Can spreader grafts be used to raise a nasal bridge, without making it wider?

Question

I have valve collapse and a flat nasal bridge after a poor surgery. Can spreader grafts be used to raised the dorsum/add aesthetically pleasing height to a flat, wide bridge, instead of just adding width to the nose? #valve collapse #spreader graft #inverted-v #bridge

Jason Roth, MBBS, FRACS · Answer

Spreader grafts add great stability to the mid-third of the nose and in doing so can help suspend the upper lateral cartilages to their appropriate height. These are however fairly subtle improvements in the actual height of the dorsum. Usually after a strong support has been created through spreader grafts some type of onlay graft is then used to add further height. This is usually stitched over the top of the spreader grafts. There are many options for harvesting the material needed for these grafts - nasal septum, ear or rib are the commonest.

Andrew Miller, MD · Answer

If you truly have valve collapse, then spreader grafts are placed to improve the situation. This usually corrects a concavity and the resulting slight increase in wideness usually makes the nose appear more symmetric. If the bridge is flat, then an additional graft may be needed to raise the dorsum back up. Be sure to see someone experienced in revision rhinoplasty surgery for consultation.

Adam J. Oppenheimer, MD, FACS · Answer

Spreader grafts widen the nose, but don't add to build up the dorsum, per se. The purpose of a spreader graft is to open up the nasal airway. To augment to dorsum, onlay grafting is required, meaning adding cartilage to the top of the nose. Sometimes you can borrow from the ear or even the rib to do this.

Toby Mayer, MD · Answer

The height of your nasal bridge can be raised with Cartilage grafts takes  from your septum or ear. Spreader graphs are used for the valves on the middle side parts of the nose. See a very experienced rhinoplasty revision surgeon who does natural looking noses and look at his before and after revision work.

William Portuese, MD · Answer

Spreader grafts are placed underneath the upper lateral cartilage to widen the mid vault of the nose. A  onlay graft is performed  to add height to the bridge. For more information and diagrams, please see link below

Michael Suzman, MD · Answer

Spreader grafts are small strips of cartilage that are placed along side the septum in the middle portion of the nose to widen the area. They will not increase the height of the nose thoughThe spreader grafts can do a few important things--  help air flow in the narrow nose, create symmetry and ideal "aesthetic lines" on the front view of the nose, and also ease the transition form the bones of the upper nose to the middle part of the noseTo raise the height of a nose that has been indented or changed from injury or surgery typically requires placing some material on top of the septum in the middle part of the nose.  This graft can be cartilage, fascia, or even a slid silicone implant.  Severely depressed noses can be treated with bone. Minorly depressed areas can be treated in the office with injectable fillersMeeting with an experienced plastic surgeon is the only way to learn which is best for you

Aaron Stone, MD · Answer

The spreader grafts are placed between the septal cartilage in the midline and the lateral triangle shaped cartilages on the outer walls in the middle third of the bridge. Therefore they always widen the bridge. They can also be used to raise the bridge forward and accentuate the aesthetic line that runs from the inner eyebrow down to the tip of the nose if they are aligned so they protrude a couple of millimeters forward of the forward edge of the septum when the skin/fat layer is not too thick. But if you need true raising of a flat bridge a graft placed on top of the forward edge of the septal cartilage is a better option.

Steven Wallach, MD · Answer

Spreader grafts are used to reduce middle vault collapse. They do widen the  mid vault a bit in the process.

Elbert T. Cheng, MD · Answer

Hello,That's a great question.  In general, when I place spreader grafts, I place them flush to the cartilage and bone.  If I want to raise the dorsum of the nose, we have to obtain bone, cartilage, soft tissue, or use a gortex/silastic implant to place on top.  Great question!   Best of luck to you.

Richard W. Fleming, MD (retired) · Answer

Spreader grafts are used to open a collapsed internal nasal valve, improve breathing, and possibly increase the width of the mid-portion of the nose but only if that is necessary. Cartilage, other than spreader grafts can be placed to augment the flat nasal bridge. I need to see pictures before making specific suggestions.

Can spreader grafts be used to raise a nasal bridge, without making it wider?

Answers (10)

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