Spreader graft question
Doctor Answers 10
It is not true that 'it makes no difference' whether spreader grafts are placed via an open or close procedure. Virtually everyone who places spreader through a closed procedure does so without suture fixation. I adhere to the philosophy of a thoughtful surgeon who just retired, John Tebbits. He believed and wrote in his book that rhinoplasty is too difficult to perform consistently and successfully without every possible advantage the surgeon could use. Open rhinoplasty affords that advantage, so that accurate and secure placement of grafts can be made, every time.
Best of luck!
Spreader grafts and grafts in general for rhinoplasty can be confusing
thank you for the question
- the type of approach (open or closed) doesnt influence whether a graft is used;
- spreader grafts and others are commonly used in closed or open rhinoplasty
- consider the goals that you are seeking and balance those with what your surgeon says is possible- then the graft choices and surgical procedure can be tailored to you by your surgeon.
- basically, a spreader graft is a cartilage taken from your septum, ear, or rib that is shaped and placed between the septum of your nose and the shield like cartilage called the upper lateral cartilages.
- They can have both functional and aesthetic uses.
Best Wishes and of course discuss with your surgeon in a face to face meeting.
Everything you've ever wanted to know about Spreader Grafts
So spreader grafts are small pieces of cartilage (usually taken from the septum during septoplasty - when fixing the breathing) and stitched in place in the INTERNAL NASAL VALVE area of the nose. They help increase the angle of the internal nasal valve, thereby increasing airflow in this region.
Spreader grafts can be placed by the open or the closed approach. It is very simple and straightforward to place these with the closed approach and it is NOT necessary to do open rhinoplasty just to place spreader grafts.
Spreader grafts are placed if the valve area is weak causing breathing issues, or if the valve area is weak and causes a cosmetic pinch of the mid-third of the nose (which can naturally occur before surgery or can occur during the surgery after the hump/bump is taken down on the dorsum of the nose - at which point your surgeon would likely elect to place spreaders to help prevent a mid-third pinch).
All the best!
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Spreader graft placement during rhinoplasty
Spreader grafts can be placed via open or closed rhinoplasty approaches. I find that the open approach allows for more precise placement of spreader grafts and allows for better suture fixation of the grafts, but that's my personal preference. An experienced surgeon will use the approach he or she is most comfortable with and either approach--open or closed--is acceptable.
All the best,
Pearson Facial Plastic Surgery®
Use of and Placement of Spreader Grafts
Spreader grafts can be placed using the open or closed approach. Experienced surgeons do not elect to use the open approach just because spreader grafts will be used.
Spreader graft placement with closed rhinoplasty
In our practice, it is common to perform spreader graft placement with Closed rhinoplasty. Spreader grafts are placed for patients who have a concave upper lateral cartilage, or who have a very weak upper lateral cartilages after the dorsal hump removal to prevent a collapse in that area. Spreader grafts can be placed through either an open or closed approach. For more information in many before-and-after examples of spreader grafts, please see the link and the video below
Spreader grafts can be placed through the open approach, but endonasal spreaders can also be placed. The placement is slightly different through the closed approach, but have the same effect. An experience surgeon will do what is most appropriate for each situation.
Spreader grafts are used to stabalize the middle vault and the prevent collapse of the internal valve. This is often needed in a hump removal, or anytime a patient has a narrow valve. Many surgeons place them in every case where the upper lateral cartilages are displaced to prevent collapse of the valve in future years.
Best of luck
Use of spreader grafts.
Spreader grafts can be inserted during either a closed or open rhinoplasty and are felt to be necessary when a dorsal hump is reduced or in patients who have inspiratory collapse and nasal obstruction before surgery. We use them either prophylactically to prevent obstruction while narrowing the nose or to treat narrow "internal nasal valves." Thanks for your question. It's a little technical but a good one.
Jon A Perlman MD FACS
Certified, American Board of Plastic Surgery
Extreme Makeover Surgeon ABC TV
Best of Los Angeles Award 2015, 2016
Beverly Hills, Ca
Spreader grafts--open or closed rhinoplasty?
Spreader grafts--open or closed rhinoplasty? It makes no difference to an experienced rhinoplasty surgeon which approach. Choose a rhinoplasty surgeon who does natural noses with either technique.
Spreader graft question
Spreader grafts can be placed through either a closed or open approach in the appropriate patient. A natural appearing nose can be achieved with either technique when the procedures are performed by an artistic plastic surgeon with extensive experience in nasal surgery.
Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do and how to do it without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic surgeon (Otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California