[email protected]
+82-10-5059-6626 (WhatsApp)
VIPPS Instagram facebook icon Realself icon YouTube Icon Plastic surgery blog icon Pinterest icon VIPPS Linkedin

Contact Us

 [email protected]
+82-10-5059-6626 (WhatsApp)

Academic Activity

[2005.03.26] New Wedge-Shaped Spreader Graft for Nasal Septum

VIP Logo

[2005.03.26] New Wedge-Shaped Spreader Graft for Nasal Septum

view79 Comment0
 

A New Wedge-Shaped Spreader Graft for Correcting Curvature at the Osteocartilaginous (Key-Stone) Junction of the Nasal Septum

Author: Dr. Myung Ju Lee MD PhD, VIP Plastic Surgery Clinic


Objective

The nasal septum is composed of bone (ethmoid, vomer) in its upper portion and cartilage in its lower portion. When a septal deviation occurs at the osteocartilaginous junction (often referred to as the “key-stone area”), it cannot be corrected with conventional methods such as SMR (Submucosal Resection), the swing-door technique, or standard spreader grafts. Moreover, because the key-stone area plays a crucial role in maintaining the external nasal framework, separating the bone-cartilage junction poses significant risks. As a result, there has previously been no straightforward method to correct deformities in this region without detaching this junction. The author devised a new approach, a “wedge-spreader graft,” to correct key-stone area deviations safely—without separating the bony-cartilaginous connection—and aims to validate its effectiveness.


Materials and Methods

From January to February 2005, 18 patients who underwent rhinoplasty and were diagnosed with septal deviation at the key-stone area were selected. The author reviewed their medical charts, surgical records, and pre- and postoperative photographs.


Technique

  1. Exposure and Preparation

    • After separating the upper lateral cartilages from the dorsal septum, a fine osteotome is used on the concave side to create a paramedian space of about 3–7 mm into the bone.
  2. Graft Placement

    • A single spreader graft is inserted from the newly created bony space above the key-stone area down to the lower portion of the septal cartilage.
    • Instead of using conventional cartilage grafts, the author employs a bony septum graft (either ethmoid or vomer), which is then secured to the septum with 4–0 PDS sutures.

Results

Because the wedge-spreader graft extends above the key-stone area and involves rigid bony structures (like the bony septum), there were instances where additional fixation was necessary to ensure stability at the osteocartilaginous junction.


Conclusions

This wedge-shaped spreader graft technique corrects deviations at the key-stone area without detaching the bone-cartilage junction. By preserving the key-stone region’s integrity, it offers a safe and effective solution for septal deviations that extend into critical supporting structures of the nose. The author proposes that this method serves as a convenient and beneficial option for managing complex nasal deformities involving the key-stone area.






Start your free online consultation today!
We offer free online consultations via WhatsApp for international patients, as we understand that in-person visits can be challenging. Our experienced consultants and doctors are here to assist you. Simply let us know which procedures you’re interested in, and we’ll get back to you shortly.

VIP Plastic Surgery Korea footer logo
cer2 cer1 cer3
reviews
instagram facebook realself youtube blog pinterest linkedin

Phone: +82 64 713 1007

WhatsApp: +82 10 5059 6626

Consultations: [email protected]

Business inquiries: [email protected]

Address: 46, Eunnam-1gil, Jeju-si, Jeju-do, Korea (63124)

Dr. Myung Ju Lee M.D. Ph.D. is a board certified plastic surgeon in Korea, specializing in facelift, necklift, and rhinoplasty.

Business Registration No. 841-58-00455

© 2025 VIP International Plastic Surgery in Korea. All Rights Reserved.

Please note that before-and-after photos may vary depending on each patient's case. This website provides information on plastic surgery based on theoretical knowledge and extensive experience. No content contained herein may be used as a substitute for direct consultation.