[2004.11.11] The Role of Septal Spreader Grafts for Short Nose Rhinoplasty

Date: November 11, 2004
Conference: 57th Academic Meeting of the Korean Society of Plastic and Reconstructive Surgeons (2004 Fall Conference)
Venue: Walkerhill Hotel, Seoul

Presenter: Dr. Myung Ju Lee MD PhD

Title

The Role of Extended Septal Spreader Grafts in the Correction of the Short Nose

Objective

Maintaining proper nasal length—determined by its osteocartilaginous framework—is essential for achieving an aesthetically pleasing, harmonious nose. Clinically, it is not uncommon to encounter cases where the nose is congenitally short or has become shortened due to trauma or multiple previous procedures. However, correcting a short nose can be challenging. The authors posit that effectively lengthening a short nose requires increasing the supporting framework in the space between the upper lateral cartilages and the lower lateral cartilages. Since the septal cartilage is integral to maintaining this continuity, the authors tested an “extended spreader graft” technique to elongate the septum and examined its efficacy.

Methods

Between March 1998 and September 2004, the authors applied an extended spreader graft technique in 54 patients with a short nose. Unlike a standard spreader graft, this graft was extended to project beyond the caudal end of the septal cartilage. Depending on how the extended graft was connected:

• Posterior Supporting Method
• Tongue-in-Groove Method
  • Merging the caudal portion of the graft with a columellar strut graft

The authors reviewed patient charts, surgical records, and photographs for 2–12 months postoperatively.

Results

By extending the septum, the position of the lower lateral cartilages changed, allowing for better control of the tip’s caudal rotation and improving tip projection. The extended graft also helped correct asymmetric nasal tips. Most cases yielded satisfactory outcomes; however, two patients developed asymmetry or deviation requiring revision. Materials used for grafting were septal cartilage (25 cases), vomer-ethmoid bone (11 cases), and rib cartilage (18 cases).

Conclusion

The extended spreader graft—an elongated form of septal cartilage—occupies the space between the upper and lower lateral cartilages, effectively lengthening the nasal framework. By providing bilateral support to the lower lateral cartilages, it allows for improved tip rotation, projection, and midline alignment of a previously displaced nasal tip. The authors propose this as a valuable technique for short-nose correction.