Is It Absolutely Necessary to Put a Spreader Graft in to Imporve Breathing?

Breathing is much more a function of the internal nasal structures rather than the external ones that have more to do with nasal appearance. The internal nasal valve is "overrated" as a functional structure, in my humble opinion, and widening it via spreader grafts is, in my experience, less helpful than restoring the septum to mid-line (if necessary), and opening the airway appropriately by partial inferior turbinectomy/turbinoplasty.

I have operated on many patients who have had failed one (or sometimes more) breathing operations (after septoplasty only, after spreader graft placement, or after septorhinoplasty), and have corrected their airway problems with septal centralizing and partial inferior turbinectomy/turbinoplasty.

Though I have no specific "beef" against spreader grafts, I use these only when the nose is excessively narrow and would be improved cosmetically by widening. Otherwise, I prefer to make the appropriate and desired cosmetic changes in the nose first, followed by the septal and turbinate work to maintain or improve the airway.

Thus, you do NOT have to have spreader grafts to breathe properly, and can still obtain the desired cosmetic appearance!

Dear Rhinoplasty patient from Illinois,
Due to the complex nature of the nose, swelling may take several months to resolve after a rhinoplasty. Most swelling resolves after two weeks. It is important to know that due to swelling there is significant internal and external swelling. This swelling may causes nasal obstruction as well as widening of the nose. If you just had your surgery, this is very normal healing process of nasal surgery. However if this is more than two months you need to talk to your surgeon for guidance. Good luck and good healing
 

If someone has septal deviation or large turbinates as the cause of the breathing problem, spreader grafts won't help. They are used to open the "valve" area and will make the nose slightly wider. Ask your surgeon and if you are not happy see an experienced revision rhinoplasty specialist. 

Spreader grafts by themselves do not insure and improved airway. They must be utilized appropriately. The key issue is whether the spreader graft is appropriate for the nasal airway at hand, AND, does it open the nasal valve as designed. 

Spreader grafts are used quite commonly for airwqy difficulty thought to be due to airway collapse. They can also help keep seotum straight.  If there are other causes for airway difficulty they have to be investigated and potentially treated.