Rhinoplasty - Spreader graft

Considerations

• • Indications 

    • Reconstructing the internal nasal valve

    • Reconstruct the mid-vault 

    • Re-contour the dorsum 

  • Key anatomy and physiology

    • The nasal valve 

    • Nasal mid-vault and dorsum 

  • Graft material, shape, and dimensions 

    • Typically harvested from a straight portion of septal cartilage 

    • Rectangular shape [think 2-5-25]

      • 1-3 mm in thickness

      • 4-6 mm in width

      • 20-35 mm in length

  • Dimensions depend on the individual's nasal anatomy

    • Occasionally, longer, broader, or even double-thickness grafts are indicated

• Surgical approach

  • • Both endonasal ("closed") and external ("open") are possible 

• Variations

• • Auto-spreader

  • etc. 

• 2004: Endonasal Spreader Graft Placement as Treatment for Internal Nasal Valve Insufficiency

• 2008: The Effect of Spreader Grafts on Nasal Dorsal Width in Patients With Nasal Valve Insufficiency

• 2012: The value of spreader grafts in rhinoplasty: a critical review

Preparation

Procedure

Post-op

High-Yield

Links

• eMedicine: Spreader Grafts Rhinoplasty

• Rhinoplasty Archives: Featured Techniques – Spreader Grafts

• YouTube: (11:22) Dr. Pearlman teaching and placing spreaders

• YouTube: (4:22) Endonasal Rhinoplasty Technique: Securing Spreader Grafts With Barbed Suture

• YouTube: (9:18) Dr. Nassif placing spreaders