Most patients who augment their nose have small noses. Small nose means a flat and a short nose. In this case the nose needs to be both augmented and lengthened. In other cases such as upturned nose or shortened nose after complications must be lengthened as well. To lengthen extended spreader graft is used. By using autologous cartilage the space between the septum and the lower lateral cartilage is lengthened on purpose. If silicone is used instead of autologous cartilage it might slip through the skin and come out which is terrible.