Endonasal (Closed) Rhinoplasty Technique: Securing Spreader Grafts With Barbed Suture.

Abstract

Spreader grafts are used for aesthetic and functional enhancement of the middle nasal vault in rhinoplasty. The spreader graft was originally described by Sheen as an endonasal (closed) rhinoplasty technique.1 More recently, most variations of the spreader graft have been described as anadjunct in theexternal rhinoplasty approach.2-4 The external approach allows improved visualization and access to the middle vault, which aids in accurately positioning and securing spreader grafts. In endonasal rhinoplasty, the correct placement and fixationof spreader grafts is typicallymorechallenging.4Knotless, “barbed” suture is a relativelynew technology that eliminates the need to tie knotswhile securing tissue. To our knowledge, we provide the first description of securing spreader grafts using barbed suture in endonasal rhinoplasty (Figure). The technique can be viewed in the Video.