Auto-spreader technique Vs. Spreader grafts

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.

The auto-spreader graft is more commonly performed on primary and reductive rhinoplasty where excess upper lateral cartilage may be available. In secondary or revision rhinoplasty where the upper lateral cartilage is scarred or already reduced an auto spreader graft is not possible and the septum or other donor cartilage must be used.hope that helps!

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!

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.

 Thank you for your question. Both techniques achieve similar results. However with spreader grafts, a surgeon has more control in regards to straightening out nasal septum and proving support. Also, auto-spreader graft quality is limited by the height of the upper lateral cartilage as well as patient's anatomy.  it's always best to have a thorough discussion with your board-certified plastic surgeon prior to your scheduled proceed. Best of luck.Dr. Dhaval Patel 

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

Thank you for your question.I think of all the questions i have seen on this forum, yours is really the best. When I started out, I was using spreader grafts in everyone. I have also done extensive research on spreader grafts when I was a fellow at the Cleveland Clinic in Ohio. Some of the research is published in October 2015 PRS.I then bought Dr Cerkes's video on rhinoplasty from QMP and he beautifully demonstrates how to perform an auto-spreader in the videos. Since that time, I have switched over to using auto-spreaders.I must say I find auto-spreaders much easier to perform, they save at least 30 minutes in the procedure, the cartilage on the upper lateral cartilages are thin compared to that found in the septum so you do not face the problem of creating a boxy looking nose when you use thick cartilage from the septum. Auto-speaders also give a very natural looking nasal profile. Everyone has good cartilage on the upper laterals. You just have to peel off the overlying musculature to expose it.Hope my answer helps.Ivo

This depends upon the technique preferred by your surgeon and your anatomy. Both techniques work well in properly selected patients. Good luck! I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Not every patient has enough height to the upper lateral cartilages to turn them over and use as an auto spreader graft. Harvested septal cartilage is far more versatile and usually readily available.

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.