Can I Have a Spreader Graft Removed After a Revision Rhinoplasty? My Breathing is Worse.

Spreader grafts when placed in the appropriate position are supposed to improve airflow dynamics through the nose and not make them worse.  When done for cosmetic purposes they can also give a visual improvement to the external midthird of the nose.  Removing a spreader graft is quite difficult due to the amount of scar tissue formation that is present circumferentially around the graft.  There is usually no reason to remove the graft unless it is displaced and creating obstructional or cosmetic issues.

Spreader grafts are designed to open the internal nasal valve.  If incorrectly positioned, however, they can result in worsening of the airflow.  A careful internal nasal examination will help determine the true cause of your nasal obstruction at present. 

Mario J. Imola, MD, DDS, FRCSC.

A spreader graft can definitely be removed during revision rhinoplasty, but it may not be to blame for your worsened breathing.  A useful way to evaluate your nasal valve area would be to look at your dynamic inspiration (breathing in and out) with an endoscope (small camera).  This provides a very clear view of the area where the spreader graft is (nasal valve), and would be useful to determine whether it really is at fault.