten grafts for correction of nasal valve collapse. Arch Otolaryngol Head Neck Surg 123:802–808 8. Ahmet I, Necmi A, Aslan FS, Hatice C, Munir D, Haldun O (2008) Reconstruction of the internal nasal valve: modiﬁed splay graft technique with endonasal approach. Laryngoscope 118:1143–1739 9. Mehdi D, Aram A, Hamid K (2005) Reconstruction of the internal nasal valve with a splay conchal graft. Plast Reconstr Surg 116:712–720 10. Peltonen LI, Vento SI, Simola M, Malmberg H (2004) Effects of the nasal strip and dilator on nasal breathing: a study with healthy subjects. Rhinology 42:12205 11. Wong LS, Johnson AT (2004) Decrease of resistance to air ﬂow with nasal strips as measured with the airﬂow perturbation device. Biomed Eng Online 3:38 12. Portual LG, Mehta RH, Smith BE, Sasbnani JB, Matava MJ (1997) Objective assessment of the breathe-right device during exercise in adult males. Am J Rhinology 11:393–397 13. Coan BS, Neff E, Mukundan W Jr, Marcus JR (2009) Validation of a cadaveric model for comprehensive physiologic and ana- tomic evaluation of rhinoplastic techniques. Plast Reconstr Surg 124:2107 14. Ognibene NE, Merrick MA, Ingersoll CD (2001) Intra- and intersession reliability of acoustic rhinometry in measuring nasal cross-sectional area. Ear Nose Throat J 80:539–540 15. Gosepath J, Mann WJ, Amedee R (1997) Effects of the breathe- right nasal strips on nasal ventilation. Am J Rhinol 11:399–402 215 123