Is it a necessity to add spreader grafts to the nose when performing osteotomies? Why or why not?

Hello! Spreader grafts are placed below the nasal bones and typically above the tip so they make the area BETWEEN the bones and tip appear wider, although the effect can be slight depending on the width of the graft. They are used to prevent the sidewalls from caving in over time and causing nasal obstruction and cosmetic deformities, and are often used when large humps on the nose are reduced. They are not always needed when nasal bones are broken but every nose is different. Good luck!

There are a number of reasons why spreader grafts might be needed during rhinoplasty. Simply having osteotomies doesn't necessarily mean they are required.Generally speaking spreader grafts are used to support the middle third of the nose and provide correction for a crooked nose or a narrow internal nasal valve (which can cause airway obstruction).Osteotomies are often done to help close an "open roof" leftover from reducing a large hump. In these cases spreader grafts are often very useful.  The grafts can be carved specifically to minimize the widening effect if needed. Obviously, the reason for using them is dependent on your individual anatomy and indication so be sure to discuss this with your surgeon. Good luck!