The Use of Spreader Grafts or Spreader Flaps-or Not-in Hump Reduction Rhinoplasty

Overview

Hump reduction is one of the most common reasons people seek cosmetic rhinoplasty, and it destabilizes the middle third of the nose. Spreader grafts and spreader flaps have become the standard way of supporting that section afterward. This article reviews when each is indicated and what can go wrong.

Sections of note

• Hump reduction is described as one of the most common reasons patients seek cosmetic rhinoplasty.
• Spreader grafts or spreader flaps are described as a key maneuver in supporting and reconstructing the midvault after profile reduction.
• Their stated purpose is preventing long-term functional and cosmetic consequences.
• The article reviews the relevant anatomy.
• It describes indications for spreader graft or spreader flap placement.
• It discusses surgical techniques and approaches for placing spreader grafts.
• It describes complications of spreader graft use after hump reduction. The abstract reports no patient numbers, rates, or follow-up.

What it means for a patient

• Rebuilding the middle of the nose after a hump is removed is standard, not optional, in most cases.
• The title's or not signals the review also addresses when neither is needed.
• Spreader grafts have their own complications, which the article covers.
• This is a review with no data, so it does not report how the options compare in outcomes.

Why this paper matters

Middle vault collapse after hump reduction causes both a pinched appearance and blocked breathing, and is a leading revision diagnosis. Setting out indications, including when to do nothing, makes the step a decision rather than a reflex. No outcome data accompanies the review.

Terms

• Midvault: The middle third of the nose, between the bony bridge and the tip.
• Spreader graft: A separate cartilage strip placed alongside the septum for support.
• Spreader flap: The upper lateral cartilage folded inward and used instead of a graft.
• Profileplasty: Reshaping the profile line of the nose.
• Hump reduction: Lowering the bump on the bridge of the nose.