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Page 6 of 14 Patel et al. Plast Aesthet Res 2024;11:20 https://dx.doi.org/10.20517/2347-9264.2024.17
Figure 4. Septal extension grafts can be placed in an end-to-end fashion, but require stabilization. As shown here, the extension graft is
supported with two spreader grafts as well as more inferiorly placed batten-type grafts.
Figure 5. This patient, who had a prior rhinoplasty, presented with a number of external and internal manifestations of a short nose. A
side-to-side septal extension graft was used as a primary means to lengthen the nose. The additional use of a left spreader graft and
alar repositioning were also necessary.
Figure 6. Lengthening of the nose requires anterior septal reconstruction. Bilateral spreader grafts are attached to the more cephalic
portions of the dorsal septum and attached to the anterior septal replacement graft. Notably, there is a discontinuity between the dorsal
septum and this graft, with the spreader grafts acting as the primary means of stabilization.
achievable projection and lengthening. The extensive soft tissue attachments and ligamentous anatomy of
