Composite grafts are occasionally used in Rhinoplasty, particularly in Revisions. Nostril asymmetry in Revision surgery is common and due to post-surgical alar retraction (scar tissue forming inside the nose) from excessive removal of the natural tip cartilage. In order to correct this, you must first bring the nostril(s) down with strong Lateral Crural Strut Grafts. Then, if a skin defect exists at the site of the internal incision, a composite graft is used as a “spacer” graft to fill this void.