Dorsal Width and Functional Outcomes with use of Autospreader Flaps in Cosmetic Rhinoplasty

Overview

Spreader grafts protect the internal nasal valve after hump removal but can widen the bridge. The authors reviewed cosmetic primary rhinoplasty patients who received prophylactic autospreader flaps (the patient's own upper lateral cartilage folded inward). Breathing was scored with NOSE and VAS before surgery and at 1, 6 and 12 months; dorsal width was measured on photographs at the same intervals.

Sections of note

• Width at the keystone fell significantly (p < 0.0001) and stayed reduced at 1 year.
• Width at the upper and lower lateral cartilages showed transient swelling at 1 and 6 months, normalising by 1 year (p = 0.0011).
• Net width at 1 year was 1 mm more than preoperative, not statistically significant (p > 0.05).
• NOSE and VAS scores were worst at 1 month, then returned to preoperative levels by 1 year (p = 0.0003 and p = 0.0012).
• Patient count is not stated in the abstract.

What it means for a patient

• A technique used to prevent valve collapse after hump removal did not visibly widen the bridge in this study.
• Breathing was temporarily worse at 1 month and recovered to baseline by 1 year; it did not improve beyond baseline, which fits a cosmetic population without preoperative obstruction.
• Swelling at the mid-nose can persist for 6 months before settling.

Why this paper matters

It quantifies the cosmetic cost of a common functional safeguard. Limits: retrospective, no control group without autospreaders, patient numbers not stated in the abstract.

Terms

• Autospreader flap: the upper edge of the upper lateral cartilage folded inward to act as a built-in spreader graft.
• Spreader graft: a cartilage strip placed between septum and upper lateral cartilage to keep the valve open.
• Keystone area: the junction of nasal bones and upper lateral cartilages mid-bridge.
• NOSE: Nasal Obstruction Symptom Evaluation score, 0-100.