Straighten septum without spreader grafts? (Photo)

Question

I need a septoplasty which will be combined with revision rhinoplasty. My first surgery was to narrow a very wide bridge. The surgeon stated that my nose was crooked before surgery but no work was done on my septum. I've heard that spreader grafts used for septoplasty will make the nasal bridge wider. This is unacceptable for me because A: I already paid money to get a narrower nose and B: Even after surgery my nose is still on the wider side. I don't want to be back where I started.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have a wide and slightly crooked nasal bridge appearance. You're correct that spreader grafts may lead to a wider nasal appearance. Consider consulting with another reputable rhinoplasty specialist who offers computer imaging. Also consider procuring a copy of your operative report for a consultation. Hope this helps you! Dr Joseph

Ronald J. Edelson, MD · Answer

I think your result is pretty good and don’t see the need for spreader grafts. I think spreader grafts are overused and over rated. I’ve seen enough cases where surface grafts were used and the nose was still crooked.  I don’t see their value in your case.

Robert Ciardullo, MD · Answer

Can the airway be improved without spreader grafts? The answer depends on where the obstruction is. In some cases the airway can be improved by removing a portion of the deviated septum which is obstructing the airway without the addition of spread or grafts. The bony portion of the bridge can often be narrowed without affecting the airway since it is above the airway. It is the mid portion of the nose that in some cases needs to be widened to open the internal valve. But if this area is not obstructed and the obstruction is lower down in the nose, significant improvement can often be obtained by doing a submucous resection of the deviated portion of Cartilage and sometimes bone, without adding spreader grafts if the patient feels as you do. I have often obtain significant airway improvement doing a Submucous resection and /or septoplasty without the addition of spreader grafts.

Straighten septum without spreader grafts? (Photo)

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