Narrow, Pinched Tip Rhinoplasty
A narrow or pinched tip can be related to tip cartilages that are inadequately spaced apart or collapsed. This can occur naturally, or more commonly can be due to prior rhinoplasty surgery where the nasal tip cartilages are overlying resected and weakened. Another cause of a narrowed tip is that the tip defining points were placed too close together.
The treatment of tip pinching focuses on recreating the proper cartilage support of the nose. This can involve repairing the external nasal valves with alar batten grafts, lower lateral crural strut grafts, or lower lateral crural reconstruction (i.e., replace the LLC all together).
These concave or weakened lower lateral cartilages result in visual isolation of the tip making it appear narrow. The solution to this issue is to rebuild the lower lateral cartilages so that they are more straight and better support the nostril margins. This leads to a natural transition from the nasal domes laterally to the nostril rims.
Overlying narrow tip defining points can be made wider with a soft tissue spacer graft that is placed between the domes. The patient below had naturally narrow tip that Dr. Lamperti treated during her rhinoplasty.