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Spreader Graft: A Method of Reconstructing the Roof of the Middle Nasal Vault Following Rhinoplasty
Abstract
Los Angeles, Calif. From the Department of Surgery, Division of Plastic Surgery, at the UCLA School of Medicine. 9201 Sunset Boulevard, Suite 814 Los Angeles, Calif. 90069
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In the citing paper
“The etiology may be congenital, traumatic, or iatrogenic, especially after septorhinoplasty [1, 2, 5].”
From The value of spreader grafts in rhinoplasty: a critical review (2012) · cites this paper as [2]
In the citing paper
“Nasal valve collapse is a common anatomical cause for nasal obstruction [1, 2].”
From The value of spreader grafts in rhinoplasty: a critical review (2012) · cites this paper as [2]
In the citing paper
“Rhinomanometry is an objective test used to assess nasal obstruction [2, 10].”
From The value of spreader grafts in rhinoplasty: a critical review (2012) · cites this paper as [2]
In the citing paper
“Following the reduction of the nasal hump to a desired level, spreader grafts are usually positioned to prevent the complication of nasal valve collapse.”
From The value of spreader grafts in rhinoplasty: a critical review (2012) · cites this paper as [2]
In the citing paper
“In the 1980s, Sheen [2] popularized spreader grafts as a method of reconstructing the internal nasal valve and recontouring the aesthetic appearance of the nasal dorsum in rhinoplasty.”
From The value of spreader grafts in rhinoplasty: a critical review (2012) · cites this paper as [2]
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“With endonasal approaches, shield [38], spreader [39], or lateral alar batten [40] grafts can be placed in precise pockets to improve projection and aid in function (Figs.”
BackgroundNakamura, N., Okawachi, T., Matsumoto, K., et al. (2016) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.joms.2016.03.027 · Cited by 16
Measurement of Warping Angle in Human Rib Graft: An Experimental Study
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“Even though Sheen’s original description of the procedure was transnasally, he recommended skeletonization of the nose prior to addressing the valve for the same reasons.(5) The disadvantages are the disruption of normal tissue planes with the extensive dissection and with the open approach, a columellar scar.”
BackgroundMethodThe Use of Short Spreader Grafts in Rhinoplasty for Patients with Thick Nasal Skin
Grigoryants, V., & Baroni, A. (2013) · Aesthetic Plastic Surgery · doi:10.1007/s00266-013-0103-7 · Cited by 15
“They effectively restore the dorsal aesthetic lines and prevent midnasal vault collapse [1, 2].”
An algorithm for deciding alternative grafting materials used in secondary rhinoplasty
Acartürk, S., Arslan, E., Demirkan, F., et al. (2005) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2005.05.023 · Cited by 15
“In correcting severe middle nasal vault deformity and airway problems related to the internal nasal valves, spreader grafts were found to have the most successful outcomes.(3,4,19,24,29) Thus spreader grafts, which were noted to widen the angle and significantly improve nasal airway function, were the treatment of cho…”
BackgroundWhy Can’t More Good Surgeons Learn Rhinoplasty?
Constantian, M. B., & Martin, J. P. (2015) · Aesthetic Surgery Journal · doi:10.1093/asj/sju087 · Cited by 15
Pedroza, F., Pedroza, L. F., Achiques, M. T., et al. (2014) · JAMA Facial Plastic Surgery · doi:10.1001/jamafacial.2013.2348 · Cited by 15
Bagheri, S. C. (2012) · Oral and Maxillofacial Surgery Clinics of North America · doi:10.1016/j.coms.2011.10.001 · Cited by 15
Surgery of the Nasal Columella in External Valve Collapse
Ghidini, A., Dallari, S., & Marchioni, D. (2002) · Annals of Otology Rhinology & Laryngology · doi:10.1177/000348940211100808 · Cited by 15
Zeid, N. G., Mohamed, A. S., El-Fouly, M., et al. (2019) · Plastic Surgery · doi:10.1177/2292550319880919 · Cited by 14
Fedok, F. G. (2016) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2016.03.009 · Cited by 15
ZIJLKER, T. D., & Adamson, P. A. (1993) · Clinical Otolaryngology · doi:10.1111/j.1365-2273.1993.tb00544.x · Cited by 15
A New Technique for Nasal Tip Cartilage Graft in Primary Rhinoplasty
