Do spreader grafts change the shape of the nose ?

Question

Hello, I was wondering if placement of spreader grafts for an internal nasal valve repair would change the shape of the nose and how much different will it be ? Thank you.

Eric M. Joseph, MD · Answer

The internal nasal valves are located in between the upper lateral cartilages and the nasal septum. Spreader grafts are small pieces of cartilage that are placed in between the upper lateral cartilages and the nasal septum to widen the internal nasal valves. I hope this helps! Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

Spreader grafts do not change the dorsum but may change the width of the cartilage portion of the nose. If you are having problems with internal nasal valve collapse it is worth having the spreader grafts.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It depends on how the spreader grafts are placed and the desired goals of the patient. For example, spreader grafts can be placed lower on the septum to avoid widening the mid-vault when needed. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Jeffrey M. Darrow, MD · Answer

Spreader graphs, as you have already noted, are used to open up the internal valve, which may have collapsed after a previous rhinoplasty. A spreader graft is usually only approximately 2 mm thick and therefore the nasal dorsum will get slightly wider with placement of spreader graphs.  Well placed spreader graphs can improve the dorsal aesthetic lines of a nose as well as improve breathing.   Your plastic surgeon should be able to describe to you the approximate results of placing one or two spread graphs on your nasal dorsum. Best wishes.

Sean Fisher, MD · Answer

Spreader grafts can potentially lead to a wider appearance to the nose. This can be controlled, to a degree, but the thickness of the graft material used, whether spreader grafts are placed on one or both sides, and if they are placed in a recessed position. If spreader grafts are being used to address a functional problem, it is often worth the trade off of a slightly wider appearance for easier breathing. I would recommending undergoing consultation with a surgeon who has extensive experience in rhinoplasty surgery to determine the need for spreader grafts and can discuss the pros and cons with you. 
Sean M. Fisher MD

Steven Schuster, MD, FACS · Answer

While a spreader graft is a common procedure in rhinoplasty it may cause a slight alteration in the with of the nose.  If done in conjunction with a rhinoplasty it is very easy to make this a smooth transition by carefully adjusting the thickness and position of the graft.  If you have collapse of what is known as the upper lateral  cartilage this spreader graft will certainly improve your breathing and give you a nicer curve and contour to the nasal dorsum.  It is usually a minor increase in with and most people do not even notice it after it is healed.

Robert J. Chouake, MD · Answer

Hi,Spreader grafts will usually make the middle third of the nose slightly wider, typically just by a few millimeters. However, the larger the graft, the more noticeable the change in the shape of the nose. They are used to improve breathing in cases of internal valve collapse or to even out asymmetries in the mid-vault during cosmetic rhinoplasty.

Thomas Spalla, MD · Answer

In short, yes, spreader grafts add some width to the middle third of the nose. The change is, generally, fairly small, but could be noticeably different in a very narrow and delicate nose with thin overlying skin.
They are a very common technique used in internal nasal valve reconstruction in both male and female patients. Discuss your concerns with your surgeon to see if they are optimal for your individual needs.

Mats Hagstrom, MD (license on probation) · Answer

There’s no yes or no answer to your question.
A lot depends on how the grafts are placed and what is being done in conjunction.
It also depends on how bad the collapses.
Overall, the procedure usually entails reshaping the nose to some extent, so the surgery is often intended to improve the aesthetic look and correct the mechanical breathing obstruction.
It is very dependent on a case by case basis and who does the procedure.
Best,
Mats Hagstrom MD

Do spreader grafts change the shape of the nose ?

Answers (9)

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