A mask assembly comprising: a mask seal comprising lateral portions; a mask base comprising a pair of wings that include upwardly projecting portions that provide reinforcement to the lateral portions of the mask seal ; the mask seal comprising an upper surface configured to underlie the nose of a user and define a primary seal between the mask assembly and the face of the user, a first hollow paddle and a second hollow paddle that extend upwardly from the upper surface , are configured to extend upward along the lateral sides of the nose of the user to create a secondary seal with the face of the user, and are configured to extend along a surface of the face adjacent to the nose of the user, an upward directed nasal opening positioned laterally between the first and second hollow paddles and through the upper surface , a rearward directed oral opening , a support region located on a forward-facing surface of each of the first and second hollow paddles , and a ballooning or flexing region , the support region being more rigid than the ballooning or flexing region , the support region overlying the ballooning or flexing region and being configured to control a ballooning effect of the ballooning or flexing region ; and a mask seal clip integrated into a single component with the mask seal and configured to connect the mask seal with the mask base . a mask seal comprising lateral portions; a mask base comprising a pair of wings that include upwardly projecting portions that provide reinforcement to the lateral portions of the mask seal ; the mask seal comprising an upper surface configured to underlie the nose of a user and define a primary seal between the mask assembly and the face of the user, a first hollow paddle and a second hollow paddle that extend upwardly from the upper surface , are configured to extend upward along the lateral sides of the nose of the user to create a secondary seal with the face of the user, and are configured to extend along a surface of the face adjacent to the nose of the user, an upward directed nasal opening positioned laterally between the first and second hollow paddles and through the upper surface , a rearward directed oral opening , a support region located on a forward-facing surface of each of the first and second hollow paddles , and a ballooning or flexing region , the support region being more rigid than the ballooning or flexing region , the support region overlying the ballooning or flexing region and being configured to control a ballooning effect of the ballooning or flexing region ; and an upper surface configured to underlie the nose of a user and define a primary seal between the mask assembly and the face of the user, a first hollow paddle and a second hollow paddle that extend upwardly from the upper surface , are configured to extend upward along the lateral sides of the nose of the user to create a secondary seal with the face of the user, and are configured to extend along a surface of the face adjacent to the nose of the user, an upward directed nasal opening positioned laterally between the first and second hollow paddles and through the upper surface , a rearward directed oral opening , a support region located on a forward-facing surface of each of the first and second hollow paddles , and a ballooning or flexing region , the support region being more rigid than the ballooning or flexing region , the support region overlying the ballooning or flexing region and being configured to control a ballooning effect of the ballooning or flexing region ; and a mask seal clip integrated into a single component with the mask seal and configured to connect the mask seal with the mask base . <EOS>