Rhinoplasty for the Narrow Nose

Dallas Plastic Surgeon, Dr Steve Byrd, references his publications on the correction of the narrrow midvault in primary and secondary rhinoplasty.

The too narrow nose most often presents as a secondary rhinoplasty deformity(from prior nose job) but can be seen primarily. It is usually characterized by a collapsed or pinched midvault that manifests an "inverted V" deformity at the junction of the upper lateral cartialges with the nasal bones.

When the midvault is pinched or narrowed as shown in the above patients, internal valve obstruction is a likely occurrence following rhinoplasty unless spreader grafts are used. Internal valve obstruction is a paradoxical obstruction characterized by a pinching closed of the airway on force inspiration as required during vigorous exercise. I use different types of spreader grafts and spreader flaps in these situations to enable an improved airway as well as establishing balanced dorsal aesthetic lines.

Byrd HS, Andochick S, Copit S, Walton G: Septal extension grafts: a method of controlling tip projection, rotation, and shape. Plast Reconstr Surg 1997, in press.

Byrd HS: Use of Resorbable Spacers for Nasal Spreader Grafts (Discussion). Plast Reconstr Surg 2000 Sept 106(4);929