Unilateral Versus Bilateral Spreader Grafts to Correct Cartilaginous Deviations in Structural Rhinoplasty: A Comparative Study on the Aesthetic and Functional Outcomes

Gimeno-Torres L, Calvo-Gómez J, Pérez-Carbonell T, Roselló MV, Vallejo-García A, Marrero-Pérez JC, Marco-Algarra J.

PubMed 41265885 Publisher (DOI)

What this paper says

In 35 patients with crooked cartilaginous noses, bilateral spreader grafts straightened major deviations better than a single graft (179.6 versus 172.9 degrees), widened the bridge slightly more, and gave the same patient-rated results.

Overview

Spreader grafts are used to straighten a deviated middle vault, but no study had compared one graft against two. The authors retrospectively reviewed 35 septorhinoplasty patients who received unilateral (USG) or bilateral (BSG) spreader grafts, measuring the deviation angle and dorsal width ratio on frontal photographs before and 6 months after surgery, and collecting NOSE and VAS scores.

Sections of note

Postoperative deviation: 179.6 degrees with bilateral versus 172.9 degrees with unilateral grafts (p < 0.05); 180 degrees is straight.
Minor preoperative deviations: no difference (179.57 versus 177 degrees, p > 0.05).
Major preoperative deviations: bilateral corrected better (179.62 versus 170.5 degrees, p < 0.05).
Dorsal width ratio increased more with bilateral grafts (0.12 versus 0.04, p < 0.05).
VAS and NOSE scores were similar in both groups.

What it means for a patient

For a mildly crooked nose, one spreader graft was enough in this study; for a badly crooked one, two worked better.
Two grafts widened the bridge measurably more, but patients did not rate their appearance or breathing any differently.
Follow-up was only 6 months.

Why this paper matters

It is the first comparison of unilateral versus bilateral spreader grafts for deviation, giving surgeons a rule of thumb tied to deviation severity. Limits: 35 patients, retrospective, short follow-up.

Terms

Spreader graft: a strip of cartilage sutured between the septum and upper lateral cartilage to straighten or widen the middle vault.
Cartilaginous deviation: a bend in the middle (cartilage) third of the nose.
Dorsal width ratio (DWR): bridge width relative to another facial measure on frontal view.
Deviation angle: the angle of the nasal axis; 180 degrees is perfectly straight.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Spreader grafts (SG) are used in rhinoplasty to correct cartilaginous deviations. There are no studies that compare aesthetic and functional outcomes of unilateral (USG) and bilateral SG (BSG). Objectives And Hypotheses: Compare whether USG or BSG is better to correct cartilaginous deviations, if there are differences…”

Excerpt; the full abstract is on PubMed.