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A Finite Element Model to Simulate Formation of the Inverted-V Deformity
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Osseous-Cartilaginous Spreader Graft and Nasal Framework Reconstruction
Örs, S. (2017) · Aesthetic Plastic Surgery · doi:10.1007/s00266-017-0916-x · Cited by 14
The Auricular Cartilage in 197 Secondary and Tertiary Rhinoplasties
Pascali, M., Gentile, P., Pasquali, C. D., Bocchini, I., & Cervelli, V. (2016) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000002380 · Cited by 14
Endonasal Placement of Spreader Grafts in Rhinoplasty
Pontius, A. T., & Williams, E. F. (2005) · Ear Nose & Throat Journal · doi:10.1177/014556130508400308 · Cited by 14
Anatomic Reconstruction of the Nasal Tip Cartilages in Secondary and Reconstructive Rhinoplasty
Menick, F. J., & Sheen, J. H. (1999) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-199912000-00040 · Cited by 14
Self-citationConservative Subtraction‐Addition Rhinoplasty
Younger, R. A. L. (1997) · Otolaryngology · doi:10.1016/s0194-5998(97)70122-0 · Cited by 14
“Septal Conservative nasal septa 131 (43) reconstruction Septal surgery only for graft harvest 88 (22) Turbinate Bilateral asymmetric turbinate 151 (50) volume reduction Unilateral turbinate volume reduction 84 (31) Columellar Soft tissue subtraction 34 (1 t ) Distal septal shave 28 (9) Crural foot reduction 19 (6) Col…”
BackgroundA Double-Layered, Stepped Spreader Graft for the Deviated Nose
Seyhan, A., Ozden, S., Gungor, M., & Celik, D. (2009) · Annals of Plastic Surgery · doi:10.1097/sap.0b013e318184ab4f · Cited by 13
“The larger component of the composite graft should be wider than a standard spreader graft that was described by Sheen.(5) Two 5/0 polydioxanone sutures are usually needed to join the pieces of cartilage together.”
BackgroundEliason, M. J., Schafer, J., ARCHER, B. P., & Capra, G. G. (2020) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000007024 · Cited by 13
Buba, C. M., Patel, P. N., Saltychev, M., Kandathil, C. K., & Most, S. P. (2022) · Aesthetic Plastic Surgery · doi:10.1007/s00266-021-02735-0 · Cited by 12
“It has been shown to preserve support of the nasal dorsum and function of the internal nasal valve [3].”
BackgroundInfluentialHow I do it: Lateralizing the collapsed nasal valve
Rizvi, S. S. A., & Gauthier, M. G. (2003) · The Laryngoscope · doi:10.1097/00005537-200311000-00037 · Cited by 13
The accordion suture technique: A modified rhinoplasty spreader flap
Görgülü, T., Özer, C. M., & Kargı, E. (2015) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2015.03.036 · Cited by 13
“After excising the hump, there are various ways to reconstruct the nasal dorsum using inlay and onlay grafts (Sheen, 1984; Constantian and Clardy, 1996; Skoog, 1966; McKinney, 1996).”
MethodTreatment of The Internal Nasal Valve
Park, S. S. (1999) · Facial Plastic Surgery Clinics of North America · doi:10.1016/s1064-7406(23)00448-0 · Cited by 13
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“The use of spreader grafts as “spacers” between the dorsal cartilaginous septum and upper lateral cartilage is a well-established method for the correction or prevention of internal nasal valve failure during rhinoplasty (7,8); however, there is little information in the literature about the modified Glatzel mirror an…”
MethodAdamson, P. A., Constantinides, M. S., Kim, A. J., & Pearlman, S. J. (2013) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2013.09.001 · Cited by 12
Upper Lateral Strut Graft: A Technique to Improve the Internal Nasal Valve
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MANAGING THE POSTRHINOPLASTY OR POST-TRAUMATIC CROOKED NOSE
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Spreader graft placement: A simplified technique for young surgeons
Varedi, P., Bohluli, B., Bayat, M., et al. (2014) · International Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.ijom.2014.06.011 · Cited by 11
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120 Years of Dorsal Preservation in Rhinoplasty
Ng, C. L., & D'Souza, A. R. (2021) · Facial Plastic Surgery · doi:10.1055/s-0041-1723826 · Cited by 11
Crushed Cartilage and Autologous Fat for Dorsal Nasal Refinement
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“Contour irregularities tend to become apparent longer term, once postoperative edema has subsided [1, 2].”
