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Surgical Pearls
Sept/Oct 2016

Endonasal (Closed) Rhinoplasty TechniqueSecuring Spreader Grafts With Barbed Suture

Author Affiliations
  • 1Division of Facial Plastic Surgery, Department of Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, California
  • 2Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Facial Plast Surg. 2016;18(5):395-396. doi:10.1001/jamafacial.2016.0294

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 an adjunct in the external rhinoplasty approach.24 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 fixation of spreader grafts is typically more challenging.4 Knotless, “barbed” suture is a relatively new technology that eliminates the need to tie knots while 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.

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