Typically there are two reasons why a patient would have a pinched nasal tip. There are a number of patients who present with growth of the lower lateral cartilages in an unfavorable direction, and as a result have developed a pinched or unnatural looking tip. Secondly, a more common result is a previous nasal surgery (primary rhinoplasty) with an attempt at refining the tip by a technique that may have been too aggressive.
Correcting this type of deformity is generally accomplished by using an external or open approach to the nasal tip and restoring the lower lateral area by rebuilding it from cartilage harvested from either the nasal septum or ear. Many of these patients also have nasal airway obstruction as a result of a pinched nasal valve. Revision tip rhinoplasty provides patients with a more natural appearing nasal tip.