BackgroundPrevention and Correction of Airway Compromise in Rhinoplasty
Burstein, F. D. (2008) · Annals of Plastic Surgery · doi:10.1097/sap.0b013e3181788e50 · Cited by 11
“Grymer and Sheen independently reported a high incidence of nasal valve narrowing with the external valve compromised in 85% and the internal valve in 25% of patients after rhinoplasty.(2,3) Reductive rhinoplasty, by its very nature, removes a portion of the”
BackgroundEmsen, İ. M. (2008) · Aesthetic Plastic Surgery · doi:10.1007/s00266-007-9108-4 · Cited by 11
RetractedEffect of Spreader Graft on Nasal Functions in Septorhinoplasty Surgery
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Die nasenrückenerhaltende „Dorsal-Preservation“-Septorhinoplastik
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“If the internal nasal valve has collapsed or the angle between the caudal border of the upper lateral septum is less than 10 to 15 , dorsal spreader grafts are necessary to prevent postoperative nasal airway obstruction [26].”
BackgroundInfluentialTreatment of the internal nasal valve
Park, S. S. (2001) · Otolaryngologic Clinics of North America · doi:10.1016/s0030-6665(05)70021-9 · Cited by 11
Tip Ligament Preservation and Suspension
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Functional and aesthetic outcomes of spreader graft and auto-spreader flap after nasal hump removal
Naguib, M., Ahmed, M., Madian, Y., Elnahriry, T., & Eldeeb, W. (2020) · The Egyptian Journal of Otolaryngology · doi:10.1186/s43163-020-00058-6 · Cited by 8
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“According to Sheen, this situation can be seen approximately in 75%–85% of the patients [26].”
BackgroundPascali, M., Boccieri, A., Carinci, F., et al. (2016) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000003306 · Cited by 10
Yang, X. S., Dong, L., Xue, H., et al. (2019) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000005149 · Cited by 10
Sazgar, A. A., Razmara, N., Razfar, A., Sazgar, A. K., & Amali, A. (2019) · Journal of Plastic, Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2019.06.022 · Cited by 8
Rhinoplasty Using Three-Dimensional Analysis and Simulation
Singh, A., Maniskas, S. A., Bruckman, K. C., et al. (2020) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000006687 · Cited by 10
The Combined Use of Spreader Flap and Asymmetric Spreader Graft in Crooked Nose
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E-M Shaped Septal Encircling With Medpor Reconstruction on Crooked Noses
Emsen, İ. M. (2008) · Journal of Craniofacial Surgery · doi:10.1097/scs.0b013e31815c9477 · Cited by 10
“On the other hand, these grafts are useful in the correction of dorsal deformities such as the inverted-V deformity and collapse of the middle vault.(21) In the beginning, single side bone and cartilage extended grafts may provide correction for the deformity.”
BackgroundWinkler, A. A., & Downs, B. W. (2008) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2008.03.005 · Cited by 10
Zoumalan, R. A., Carron, M. A., Tajudeen, B. A., et al. (2009) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2009.04.012 · Cited by 10
Anatomical Variations of the Upper Lateral Cartilages and Their Implications in Rhinoplasty
de Pochat, V. D., Alonso, N., Ribeiro, E. B., et al. (2011) · Aesthetic Plastic Surgery · doi:10.1007/s00266-011-9824-7 · Cited by 10
Septal Cartilage Graft for Nasal Valve Incompetence Associated with Deviated Septum
Paccoi, P., & Peco, V. D. (2007) · American Journal of Rhinology · doi:10.2500/ajr.2007.21.3074 · Cited by 10
Kridel, R., Kelly, P., & Holzapfel, A. M. (2010) · Elsevier eBooks · doi:10.1016/b978-0-323-05283-2.00035-5 · Cited by 6
Hump Nose Correction in Asians
Won, T. (2018) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2018.03.009 · Cited by 10
M-Plasty Correction of Nasal Valve Obstruction
Schulte, D. L., Sherris, D. A., & Kern, E. B. (1999) · Facial Plastic Surgery Clinics of North America · doi:10.1016/s1064-7406(23)00454-6 · Cited by 14
