Can I Have a Spreader Graft Removed After a Revision Rhinoplasty? My Breathing is Worse.

Question

Two years ago I had a revision rhinoplasty which included a spreader graft, but it made my breathing worse. Instea

Donald B. Yoo, MD, FACS · Answer

A spreader graft can definitely be removed during revision rhinoplasty, but it may not be to blame for your worsened breathing. A useful way to evaluate your nasal valve area would be to look at your dynamic inspiration (breathing in and out) with an endoscope (small camera). This provides a very clear view of the area where the spreader graft is (nasal valve), and would be useful to determine whether it really is at fault.

John M. Hilinski, MD · Answer

The answer is - yes - spreader grafts can be removed if necessary. The real question is whether or not it is truly necessary to remove the previously placed spreader graft. You will need to seek consultation with an experienced revision specialist to be more certain.

William Portuese, MD · Answer

Spreader grafts when placed in the appropriate position are supposed to improve airflow dynamics through the nose and not make them worse. When done for cosmetic purposes they can also give a visual improvement to the external midthird of the nose. Removing a spreader graft is quite difficult due to the amount of scar tissue formation that is present circumferentially around the graft. There is usually no reason to remove the graft unless it is displaced and creating obstructional or cosmetic issues.

Mario J. Imola, MD, DDS · Answer

Spreader grafts are designed to open the internal nasal valve.  If incorrectly positioned, however, they can result in worsening of the airflow.  A careful internal nasal examination will help determine the true cause of your nasal obstruction at present. 

	Mario J. Imola, MD, DDS, FRCSC.

Jon F. Harrell, DO, FACS · Answer

Of course the grafts can be removed but they perhaps only need to be modified. There are other anatomical issues that could cause this problem but a detailed examination and review of your operative note would be essential in determining just what approach would suit you best. Best of Luck Dr Harrell

Steven Wallach, MD · Answer

Without having more details, it is difficult to say why you have worse breathing. Removing a spreader graft may make it worse.

Moneer Jaibaji, MD · Answer

It is difficult to give you a precise answer without full history and examination. Online consultation can be misleading and it may not be in your best interest to give you a yes or no answer. Revision rhinoplasty procedures need to addressed by surgeons who have experience in the subject and after detailed evaluation.

Stuart H. Bentkover, MD (retired) · Answer

Any cartilage graft to a nose can be removed, but it is certainly usual to have a spreader graft decrease airflow. It is designed to do the opposite. I would suggest a careful re-examination of your airway. Perhaps it slipped down into the airway, but that is unlikely.

Jay M. Pensler, MD - Account Suspended · Answer

Removal is technically possible  The real question is ,would it be beneficial to remove the graft.There is not enough information to answer that question.

Can I Have a Spreader Graft Removed After a Revision Rhinoplasty? My Breathing is Worse.

Answers (9)

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