Fixing the Pinched Nasal Tip

Pinched Nasal Tip: Why It Happens and How Modern Rhinoplasty Fixes It

A “pinched tip” is one of the most common deformities I see in revision rhinoplasty. It makes the nose look overly narrow, collapsed, or unnatural — and often causes breathing problems. It is possible to be born with form of a pinched tip as well leading to some of the issues that revision patients have.

Most pinched tips come from over-resection of the lower lateral cartilages during reductive rhinoplasty, over suturing of the cartilage in an attempt to narrow, or from dividing the cartilages themselves (dome division).

Why the Tip Looks Pinched

Common causes include:

  • too much cartilage removed

  • weak or collapsing lateral crura

  • previous reductive rhinoplasty

  • aggressive cephalic trim

  • poor support or missing cartilage

  • synching of sutures

  • and bowing in of the cartilage of the tip

A pinched tip is almost always a structural problem, not just a surface issue.

My Approach to Fixing a Pinched Tip

Correction requires correction of the underlying issue. Usually restoring support to the nostril rim and unpinching the cartilage. This can be don in any of these ways: I use all these techniques.

1. Lateral Crural Strut Grafts

Strengthen and support the collapsed tip cartilages.

2. Precision Tip Sutures

Refine shape without removing more structure.

4. lateral crura replacement

replacing the tip if its so scarred and completely removed.

Want a more detailed explanation?

I wrote a full article on correcting pinched nasal tips here:
👉 “Correction of nasal pinching”

ARI HYMAN