Are extended spreader grafts needed to lengthen the nose? Or can this be done with a septal extension graft only?

I want my nose lengthened but I do not want it to be wider. Can I have a septal extension graft only? Or do I need spreader grafts?

Doctor Answers 9

Grafts for Nasal Lenthening

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Although many types of grafts have been described for nasal lengthening, caudal extension grafts and extended spreader grafts are very effective and used most frequently by surgeons that perform open rhinoplasty. The caudal extension graft is best secured with extended spreader grafts, so in my practice when a caudal extension graft is necessary, extended spreaders are also used. The opposite is not always true however, and a caudal extension graft is not always used when extended spreaders are used. Confused? That's ok, because these are details that a patient doesn't need to know. Best of luck!

Surgical techniques to lengthen a nose

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Hi there, very good question. The septal extension graft is placed at the end of the septum to lengthen the septum. The tricky part about using a septal extension graft is securing it at the correct position in a manner that will be stable for many years. Sometimes the spreader grafts are used to help stabilize the septal extension graft. Other ways to stabilize the extension graft can be used but often it might require overlapping the septum with the extension graft (which means the extension graft might tilt). The spreader grafts can be placed in a way that they do not add extra width. Other surgical techniques are available to stabilize the graft (like PDS plate). My recommendation is that you discuss your concerns with your rhinoplasty surgeon so that your results meet your expectations. Hope this helps!

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Lengthening My Nose

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Septal extension grafts can be used to lengthen the nose. Spreader grafts are not necessary. As I've said many times  a patient should make it very clear to their surgeon what they want to achieve but when they start selecting techniques they're asking for problems. Pick the surgeon, not the technique.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Procedures to lengthen the nose

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Rather than micromanage the conduct of your surgery (i.e. what grafts are placed and where), you may be better off finding an experienced plastic surgeon with a great reputation who has dealt with your problem many times before.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews


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Hello and thank you for your question. The best advice you can receive is from an in-person consultation.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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

Lengthening the nose

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It is a common myth that spreader grafts will always "widen the nose", let me just say that to start.  Every patient is different, and in some cases a "septal extension graft" alone is all that is needed, where as in other cases it is flanked by thinned, bilateral extended spreader grafts.  Truth is, more often than not, extended spreaders are placed to provide symmetry while anchoring a septal extension graft.  The nose is also narrowed with osteotomies - therefore, there is no increased width.  Again, that is a gross oversimplification of a complicated and artistic surgery, but I hope my point is coming across.  The best way to know what you would be a candidate for is to spend some time with the surgeon during your consultation as they explain what would benefit you and why.  Remember, you are your own best advocate.  Not only should your surgeon feel comfortable with the plan, but you should as well.  Best of luck! I hope some of this helps.

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Lengthening nose

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Thank you for the question and though an examination is needed your nose can be lengthened without it being widened.  So go on some complimentary consultations and find out how after an examination

Dr Corbin

Rhinoplasty techniques: extended spreader grafts and caudal septal extension graft for lengthening

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Rhinoplasty is a surgery to improve the shape of the nose for breathing or appearance.

A rhinoplasty surgeon may employ extended spreader grafts together with caudal septal extension graft for patients who desire lengthening of the nose. The caudal septal extension graft sits at the end of your septum cartilage. The extended spreader grafts support the caudal septal extension graft and hold it in a midline position. By tapering the extended spreader grafts and setting them lower on the dorsal septum, they will not make the nose excessively wide. I recommend asking your surgeon about this advanced technique. Safety comes first. 

Septal extension graft

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You do not necessarily need spreader grafts to lengthen the nose, although some overlap between the extension graft and the septum does occur resulting in slight "spreading" of the septum.  It should not be aesthetically displeasing.  

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.