Auto-spreader technique Vs. Spreader grafts

Is there a difference in the outcome when using the auto-spreader technique to correct internal nasal valve collapse vs using spreader grafts harvested from cartilage? Why is it more common to use spreader grafts when the other technique doesn't require harvesting extra cartilage? Thank you

Doctor Answers 16

Autospreader grafts vs regular spreader grafts.

I have performed many autospreader grafts and even more convetional spreader grafts. Sometimes, I used both techniques at the same time.  I measured the degree of valve opening intraoperatively and observed functional and cosmetic results after surgery. This is what I concluded:
- auto spreader grafts are more powerful at internal nasal valve opening because bending the cartilage inward results in  a spring-like effect that pushes the lateral wall out
- breathing   was noticeably better and improved earlier in the postoperative period after autospreader graft use.
- some  patients, however, complained that their  noses were too wide in the midnasal area   (area of the valve) when autospreader grafts were used.
- auto spreader grafts did not close the open 
  roof following dorsal hump reduction.

Today, I mainly use conventional spreader grafts and resort to autospreader grafts in rare cases.

Los Angeles Plastic Surgeon
4.6 out of 5 stars 311 reviews

Good question

In order to do auto-spreaders, a patient needs to have very tall and clean upper lateral cartilages. This is typically not available in every patient; that makes spreaders more reliable. More over, using the septum, the surgeon can control the thickness and length of the spreaders with more ease than ULCs.

Marcelo Ghersi, MD
Miami Plastic Surgeon
5.0 out of 5 stars 150 reviews

Spreader grafts

Choose the technique that your chosen surgeon performs best as that is far more important than which technique is chosen. Certainly the harvested cartilage technique offers more flexibility and , in my personal opinion, control.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 82 reviews

Auto-spreader vs. spreader grafts in rhinoplasty

I think this is an excellent question. The problem with internal valve collapse is the outer wall approaches the midline septum on one or both sides of the nose on inhaling and occasionally in repose. The surgical answer is to place a narrow piece of cartilage between the sidewall cartilage and the midline septum cartilage hence the term spreader graft. That cartilage was classicaly obtained by harvesting the cartilage from the septum, ears or ribs. In 1992 a surgeon proposed folding that sidewall cartilage as an autograft between the midline septum cartilage and itself as an autograft. The main problem in doing so is that it lowers the cartilage portion of the bridge and may be contraindicated if you do not have a hump that is taken down at the time of surgery. Other issues are it has to be done open to get the necessary exposure and requires more dissection susceptible to button holing the mucosa in order to get it to fold. Inserting a classical spreader graft can be done closed and gives the surgeon more options as to the size and type of cartilage used.

I would not recommend choosing a surgeon based solely on which type of spreader graft they use. I am sure there are patients who could benefit equally from either approach as well as those who could benefit from one more than the other.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

The difference between auto spreader grafts and spreader grafts ?

The difference between auto spreader grafts and spreader grafts ? Both  methods have their advantages and disadvantages. Pick the surgeon who has noses that you like and don't worry about what type of spreader graphs he uses. Choose the surgeon who does noses you like the best and not the technique.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Spreader grafts

The tried and true technique is spreader grafts, to prevent or treat internal valve collapse.
It stood the test of time. Besides nothing is 100% perfect. This comes technique comes close, if executed correctly.

Dennis Barek, MD
Great Neck Plastic Surgeon
4.4 out of 5 stars 8 reviews

Auto spreader technique versus traditional spreader grafts

 Auto- spreader graft turns in a portion of the upper lateral cartilage which is very thin and doesn't offer as much augmentation when needed. A traditional spreader graft can control the ability to augment the upper lateral cartilage area and nasal valve with  improved length and width of the graft. For more information and many examples, please see the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Auto spreader vs spreader grafts

Not everyone has the height to their lateral cartilages to basically roll them over to perform autospreader grafts, but they basically provide the same function.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Auto spreaders vs traditional spreader grafts

 Both techniques have merit and can be used effectively in the right hands. The determinant of the result is not so much the technique, but the experience and judgment of the operator and the skill with which the technique is applied. Additionally, some pat may not have the right anatomy for the Auto spreaders. 

Reza Momeni, MD FACS
Summit Plastic Surgeon
5.0 out of 5 stars 44 reviews

Nasal valve Collapse and Spreader Grafts

Thanks for your question,

This is an area where I have considerable interest as I do research in nasal valve collapse. It is a complicated and controversial answer to your question. Many surgeons will swear by their technique, however in the end both have benefits and weaknesses.  I use standard spreader grafts as I feel I have more control over the amount of "spread" I can achieve. As mentioned below, you need tall lateral cartilages to do an autospreader, so in some people it is not possible. 

Regardless of the technique, they both achieve a similar result. 

Dr James Bonaparte

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.