Alar Spreader Grafts Still Used to Correct Nasal Pinch and Alar Collapse?

I am researching revision rhinoplasty and want to make sure I have the correct procedure done to fix my pinched tip, noticeable alar creases and breathing problem. My original nose had a wide nasal tip, no hump. Tip has been reduced too much. Am I correct and is this problem called "external valve collapse"? I found two techniques to fix this: 1) alar batten grafts 2) (older technique?) alar spreader grafts (see pic). Which one is the best to correct my problem?

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8 Doctor Answers | Asked by MissLouise in Europe

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Battens vs. Alar Spreaders

Unfortunately, your problem occurs fairly often when too much cartilage is removed from the nasal tip. The result is pinching of the nasal tip and collapse of the nostrils with breathing. Many, many rhinoplasty maneuvers have been described for correcting nose problems throughout the years. Most of these have come and gone with the times, others have become standards. To treat your problem, alar batten grafts and lateral crural strut grafts are much more commonly... more

Best method to correct tip pinching

You appear to have cephalically positioned lower lateral crura. In situations like this where there is tip pinching and collapse I find that strengthening and repositioning the lower lateral cartilage is a much more powerful technique than alar batten grafting or alar spreader grafts. This lower latreal crural strut grafting improves the dynamics of the area by creating a stronger external valve. At the same time the lower lateral cartilages (with their strut) can be relocated so that... more

Cephalic Oriented Lower Lateral Cartilage

Cephalically-oriented lower lateral cartilage is a very common ethic variation and can be a trap for lateral collapse after a "routine" rhinoplasty. This usually ends up with the "parentheses deformity" where too much lower lateral cartilage was removed or lateral support was not added during the primary procedure. Alar retraction or notching is also commonly associated with these patients. I don't think the "alar spreader" graft is a... more

Revision rhinoplasty for a pinched tip

Dear MissLouise, It is great that you are doing a lot of research before your procedure. That way, you can have an educated conversation with you plastic surgeon regarding revision rhinoplasty. There are several issues that can lead to problems breathing including a deviated septum, enlarged turbinates (soft tissue covered bone inside your nose), external nasal valve collapse (where the nostrils, at their base, collapse when you breathe in), and internal nasal valve collapse... more

Correcting nasal pinching and collapse

There are a number of good options for correction of pinching and collapse - the best options depends on whether your breathing is also compromised - some of the techniques are more cosmetic while other also improve breathing

Sam Naficy, MD

80 reviews

Seattle Facial Plastic Surgeon

www.seattleface.com

Spreader grafts and alar batten grafts

Spreader grafts are used to cosmetically straighten the concavity on the outside of the nose. They are also used to improve airflow dynamics through the nose when there is vestibular collapse on the internal portion of the nose usually on that concaved side. Alar batten grafts are used to correct asymmetrical alar rim collapse. It is important to research and find a very experienced rhinoplasty surgeon prior to embarking on this endeavor. Look for a surgeon who has... more

Correction of Nasal Pinch and Alar Collapse

Rather than trying to determine the best technique to improve your result, spend your time finding the best revision rhinoplasty surgeon that you can. There is no 1 right way to meet your objectives.

Richard W. Fleming, MD

9 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Spreader grafts add significant width to the nasal tip

There appear to be some cartilage irregularities in the area above the nasal tip and the left tip cartilage has an indentation but I do not see the need to use a spreader graft. Spreader grafts are for indentations along the internal nasal valve (middle of the nose just behind the nasal tip) which does not appear on the photo provided. Spreader grafts add significant width to the nasal tip, which would not be an aesthetic improvement to your nose IMHO. I would perform... more