Custom patient interface and methods for making same

A patient interface assembly for delivery of a supply of pressurised air or breathable gas to an entrance to airways of a patient, the patient interface assembly comprising:

• a frame assembly having an elliptical wall and configured to be disposed over nares of the patient, the frame assembly having an opening to a delivery tube and having a plurality of vent holes in a row along a surface of the frame assembly, the frame assembly forming at least a portion of a plenum chamber between the elliptical wall and the patient;
• a sealing element configured to form a seal against skin that surrounds both nares of the patient without being partially located inside the patient's nose, the sealing element being less rigid than the frame assembly and having at least one side of the sealing element configured to couple to an anterior portion of the elliptical wall of the frame assembly, wherein at least one side surface of the sealing element is configured, when in use, to extend along a generally elliptical path that covers outer peripheries of the nares including alar sidewalls and a portion of a columella of the patient;
• and
• a headgear coupled with the frame assembly and comprising a positioning and stabilising structure, the positioning and stabilising structure being configured to maintain the sealing element in sealing contact with an area surrounding the entrance to the patient's nares while maintaining a therapeutic pressure at the entrance to the patient's nares, the positioning and stabilizing structure comprising a left-side portion, a right-side portion and a crown portion, wherein the positioning and stabilizing structure comprises relatively non-stretchable material and relatively stretchable material, and wherein the left-side portion and the right-side portion each comprise a textile cover.