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What is the VivAer® Procedure? Benefits & Risks

VivAer® Procedure

VivAer® Nasal Airway Remodeling is a cutting-edge technology that uses radiofrequency energy to remodel/reshape the cartilages of your nose and open the nasal valve without altering the outward look of your nose.

Your nasal valve is the narrowest, triangular-shaped area within your nasal passages that acts as a front door to your nose. This triangle is made up of:

  • The septum (the bridge): The firm wall between the left and right sides of your nostrils.
  • The lateral (side) wall: Tissue that forms the outer wall inside your nose.
  • The turbinates: Sausage-shaped fleshy structures within your nasal passages that warm, humidify, and cleanse the air that hits your nostrils.

Any further narrowing of this already narrowed nasal valve, can lead to increased resistance and reduced airflow, making it harder to breathe through your nose.

Symptoms of Nasal Obstruction

Chronic nasal (related to the nose) obstruction can have a significant impact on the quality of your life, as it causes:

  • difficulty breathing
  • difficulty getting enough air through your nose
  • loud snoring
  • interrupted sleep
  • day-time fatigue

Who is a Candidate for the VivAer® Procedure?

Our experts at the Ear, Nose, Throat & Allergy Specialist use the VivAer® procedure to improve the airflow in patients with chronic nasal obstruction — a condition that impacts millions of Americans.

The criteria for the VivAer® procedure include:

  • chronically persistent nasal obstruction, which has not responded to optimal medical therapy (4-6 weeks of steroids)
  • need to avoid traditional surgery and the hassle of a prolonged recovery
  • when the nasal valve is found to be a primary or significant contributor to nasal obstruction as determined by the:
  1. Use of nasal dilator strips (e.g., Breathe Right Strips)
  2. Use of nasal stents
  3. Q-Tip test (Transiently pushing your nasal valve to the side with a Q-tip to see if it improves breathing or not)
  4. Cottle’s Maneuver (Placing one or two fingertips on your cheeks, then gently pressing and pulling your cheeks outside. This maneuver will open the nasal valve if it’s collapsed, thereby temporarily improving your breathing).
  5. A minimum score of 6 in the Nasal Obstruction Symptom Evaluation (NOSE) score. The NOSE score comprises five features that evaluate problems pertinent to or arising from nasal obstruction as below:
  Not a Problem Very Mild Problem Moderate Problem Fairly Bad


Severe Problem
1. Nasal congestion or stuffiness 0 1 2 3 4
2. Nasal blockage or obstruction 0 1 2 3 4
3. Trouble breathing through my nose 0 1 2 3 4
4. Trouble sleeping 0 1 2 3 4
5. Unable to get enough air through my nose during exercise or exertion


0 1 2 3 4

How is the VivAer® Procedure Done?

Our ENT specialists first numb the inside of your nose with a local anesthetic (numbing) medicine. A VivAer, small hand-held stylus is then used to deliver controlled, low-temperature radiofrequency energy to your nasal valve area. The tip of the stylus gently reshapes the tissues of your collapsed nasal valve, creating more room inside your nose. You may feel a bit of pressure during the procedure, but that’s all about it.

With the help of the VivAer® device, we can also shrink the turbinates, which are swollen in most cases of nasal allergies.

The idea behind the VivAer Nasal Airway Remodeling is relevant to a Physics law known as the Poiseuille’s law:

“Even the slightest increase in the area of the nasal valve causes a noticeable reduction in the resistance within your nasal passages, and hence, greatly improves nasal breathing.”

What are the Benefits of the VivAer® Procedure?

Painless and Non-invasive

It involves no cutting, spares the nearby tissues, including the mucosal lining, and is thereby safe and pain-free. You may only feel slight pressure during the procedure.

Simple, Quick Alternative to Surgery

VivAer® provides a simple, outpatient, surgery-free alternative to get relief from nasal stuffiness and its ramifications. The procedure usually takes only around 15 minutes.

Preserves the External Appearance

Since there is no cutting or destruction involved, VivAer® doesn’t cause any outward change to your nose structure.

Clinically Proven

More than 90% of patients report dramatic improvement in breathing by around one month. This benefit tends to improve further in three months and lasts for up to 24 months.

Moreover, patients undergoing the VivAer® procedure report:

  • Improved sleep function
  • Better concentration
  • Better productivity
  • More energy and less fatigue during the day

There’s no Downtime

Following the VivAer® procedure, you’ll be able to resume your routine activities as soon as you leave our office.

What are the Potential Risks of the VivAer® Procedure?

While there is no evidence of adverse effects associated with the procedure, potential risks include:

  • temporary swelling around the bridge of the nose
  • crusting and debris on the inside of your nose (you can use the saline rinse to help clear out the debris)
  • nasal stuffiness in the initial two weeks
  • infection
  • bleeding

If you’re having chronic nasal obstruction, or are considering the VivAer® procedure or need more information about it, please consult the Ear, Nose, Throat & Allergy Specialist.