Can spreader grafts actually obstruct breathing in rhinoplasty?

Question

Can't spreader grafts block airflow in the same way fallen upper lateral cartilage does, if they are cut too thick or put in the wrong place? What if nasal valve collapse emerges after a hump removal, indicating the problem is not narrowness, but loss of support/height? #spreader grafts #breathing #obstruction #rhinoplasty #upper lateral cartilage

Steven M. Denenberg, MD · Answer

I'm one of the heretics who doesn't think that spreader grafts are nearly as good for breathing as they are made out to be. The spreaders that most surgeon put in are thin, so they can't do all that much, even if they work perfectly like it says in the textbooks. If you put in spreaders that are thick enough to really do the job, the nose might look goofy because it's so wide in that middle vault.Then, scar tissue can form next to the spreaders, on the inside of the nose, clogging things up more.The jury is out, but your statement is reasonable.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Difficulty breathing can occur following hump reduction as this narrows an area called the internal nasal valve; spreader grafts are actually placed to widen your internal nasal valve; the thicker the graft, the more open your nasal valves become; you really need an examination to diagnose your concern; you may have a deviated septum, enlarged turbinates, or even scar tissue that is making it difficult to breathe.

Richard W. Fleming, MD (retired) · Answer

Can spreader grafts cause breathing obstruction after rhinoplasty? Properly placed spreader grafts will not cause breathing obstruction after a rhinoplasty. In fact they are frequently used to support the internal valve after removal of a large hump or to open the airway in patients who have an inherited obstruction in this area.

Michael Elam, MD (retired) · Answer

Dear greyghost, I am not a big proponent on the need of spreader grafts in a primary rhinoplasty. I perform multiple rhinoplasty procedures weekly and and have for over twenty five years and I do not need to use spreader grafts for excellent results both functionally and aesthetically speaking. I am sure you will have multiple opinions here but based on my expertise and vast experience I find them unnecessary. Best regards, Michael V. Elam, M.D.

Can spreader grafts actually obstruct breathing in rhinoplasty?

Answers (4)

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