Middle vault problems can occur with either Rhinoplasty technique

Some of the conditions that make this more likely are mentioned in the previous responses, but don't forget that thin skin does not help hide the underlying structural components either. If there is a problem, then one needs to determine if it is functional or purely aesthetic.

I don't believe that placement of grafts between the upper lateral cartilages and septum should be a routine treatment. There can be problems with this also. Sometimes other techniques are used that are better than spreaders. Post a photo and let's see what is going on here.