Spreader graft placement for an Open Rhinoplasty procedure

http://www.spaldingplasticsurgery.com
http://www.rhinoplastyspecialist.com

Dr. Paul Nassif performs multiple procedures such as placement of spreader grafts, hump reduction and osteotomies during this open rhinoplasty

Spreader grafts are intended to target a dysfunctional internal valve and/or narrowed or collapsed middle vault. This typically results in one of two different types of patients, as follows:
The first is a patient with a congenital abnormality of this region. This is either from an inherently weak upper lateral cartilage or a congenitally crooked dorsal septal margin that deviates to one side.

Spreader grafts sutured into position. Several hor¬izontal mattress sutures secure the spreader grafts and up-per lateral cartilages. A needle of adequate size (such as a PS-2) facilitates engaging all structures (upper lateral carti¬lage-to-spreader graft-to-septum-to-spreader graft-to-upper lateral cartilage) in a single pass. Note how this suture passes through the dorsal edge of the upper lateral cartilage.

The spreader grafts may be secured first to the septum to stabilize them in position. Alternatively (and commonly), simply engage all structures (upper lateral cartilage-to-spreader graft-to septum-to-spreader graft-to-upper lateral cartilage) with a single mattress suture. An additional horizontal mattress suture may be necessary to secure the spreader grafts and upper lateral cartilages in position. A needle of adequate size (such as a PS-2) facilitates en gaging all structures in a single pass. Do not cinch down the mattress sutures too tightly or inferiorly, or else the upper lateral cartilages may actually be forced medially.

In the absence of other causes of nasal obstruction, the nasal valve and nasal valve area constitute the flow-limiting segment of the nose. The nasal valve is bounded by the caudal border of the upper lateral cartilage and the nasal septum, which join at an angle of 9 degrees to 15 degrees in the normal Caucasian nose. A valve fulfills the definition of a movable structure that regulates the flow of gas or fluid. The nasal valve area includes the cross-sectional area described by the nasal valve and is affected by the inferior turbinate, the caudal septum, and the tissues surrounding the pyriform aperture. The nasal valve area is considered to be the location of the least cross-sectional area in the nose and is believed to regulate significantly both nasal airflow and resistance and the velocity and shape of the air stream. The nasal valve area is the major flow-resistive segment of the nasal airway.

http://www.spaldingplasticsurgery.com
Spalding Drive Cosmetic Surgery and Dermatology
120 S. Spalding Drive Suite 315
Beverly Hills, Ca. 90212
Tel: (310) 275-2467

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[Gaizertv]

holy fuck.. i went trought this a week ago..

if i had seen this before my surgery i ve probably didnt do the surgery

[TheBiancaaC]

omg i cant believe what im getting myself into LOL thankfully i'll be sound asleep

[AznGurl747]

@isisbenny404

I know. But learning surgery is very, very, very hard & very exclusive & only for muy attentive people

[artur1992online]

well done docter.

[benjaminjacintojr]

very brutal!

[iChrisHernandez]

-hell naa a nose job is not suppose to be this much bruised up

[badgirlsclubhoe]

SHES PURPLE AND BLUE OH LAWD

[OSMANLI6011]

oh noo ,

[xSpeciality]

Sorry, I know this is immature but I couldn't help but laugh. Hump reduction XD

[parmstrong32x]

INCREDIBLE YO