Are spreader grafts necessary? (Photos)

My current nose is wide, asymmetrical, and has a bulbous tip. I am looking to achieve a natural refinement while also a much thinner nose. I am worried, however, that the use of spreader grafts will make my bridge appear symmetrical yet boxy. What are your opinions on spreader grafts? And am I able to achieve my desired result without them? Thank you!

Doctor Answers 11

A video about spreader grafts

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I must admit it is a bit difficult to see the photos. I've attached a video about spreader grafts and the indications for using them. I hope you find this useful.

Latham Facial Plastic Surgeon

Spreader grafts and nasal width #plasticsurgery

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Spreader grafts are placed to increase airflow and space within your internal nasal valves - they have a secondary use to increase nasal width and change the shape of the dorsum of the nose. 


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Dear kkb123, I disagree with the majority of the surgeons below regarding the need for spreader grafts with rhinoplasty surgery. Personally, I rarely find them necessary to have excellent rhinoplasty results both in aesthetics and in function. Spreader grafts in my opinion are more of a personal choice of some surgeons depending on the techniques that they use. Seek some consultations with experts in the field of rhinoplasty, surgery, and have imaging performed to see the proposed results to make sure you and your surgeon are on the same page. Once the desired result is agreed upon the surgeon will discuss in length with you what exact techniques will be required to attain the desired nose. Review the surgeons before and after photographs to ensure natural looking rhinoplasty results and then make an informed decision. See the link below for examples of rhinoplasty before and afters and the video above of the imaging process. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Spreader Grafts

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Hello, spreader grafts may or may not be needed based on a physical examination.  Although the resolution is low, your photos seem to indicate wide nasal bones primarily as the culprit for your wide appearing nose. Too many patients are trying to become their own surgeons thanks to the internet, thinking they are 'doing their homework', however it doesn't really serve them well.  Go see a few specialists and let them tell you what you need and why you need it.  In the end it is our job to make you happy, whether that includes spreader grafts or not. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Are spreader grafts necessary?

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It is really not possible to give a responsible answer without and internal and external examine. Chose an experienced surgeon whose results you like. Computer imaging is often very useful in helping communicate goals.

Curtis Perry, MD
Downey Facial Plastic Surgeon
4.8 out of 5 stars 19 reviews

Spreader grafts

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Thank you for your photos. Spreader grafts are used by many surgeons for a variety of reasons from opening up your airway to improve breathing to readjusting the lines of your nose so they appear straight and defined. It is possible to shape your spreader grafts so that they do not contribute significantly to the width of your nose. Other techniques such as narrowing your nasal bones can also help refine your nose together with spreader grafts. It is important to visit an office for an in-person examination to determine what is necessary both functionally and cosmetically for your nose. You want a nose that appears natural, beautiful, but still works! Hope this helps!
Johnson C. Lee MD, Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 17 reviews

Spread grafts are great!...if placed properly

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Thank you for the photos and the great question. The concerns you're having about spreader grafts are totally valid. Some rhinoplasty surgeons do not place them properly and this can definitely lead to a wider appearing dorsum. However, they are very important when used properly. They are able to prevent collapse of your mid vault so you don't end up with a saddle nose deformity. They are also able to make your dorsum straighter and more symmetrical. If you're seeing a surgeon who says they are going to use them, ask to see pre and post op photos of their patients to see if the grafts did widen the dorsum. If so, maybe go see someone for a second opinion. I hope this helps and best of luck to you!~Dr. Sieber

David A. Sieber, MD
San Francisco General Surgeon
5.0 out of 5 stars 40 reviews

Spreader grafts?

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an examination is needed to see how thick your skin is etc. Choose an experienced rhinoplasty surgeon who does natural noses and you won't have to worry about these issues. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Rhinoplasty candidate for spreader grafts

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Spreader grafts are very commonly used today to prevent the upper lateral cartilages from falling inward. The thickness of the grafts can be adjusted to be thin or thick.  Not every patient is a candidate for spreader grafts, especially when trying to narrow a wide nose. To determine being a candidate for spreader graft placement requires a thorough examination of the nose.  For more information in many examples, please see the length and the video below 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Are spreader grafts necessary?

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If the appearance of your nose concerns you, it can be improved with an artistically performed rhinoplasty. What would be the best option and exact procedure would depend on an examination and discussion about desired outcome. Spreader grafts are worthwhile in the appropriate patient, but not in every rhinoplasty.
Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon(otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, M.D., FACS
La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 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.