Do Spreader Grafts Make the Nose Wider?

At two weeks post-op from a rhinoplasty, your nose will look very wide due to the swelling. I would be reassured that it is not necessarily a result of the spreader grafts. 

Spreader grafts are often a very good idea after taking a dorsal hump down in order to prevent over-narrowing and collapse down the road. They do widen the middle third of the nose by a couple of millimetre, but this area of the nose often needs a bit of extra width both from a breathing and an appearance perspective. 

I know it is hard, but try and be patient. Hopefully as the swelling goes down over the next few months, you will be happy with the way the nose looks as well as the way you breathe. 

Spreader grafts can make the nose appear slightly wider. However, much of what you are seeing is due to swelling. The swelling can influence the appearance of the nose after surgery, and will take some time to resolve. 70% of the swelling goes down after the first 3 months and the remainder goes down over time. In general, it can take 18-24 months to see the final result of surgery. I would recommend waiting a bit and see how you continue to heal. Your surgeon should be able to answer any questions you have in the meantime. I hope this helps, and I wish you the best of luck with the remainder of your recovery. 

Spreader grafts placed to improve airway. Generally they have no effect on the with of the nose. Thicker spreader grafts can increase the width.

Spreader grafts are most commonly used to improve or maintain nasal breathing, and can be used to straighten a crooked nose

They will add bulk to the middle vault of the nose and can widen the dorsum. Given this the advantage of using them must out way the disadvantages. At this early stage though the widening will be due to swelling. Time and patience is what is needed.

Jeremy Hunt

It depends on how wide to dorsum was prior to dorsal hump reduction.  Patients with a wide dorsum (bridge) will have narrower noses following dorsal hump reduction, spreader graft placement and nasal bone narrowing via osteotomies.
Those patients with a narrow midportion of the bridge preoperatively will have a wider midportion of the nose after spreader graft placement, which would be aesthetically more appropriate and better functionally.
Patients with an average dorsal width of about 7 -12mm will usually have about the same width after surgery as before surgery.  It is possible for the width of the midnasal area to be slightly wider after surgery  if the nose is significantly deviated and additional spreader grafts are needed to keep the nose straight.
It is very important to note  that even 12 months after rhinoplasty there is  still a small amount of swelling that takes years to go away. So, the nose may initially appear wider and continue to narrow during the first several years. 

At two weeks postop from a rhinoplasty you should not make any conclusions regarding the appearance of your nose.  Spreader grafts are generally pretty thin and help to open up the nasal vault.  In general, they should not widen the nose.  If the nose remained wide the nasal osteotomies could be repeated to narrow the nose.

Yes, spreader grafts can make the middle vault slightly wider. However most of what you are probably seeing is swelling from surgery. Give it time to settle down.

Dear Lilly,

Thank you for your question.  Yes, spreader grafts can make the dorsum look wider as they widen the top of the septum.  Some of the wideness at this point may also be swelling, as well as the bulbous nature of your tip.  Allow 6-12 months to determine if a revision is needed.

Best Wishes,

Pablo Prichard, MD

Spreader grafts may make the nose appear wider but this is usually very subtle. At 2 weeks most of the width that you are seeing is from swelling. It is too early to be thinking about a revision as you will probably be much happier once the swelling resolves. Be patient and if you still have concerns 9 months from now I would discuss with your surgeon a revision to narrow the nose.

Hello,

Thank you for the question.  Spreader grafts can make the nose look wider.  To address this thinner spreader grafts can be used, auto-spreader grafts can be used, or the spreader grafts can be removed.

All the best,

Dr. Remus Repta