Breathing Problems: Spreader Graft or Alar Batten Grafts?

I agree with Dr. Bridges' assessment that you appear to have cephalically positioned lower lateral crura. Rather than being oriented approximately 45 degrees off center, they're angled up more than ideal. The overall effect is decreased support of the sidewall of your nose (external valve).

Alar batten grafts are cartilage grafts placed in this area to improve the support and decrease the dynamic collapse. In cases like this, I find that lower lateral crural repositioning is actually a more powerful and anatomic procedure that gives very good functional and aesthetic results. Besides stregnthening the nasal sidewall it also creates more natural contours to the nasal tip. LLC repositioning is a much more complex procedure that not all rhinoplasty surgeons perform.

Spreader grafts may prevent nasal valve collapse but rarely help correct it.  Alar batten grafts (lateral crural strut grafts) with or without lateral crural repositioning are likely your best option.

In general, spreader grafts improve the internal valve and alar batten grafts improve the external valve. Although your photograph does not show the dynamic motion of your valve region when you breathe in, I suspect the problem is the external valve, and so the batten graft may be more appropriate.