Can my dorsum be fixed with spreader graft to widen it? (photo)

Spreader grafts may reduce the subtle defect that you see in the lateral dorsum on both sides. This technique can be tailored for functional and cosmetic reasons in my practice.

your photos are helpful.

i agree wit the comment about the inverted v deformity.  in you case it is somwhat subtle but is present.  you have asymetric and irregular dorsal aesthetic lines that coincide wit the sidewall irregularities.  furthermore you still have some midvault deflection/deviation.

with that said, if you were one of my patients i would inform you that a revision in reasonable, spreader grafts would definitely be part of the plan, and you have a high likelyhood of needing costal (rib) cartilage grafts used in the case given that you stated that you had a septo-rhino in the past.

good luck and dont forget that austin, tx has a major airport. i see patietns from out of state frequently for nasal surgery.  would love to help you with your desires for improvement.

The computer simulation you posted actually looks like a reasonable, achievable revision rhinoplasty result.  Spreader grafts can be used to widen the middle vault, but only up to the transition between cartilage and nasal bones.  The lateral walls of your nasal bones can certainly be made wider with a variety of possible onlay grafts.  An alar batten graft would improve the concavity you dislike of your left lower lateral cartilage.