Middle-vault narrowing in the wide nasal dorsum: the "Reverse Spreader" technique

Area of Science:

• Rhinoplasty and Plastic Surgery
• Facial Plastic Surgery
• Nasal Anatomy and Reconstruction

Background:

• The middle nasal vault is crucial for nasal aesthetics and function, connecting the nasal tip to the nasal bones.
• Conventional techniques like spreader grafts address narrow middle vaults with internal nasal valve collapse.
• A less common scenario involves broad middle vaults without valve collapse, requiring alternative approaches.

Purpose of the Study:

• To present an alternative surgical technique for patients with a broad middle nasal vault.
• To address aesthetic and functional concerns associated with a wide nasal dorsum.
• To describe a method that effectively reduces the horizontal width of the cartilaginous nasal dorsum.

Main Methods:

• The technique involves excising a vertical, wedge-shaped strip of cartilage.
• This excision occurs along the length of the upper lateral cartilage.
• The precise location is at the junction of the upper lateral cartilage and the dorsal nasal septum.

Main Results:

• This method effectively reduces the horizontal width of the cartilaginous nasal dorsum.
• It provides an aesthetic improvement for patients with broad middle nasal vaults.
• The procedure offers a functional benefit by addressing nasal width concerns.

Conclusions:

• A novel surgical approach is described for managing broad middle nasal vaults.
• This technique serves as the inverse of spreader graft application.
• It offers a solution for specific patient populations seeking nasal width reduction and improved nasal form.