Auto-spreader technique Vs. 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.

Hello,This is a highly technical question, and you have the right to know, but when a patient starts to micromanage their upcoming surgery, their lack of real surgical experience and understanding can get in the way of making good decisions.Auto spreader grafts are the ideal graft if it can be done; it avoids having to harvest cartilage from another location. There needs to be enough cartilage to 'turnover' and re-attach to the septum to make it worth while, though. I find that I am wanting a thicker, more robust graft frequently, so I turn to septal cartilage.  Harvesting septal cartilage usually does not cause extra trauma, effort, or time, because the septum is frequently deviated and submucous dissection and cartilage removal needs to be performed to straighten the septum anyway. Best of luck!

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.