Pinched nose tip could arise as a complication of rhinoplasty. Pinched nose arises from aggressive removal of nasal tip alar rim cartilage, or by over-suturing the alar cartilages together. Pinched nose is not only displeasing but can also result in the obstruction of nasal airflow at the internal nasal valve.
Correction of a pinched nose by revision rhinoplasty requires reinforcing the alar cartilage support structure of the nasal tip by adding nasal cartilage grafts, harvested either from the septum or the ear cartilage. Alar spreader cartilage grafts and/or septal spreader grafts are used to fix a pinched nose.
A spreader graft is a pair of straight pieces of cartilage which are sutured on each side of the nasal septum to reinforce and to keep straight the nasal septum and the nasal bridge. A spreader graft will not only straighten the nose but will also open a narrow internal nasal valve, which will in effect open up the nasal airway. A spreader graft rhinoplasty is performed either via an open rhinoplasty or closed rhinoplasty approach.