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Cartilage Graft to Fix Dip in Nose?

asked 1 year ago by AlmondLotion in Los Angeles
Latest answer by William Portuese, MD
Question viewed 537 times
Tags: female, cartilage, dip, graft

I'm going in for my first (and hopefully last) rhinoplasty in 2 weeks. I want a very conservative change- make my dorsum and tip more narrow and slightly more defined (osteotomy and tip sutures), but my doctor thinks I need a cartilage graft to correct the slight dip (see picture). He says that the graft will slightly add height to the tip, too. Do I need to correct the dip, and will the graft change the shape of the tip and make it pointy? I don't want a pointy tip- just slightly more defined.

14 answers to Cartilage Graft to Fix Dip in Nose?

+1

Cartilage Graft to Fix Dip in Your Nose

Cartilage grafts and fascia can be used to fill "dips" or improve contour and definition without making the tip "pointy". Make sure you and your surgeon have the same goals and expectations. A second opinion might be helpful.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

+2

Graft to fix nasal dip.

The tip will not be pointy if done properly. The graft for the bridge dip can be cartilage or soft tissue depending on the depth and the skill of the surgeon with both materials. Make sure you make clear to the surgeon that you only want the dip done and nothing else if that is the case.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

Fixing a dip in the nose

The dip in the nose is created by a very high dorsal hump which when removed will give a nice aesthetic profile to the nose.  It appears that only minimal tip surgery needs to be performed, large dorsal reduction with hump removal, and osteotomies would probably be all that is needed.  
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Primary Rhinoplasty and Cartilage Grafts: Building blocks for the nose

Rhinoplasty is a very individual procedure which can be personalized to correct specific complaints. It sounds like you have very simple complaints that are reasonable based on your photo, however these simple complaints may require differing degrees of correction which may entail a combination of operative maneuvers, including cartilage grafts. It would not be unreasonable to place a graft in combination with tip suturing, and there are a multitude of cartilage grafts which have been... more
Andrew P. Trussler, MD

Dallas Plastic Surgeon
+1

Why Gamble With Rhinoplasty? First, "Test Drive" a Filler.

Hello, Almond Lotion. Seems to me that you should consider a more predictable, less expensive answer to your problem. After all, cartilage grafting is fine when it works out perfectly, but........ there are never guarantees. Have you considered have a filler injected, to fill the dip instead of rhinoplasty? To " test drive" or " demo" the potential improvement, ask your surgeon to inject sterile salt water ( saline) and to show you how you would like the... more
Robert Kotler, MD

Beverly Hills Facial Plastic Surgeon
+1

Differences in Rhinoplasty Technique Is Best Seen By Computer Imaging

The decision to straighten or smooth the dorsal line of your nose can be done by hump reduction or middle vault and tip augmentation. Either approach could be correct if it achieves the look that you want. While you want and need to trust the experience and judgment of your plastic surgeon, you also want to have the final look that you think looks best. You should go back to your plastic surgeon and see computer imaging based on these two different approaches and see which one you... more
Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon

www.eppleyplasticsurgery.com

+1

Nasal tip cartilage or not?

The good outcome after rhinoplasty is  very directly related to the expertise and experience of the surgeon. If  your surgeon feels that a graft is necessary ,probably he' s basing it on his own experience and prior results.If you trust him then let him  proceed , otherwise look for a second opinion by another surgeon who can examine your nose.
Erel Laufer, M.D.

Tampa Plastic Surgeon
+1

Tip grafts

Often I can achieve tip correction with sutures only. Tip grafts can sometimes be very noticeable through the skin.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Cartilage grafts in the nasal tip when really needed

Your concerns are correct in that tip grafts will be visible after your procedure. If the grafts are done well the nose will not be pointy and can greatly enhance the projection and definition. It is true also that with open suture techniques that we use tip grafts much less often. We suggest working from computer simulations or photos so that you and your surgeon understand the goals and expectations. Once you set the understood plan into action you will have to rely on the... more
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Consider filler trial before rhinoplasty

From your picture and written description I would probably not do a graft in the area above the tip. I would reduce the prominent dorsum. If a conservative change is being considered, I might suggest a trial of an injectable filler such as Restylane to see how you might like the equivalent of a cartilage graft in the dip above the tip.
Sheldon S. Kabaker, MD

Oakland Facial Plastic Surgeon
+1

Rhinoplasty and Nasal Tip

Rhinoplasty can help define the nasal tip in several ways, including cartilage grafting.  But there is an array of other options a board-certified plastic surgeon will likely consider, including suturing techniques or re-shaping the existing cartilage by trimming some of the existing cartilage.  It is common for the surgeon to discuss all of these options and then use some or all of them when in the operating room.
Jeff Scott, MD

Everett Plastic Surgeon
+1

Graft for Nasal Dip

Unfortunately, it is impossible for me to match your description of the graft with the photo you provided. There are so many different cartilage grafts, i.e., strut, tip, umbrella, supratip, batten, spreader, nasion, premaxilla, onlay, rim grafts - to name just a few. All of these have their particular role and limitations. When it comes to rhinoplasty, it is often not wise to "opt out" of certain grafts or aspects of the procedure, as long as your rhinoplasty surgeon set a... more
Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

www.drfechner.com

+1

Cartilage Graft to Fix Dip in Nose?

From the picture you send it is hard to really give you an answer, but I will comment on the 3/4 profile photo you send. It appears that you have a hump above the dip, so the issue is whether you want the hump removed, as it would make the dip less noticeable. Whether you should have a dip or not, that is personal preference. Some patients like that dip, also called a supra-tip break.  A graft on the area of the supra-tip should not really make the nose pointer, as the graft is... more
Michel Siegel, MD

Houston Facial Plastic Surgeon

houstonfaces.com

+1

Rhinoplasty and Cartilage Grafts

From the photo you provided, it appears that you have either a bump on the bridge or a slight depression in the lower 1/3 of your nose. Most likely somewhat of a combination.  The addition of cartilage grafts - often termed spreader grafts in this area can help to elevate a depressed section of the nose. These grafts can help improve the look of the nose from the front as well as the side creating a more balanced appearance. The ideal bridge is straight and without humps and valleys... more
Vincent P. Marin, MD

San Diego Plastic Surgeon

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