Unilateral vs Bilateral Spreader Grafts to Correct Cartilaginous Deviations in Structural Rhinoplasty: A Comparative Study on the Aesthetic and Functional Outcomes

Introduction: Spreader grafts (SG) are used in rhinoplasty to correct cartilaginous deviations. There are no studies that compare aesthetic and functional outcomes of unilateral (USG) and bilateral SG (BSG). Objectives & Hypotheses: Compare if USG or BSG are better to correct cartilaginous deviations, if there are differences in dorsal width ratio (DWR) and in patient-perceived aesthetic and functional outcomes. Methods: Retrospective study of 35 patients who underwent septorhinoplasty with USG or BSG. Deviation angle and DWR were calculated in frontal images before and 6 months post-surgery. Aesthetic and functional results were measured using NOSE and Visual Analog Scales (VAS). Results: BSG significantly improved postoperative nasal deviation (PND) compared to USG (179.6º vs 172.9º, p<0.05). In minor preoperative deviations there were no significant differences between BSG and USG (179.57º vs 177º respectively, p>0.05). In major preoperative deviations BSG provided better correction (179.62º vs 170.5º, p<0.05). DWR increased more with BSG compared to USG (0.12 vs 0.04 p<0.05). VAS and NOSE scores were similar in both groups. Conclusions: BSG are more effective in correcting major cartilaginous deviations, while both USG and BSG effectively correct minor deviations. Though BSG increases DWR, this does not negatively impact patient-perceived aesthetic or functional outcomes.