Avashia, Y. J., Glener, A. D., & Marcus, J. R. (2022) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000009290 · Cited by 11
A systematic approach to open rhinoplasty
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Nasal Reconstruction in Granulomatosis with Polyangiitis: A Two Decade Review
Gantous, A. M., & Garcia, R. F. F.-P. (2022) · Facial Plastic Surgery & Aesthetic Medicine · doi:10.1089/fpsam.2021.0348 · Cited by 9
Sharafi, M., Jalessi, M., & Adamson, P. A. (2015) · JAMA Facial Plastic Surgery · doi:10.1001/jamafacial.2015.0904 · Cited by 9
Kim, M. J., Jeon, D. N., Choi, J. W., et al. (2020) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2020.05.013 · Cited by 9
True and Average Internal Nasal Valve Area in Septorhinoplasty
Zeina, A. A. E.-M., Zeheiry, A. M. E., & El-Din, A. M. B. (2020) · Annals of Plastic Surgery · doi:10.1097/sap.0000000000002212 · Cited by 9
Tanna, N., Lesavoy, M. A., Abou-Sayed, H. A., et al. (2013) · Aesthetic Surgery Journal · doi:10.1177/1090820x13511629 · Cited by 9
Interactive Computer Graphics: A New Technology to Improve Judgment in Rhinoplasty
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Treatment of The External Nasal Valve
Chand, M. S., & Toriumi, D. M. (1999) · Facial Plastic Surgery Clinics of North America · doi:10.1016/s1064-7406(23)00449-2 · Cited by 9
Carpentering in Septorhinoplasty: A Novel Technique to Straighten the Deviated Nasal Septum
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Innovation in Aesthetic Plastic Surgery: An International Collaborative Effort
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Free spreader grafts in rhinoplasty
Goffart, Y. L. J., Karelle, S., & Daele, J. (2015) · European Journal of Plastic Surgery · doi:10.1007/s00238-015-1085-2 · Cited by 8
The Pull-up Spreader High (PUSH) Technique for Nasal Tip Support
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Les septoplasties et gestes associés
Thomassin, J. M., Bardot, J., Michel, J., & Radulesco, T. (2014) · Annales de Chirurgie Plastique Esthétique · doi:10.1016/j.anplas.2014.08.005 · Cited by 7
Crooked nose: The asymmetric face
Hussein, W. K. A., Baker, S. R., Ismail, A. S., et al. (2015) · Egyptian Journal of Ear Nose Throat and Allied Sciences · doi:10.1016/j.ejenta.2015.08.003 · Cited by 8
Early Results and Description of a New Modification of Spreader Graft to Enlarge Nasal Valve Area
Şahin, M., & Özmen, Ö. A. (2016) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000002597 · Cited by 8
“Spreader grafts are one of the most common grafts used to widen nasal valve area and many modifications of the shape and placement techniques of those grafts were described after their first introduction by Sheen in 1984.(8,10,18,19) To get the best functional and”
BackgroundUpdate on the evidence for functional rhinoplasty techniques
Chan, D., & Shipchandler, T. Z. (2015) · Current Opinion in Otolaryngology & Head & Neck Surgery · doi:10.1097/moo.0000000000000172 · Cited by 7
“Spreader grafts were first introduced by Sheen [35] to reconstruct the internal nasal valve and mid-vault (Fig.”
BackgroundIs It Time to Rethink the Approach to Internal Nasal Valve Stenosis?
Moss, W. J. (2018) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2018.3356 · Cited by 8
„Flaring spreader flaps“ und „upper lateral advancement“
Wurm, J., & Kovacevic, M. (2012) · HNO · doi:10.1007/s00106-011-2427-4 · Cited by 8
Foda, H. M. T. (2010) · HNO · doi:10.1007/s00106-009-2036-7 · Cited by 8
“Schritt besteht in der Überlegung, ob Knorpeltransplantate zur Spreizung („spreader grafts“) notwendig sind [32]; dies basiert auf der Beurteilung der Beziehung der Dreiecksknorpel zum Septum.”
BackgroundAvoiding secondary rhinoplasty
McKinney, P. W., & Cunningham, B. L. (1995) · Operative Techniques in Plastic and Reconstructive Surgery · doi:10.1016/s1071-0949(05)80014-9 · Cited by 8
Septal Considerations in Revision Rhinoplasty
Boccieri, A., & Macro, C. (2006) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2006.06.005 · Cited by 8
“Revision rhinoplasty requires the use of spreader grafts in such cases [5].”
