Please explain what these grafts are?

I had a small bump removed, nose narrowed and tip refined. Surgeon also culled the rotation in my tip. My surgeon performed the following: in-fracture, tip graft, columella strut, spreader graft. He is on holiday but his nurse sent these pics. Can any of you amazing surgeons provide any insight into what these pics show. I wanted a less bulbous tip, and know I have much swelling, but not sure why I have all these grafts. Hope I lose a little length as swelling goes down

Doctor Answers 4

Rhinoplasty Cartilage Grafts - Extended Spreader and Caudal Septal Extension

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The pictures shown demonstrate "bilateral extended spreader grafts" and a "caudal septal extention graft."  When used together, these specific grafts can elongate the nose and "de-rotate" the nasal tip. These grafts are very effective and are an excellent way to accomplish these goals. 

Great photos of grafts

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The grafts that your surgeon used are very commonly used in rhinoplasty to help support and give shape to your nose.  From the looks of your early post-operative photos, it looks like they did just that.  Congratulations on a nice result after rhinoplasty!


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Thanks for the great question and the photos! Grafts (or pieces of your own cartilage, usually from your septum or ear) are commonly used in rhinoplasty surgery to provide support. Think of them as the beams in a house which are able to support the weight of the roof. The in-fracutre was likely to narrow the width of your nose. Depending on where the tip graft (piece of cartilage) was placed, this is likely providing a little more projection to the end of your nose. The columella strut goes underneath the skin in between your nostrils. This is very important for holding the tip of the nose up and preventing it from falling down again! Spreader grafts are placed along the dorsum (bridge) of your nose to prevent you from getting an inverted V deformity or saddle nose deformity, they also help to create those nose smooth lines on the bridge of your nose and correct any asymmetries. You will be swollen for 6 months-1 year after surgery so be patient. These grafts are very common and overall is looks like your surgeon did a very good job! I hope this helps!

~Dr. Sieber

Grafts in Rhinoplasty

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Thanks for your question. Generally speaking many nasal surgeons use cartilage grafts in order to change the shape of the nose while maintaining or even improving the strength and structure of an area. An analogy that I often use is to think of the nose as a tent. The bones and cartilage are the tent poles, and the flash and skin are the canvas of the tent. In order to change the shape of the nose and maintain proper support you need to essentially rearrange the tent poles. The cartilage grafts are essentially mini tent poles that are placed under the canvas to change shape and add support. In my opinion grafting is a far superior technique to older more reductive rhinoplasty techniques that basically just "chopped" off the tent poles to make the nose smaller, but did nothing to address the loss of support. In short, cartilage grafts are often used to make even subtle changes to the nose in a safe predictable manner. In my opinion your surgeon did so, with excellent result.  Hope this helps. 

Julian W. Dixon, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

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