I'm considering revision rhinoplasty, and a very seasoned revision expert recommended lateral crural struts to help with my valve collapse & pinching. While I would like to fill out the pinching / creases above my nostrils / shield graft edges and improve my breathing, I don't want my nose to be much wider. I've attached pictures of myself smiling - the left is my current nose, the right would be my 'ideal.' Is this achievable, or will lateral crural struts make my nose wider than this?
Do Lateral Crural Struts Always Add Width to the Nose? (photo)
Doctor Answers (9)
Do Lateral Crural Struts Always Add Width to the Nose?
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Kenneth Hughes, MD
Los Angeles, CA
Lateal crural struts and nasal width
Lateral crural struts add width to the lower third of the nose just above the alar crease where they are placed and will help with valve collapse and pinching. A shield graft will also help along the dorsal aesthetic line area for added width in that area and help improve breathing. These also help with breathing. It is difficult to show what these types of grafts will do on computer imaging since the computer imaging is 1 dimensional and the nose is 3 dimensional.
Lateral Crural Struts
The "parentheses deformity" is very common after a primary rhinoplasty where too much lower lateral cartilage was removed. The lateral crural strut is designed to reinforce this weak lateral cartilage - thus providing for a better breathing and contour. I have used both lateral crural struts and alar "batton" graphs to correct this type problem. If the graft is designed properly is should add very little width to your nose.
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Lower lateral crural strut grafts
Strut grafts and nasal width
In general, the lateral crural strut grafts give better support to the lateral crura. It may make the appearance a bit wider and less pinched.
Lower lateral crural strut grafts
Lower lateral crural strut grafts shouldn't make the nose wider. I would suspect that it should help with the tip pinching you want addressed as it mainly improves the concave contour of the lower lateral crural cartilage. At the same time the grafts should help strength the area to prevent dynamic collapse while breathing.
Lateral Crural Struts and Spreader grafts for nasal Valve collapse
It looks like you would benefit from lateral crural struts and spreader grafts.The combination should improve your breathing and have a similar cosmetic outcome to the one you have shown.
Every nose is different
With the limited pictures that you sent it is hard to determine what you need . I do not beleive that the struts would widen your nose.
Each Rhinoplasty has to be customized to fit each patient . Revision rhinoplasty is a more difficult procedure because even with the prior surgeons report sometimes the unexpected is found.
Will Lateral Crural Struts Make My Nose Wider?
Lateral crural struts will improve the convexity of your lateral tip without making your nose wider. Spreader grafts may also be necessary to improve your breathing. With revision surgery the usual goal is to improve both appearance and function.
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