Correction of the Pinch Deformity by Alar Batten Graft

The Problem

Pinch deformity is one of the main sequelae of routine reductive rhinoplasty. Although the prevailing trend is to preserve the nasal cartilages as much as possible, pinch deformity is still quite common. Several primary rhinoplasty patients show some extent of pinch deformities, therefore an alar batten graft may be an ideal option in select cases.

Introduction

The correction of a pinched nose has been extensively discussed in the rhinoplasty literature. The lateral crural strut graft has been described as the gold standard in repairing a pinched nose. However, in many revision rhinoplasties, the lateral crural cartilage is cut and damaged in several sites and application of a lateral crural strut is sometimes impossible. Conversely, many new concepts such as lateral crural tension alleviate the need for complicated grafts.

It seems that in modern rhinoplasty it is the best practice to know the main standard techniques in correcting a pinched nose and to apply each one when best indicated. The lateral crural batten graft is a reliable tool that may easily restore many aesthetic and functional issues of a pinched nose. When appropriately applied, it has minimal complications and few unwanted results.

Indications

An alar batten graft may be indicated in several primary and secondary situations. A rhinoplasty patient may have one or all of the following goals:

• Pinch deformity in revision rhinoplasty

• External and internal nasal valve incompetencies

• Alar retractions

• Soft triangle deformities