I Want to Get my Dorsal Hump Removed. Advice on Spreader Grafts? (photo)

As you can see I want a full rhinoplasty to remove my hump, straighten the bridge and a little tip work. I've seen 2 plastic surgeons ,because we only have 2 in my town, with good reputations. One said that I will need spreader grafts because my nose is already so thin and narrow. Plus he said it would protect me from something collapsing ( I forgot what exactly ) that could cause airway problems. Advice? I'm scared because I don't want my nose to wide, but also don't want a Michael Jackson nose

Doctor Answers 11

Use of spreader grafts in rhinoplasty

A spreader graft would be an excellent idea for the concaved side of the nose where it is pushed in and crooked.  Occasionally a very thin spreader graft can be placed on the opposing side if needed.  Spreader grafts are placed in thin mid vault noses that prevent the upper lateral cartilages from falling inward.  We have performed in excess of over 1,000 spreader grafts in our extensive rhinoplasty practice and it is an excellent technique to give both functional and cosmetic improvement to the nose.  Many times spreader grafts are placed on one side.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Multifaceted Rhinoplasty


Based on your photos, it seems that you could benefit the most from removing your nasal bump, de-project your nasal tip and straighten your nasal septum without the need to consider the spreader grafts.

However, it is not possible to provide you with a definitive advise without examination especially that your nose seems to be delicate and so the rhinoplasty has to be based on a conservative approach.

That being said please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of corrective surgeries dramatically.

I hope this helps.
Thank you for your inquiry.
The best of luck to you.
Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 197 reviews


Spreader Grafts and Dorsal Hump reduction may or may not be related.  The "spreaders" will widen your mid-nose, but hump removal may be the real key to your specific needs.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

I Want to Get my Dorsal Hump Removed. Advice on Spreader Grafts?

 I have performed Rhinoplasty and Revision Rhinoplasty for 25 years and aesthetically speaking, a Rhinoplasty can reduce the dorsal hump in the nose but I have not found it necessary, nor do I like using spreader grafts for the past 20 years.  The integrity, of the internal nasal valve can be protected without them and spreader grafts add volume to the lower nose and tip.  If you want a preview of how wide, spreader grafts, will make your nasal tip...take two q-tips and gently place them inside the nose at the outside of the nasal tip.  IMHO, this would not aesthetically improve the shape of your nasal tip.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

You may not require spreader grafts after hump removal and rhinoplasty surgery.

I read your concerns and reviewed your photos: You appear to have thin skin, an overprojected and underrotated tip, a hanging columella, and a dorsal hump. These issues may be improved with well-performed rhinoplasty surgery, but your thin skin may be unforgiving and reveal cartilage or bony irregularities, should they occur during nose job surgery.

I personally do not routinely use prophylactic spreader grafts in my patients with thin skin and dorsal humps, and mid-nasal collapse has not been an issue in my practice. If one of your upper lateral cartilages looks collapsed after hump removal, your surgeon may see this and elect to place a spreader graft during your operation. In my opinion, bilateral spreader grafts would make the mid-third of your nose a bit wider, and this may not be necessary depending on what your surgeon encounters.

Hope this is helpful, and good luck with your surgery.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 421 reviews

I Want to Get my Dorsal Hump Removed. Advice on Spreader Grafts? (photo)

This is a great question. In the right hands you should have a beautiful result and end up with a nose that complements you so well. There are two grafts that I have never regretted placing during a Rhinoplasty surgery, and spreader grafts are one of them. My rule is when I am shaving down a bump on the top of the nose more than about 3 mm I place spreader grafts to support what we call the internal valve of the nose. That valve can be weakened by shaving the bump down more than about 3mm and thus weaken your breathing. Spreader grafts hold that valve open. The grafts are not very wide and are all internally placed. It can slightly widen the nose, but you should not ever notice it. I have never had a patient complain of this. I use them all the time and if you have a well trained surgeon performing this procedure then if he/she suggests using these grafts I would proceed with having them placed without reservation.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Dorsal hump and spreader grafts

Keep in mind that the spreader grafts are dealing with the inside part of your nose that is narrow...not the outside visible part and will help your breathing...with your anatomy, you should have an excellent result with an experienced surgeon.

Leonard T. Yu, MD
Maui Plastic Surgeon
4.3 out of 5 stars 27 reviews

Spreader graft placement after hump removal

It is quite common to place propylactic spreader grafts after dorsal hump removal. This is done to prevent delayed collapse of the cartilage of the middle third of the nose where the overlying skin shrink wraps around the upper lateral cartilages.

Spreader grafts shouldn't ultimately make your bridge too wide as they are quite thin pieces of cartilage.

Check out my link below that discusses the problem of delayed nose collapse after hump removal in more detail.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Facial asymmetry and rhinoplasty

Spreader grafts may or may not be necessary. Your surgeon will determine that. One thing you will have be aware of is facial asymmetry that is present in everyone. In your case, if you look carefully at your nose, the lower part is set slightly to the left and upper portion of your nose to the right. By drawing a line up from the side of nostrils, you will see this better. This results in the nose looking slightly deviated and will become more obvious after rhinoplasty as your nose become more refine.  

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 reviews

Spreader Grafts Routinely Used in Rhinoplasty

Spreader grafts are routinely used in rhinoplasty to prevent what's called the inverted-V deformity (appearance) as well as helping with the nasal valve (function). If placed properly, there shouldn't be excess width associated with it's placement. Spreader grafts can also help stabilize the dorsum (bridge) of your nose which will have to be destabilized to some degree in order to make your nose straighter (go from your left to more in the middle). I hope that helps and good luck.

Michael Kim, MD

portland, or

Michael M. Kim, MD
Portland Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.