Treatment of Pinched Nose deformity
One of the most common sequelae of poorly performed rhinoplasty is the “pinched nose deformity.” The pinched nose deformity in essence is an extremely narrow and pinched tip that results both in extremely poor tip aesthetics and nasal airway obstruction secondary to collapse of the nostrils into the airway.
The patients oftentimes have a complaint of inability to breathe through their nose as well as very poor appearing nasal tips. The main cause of the pinched tip deformity is over resection of nasal cartilage in the tip area during the primary rhinoplasty procedure. Many surgeons who perform rhinoplasty unfortunately remove excessive cartilages from the nasal tip to treat a “bulbous tip.” Although at that time intraoperatively the nose appears to look appropriate, the long-term results of over resection of the cartilage results in significant loss of structural support of the nasal tip. This in due time over a period of months to years progressively results in a significant collapse of the nostrils and result in a very poorly defined pinched nasal tip. This perhaps is the most common cause of patients seeking revision rhinoplasty and secondary rhinoplasty by Dr. Azizzadeh in his Beverly Hills practice.
At the time of the consultation, Dr. Azizzadeh will first and foremost analyze the nose both in terms of its aesthetics and function, nasal airway measurements will be made. Oftentimes, the patient will undergo computed tomography (CT scan) to evaluate the internal structures of the nose to further assess the needs of the patients. Once the nasal aesthetic analysis has been performed, Dr. Azizzadeh will then discuss the surgical options for the pinched nose deformity. Dr. Azizzadeh will in most circumstances reintroduce the lost cartilages by harvesting cartilage either from the septum, ear or the rib to reconstruct the nasal tip. Multiple grafts may be necessary to correct the pinched deformity to both create better aesthetics and function. Fortunately, better aesthetics and function go hand in hand in revision rhinoplasty procedures and as a result most patients will obtain excellent function and form to their nose. In patients who have thin skin, Dr. Azizzadeh oftentimes will utilize a thin layer of fascia in order to create an aesthetically pleasing soft tip that lacks any pinched or sharp edges.
In conclusion, most patients will obtain very