BackgroundThe relationship of external and internal sidewall dimensions in the adult Caucasian nose
Setabutr, D., Sohrabi, S., Kalaria, S. S., et al. (2013) · The Laryngoscope · doi:10.1002/lary.23770 · Cited by 8
“Problems can persist after rhinoplasty and may occur as a secondary complication after dorsal hump reduction.(3,11) Short nasal bones ultimately provide less support for long and narrow upper lateral cartilages and result in collapse of the middle nasal vault and incompetence of the internal nasal valve.”
BackgroundCaudal Resection of the Upper Lateral Cartilages and Its Measured Effect on Tip Rotation
Hazani, R., Ford, R. S., Rao, A. J., et al. (2013) · Annals of Plastic Surgery · doi:10.1097/sap.0b013e3182503af4 · Cited by 8
“The septum, nasal floor, inferior turbinate, and the ULC delineate the borders of the internal nasal valve.(11,12) Manipulation of the ULC anterocaudal edge changes the internal nasal angle and reduces airflow through the nose.”
BackgroundThe Use of Spreader Grafts in Revision Septoplasty
Ateşpare, A., & Boyacı, Z. (2016) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000002898 · Cited by 8
“In 1984, Sheen described spreader grafts for the correction of nasal valve obstructions.(5,6) Nose Obstruction Symptom Evaluation (NOSE) scale is a disease-specific quality-of-life instrument to evaluate nasal obstruction.”
BackgroundAtighechi, S., Sarafraz, Z., Baradaranfar, M., Dadgarnia, M. H., Zand, V., Meybodian, M., Mandegari, M., Shirkhoda, S., & Vaziribozorg, S. (2018) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000005078 · Cited by 8
A Novel Hump Reinsertion Technique to Reconstruct the Nasal Dorsum
Öztürk, G. (2020) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000006262 · Cited by 8
“The importance of this issue was shown first by Sheen.(4) He placed 2”
BackgroundOkawachi, T., Ishihata, K., Nomoto, N., et al. (2020) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2020.08.008 · Cited by 8
Use of Tragal Cartilage Grafts in Rhinoplasty: An Anatomic Study and Review of the Literature
Rabie, A. N., Chang, J. S., Ibrahim, A. M. S., et al. (2015) · Ear Nose & Throat Journal · doi:10.1177/014556131509404-503 · Cited by 8
Amodeo, G., & Scopelliti, D. (2017) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000003604 · Cited by 7
“subperichondrially between the caudal septum and upper lateral cartilages, thus widening the angle of the internal nasal valve.(1) Andre proposed a closed approach to place endonasally the spreader graft with less invasiveness and possibility to combine this technique with other.”
BackgroundThe assessment and treatment of nasal obstruction after rhinoplasty
Joe, S. A. (2004) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2004.04.013 · Cited by 8
“Various authors have described other techniques [9,16–21].”
BackgroundA New Technique for Reconstruction of the Nasal Dorsum
Sabeti, F., & Tehrani, A. N. (2002) · Archives of Facial Plastic Surgery · doi:10.1001/archfaci.4.3.141 · Cited by 8
“Sheen presented a technique in 1983 that was based on using strips of septal cartilage along the anterior border of the septum to increase middle vault width following excision of the dorsum.(1,2) This technique kept the upper latA B”
BackgroundMethodCrooked nose: An update of management strategies
Hussein, W. K. A. (2014) · Egyptian Journal of Ear Nose Throat and Allied Sciences · doi:10.1016/j.ejenta.2014.10.005 · Cited by 8
Metadata
- Authors
- Sheen, J. H.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Sheen, Jack H.
- Venue
- Plastic and Reconstructive Surgery
- Published
- 1984-02
- Volume
- 73
- Issue
- 2
- Pages
- 230-237
- ISSN
- 0032-1052 (ISSN-L)
- OpenAlex
- W4312861572
- Cited by
- 614
- References
- 0
- Citations by year
- 2026: 15 · 2025: 32 · 2024: 23 · 2023: 14 · 2022: 37 · 2021: 38 · 2020: 35 · 2019: 28 · 2018: 22 · 2017: 20 · 2016: 28 · 2015: 29 · 2014: 27 · 2013: 33 · 2012: 15
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Plastic & Reconstructive Surgery (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Breast Implant and Reconstruction
- Health Sciences › Medicine › Surgery › Reconstructive Surgery and Microvascular Techniques
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Keywords
- spreader grafts, forehead reconstruction, scalp reconstruction, scalp flaps
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