I have had 4 revision surgeries where they use this stupid Irridiated cartilage which all 3 times have reabsorbed. I was told i was too Old at 48 to use my own rib. I think the body reabsorbed the other 3 times. I now have this white scar on the sid of my columella, when it was full in behind the columella and the columella fuller it was great.I do know the columella has retracked , can this be fixed
Can my Collumella Be Fixed
Doctor Answers (5)
Unfortunately irradiated cartilage has not worked for you. Your own cartilage from the septum, ear or ribs would be a better choice at this time. The scar could also be revised.
Continued cartilage graft resorption--what to do now?
In general, though irradiated cartilage grafts may be optimal choices for some patients, with four operations and three failed efforts that used this type of graft, I would recommend that other options should be considered. Typically, if plan A,B, and C don't work out, then plan D should NOT be the same as the other three!
I would first consider use of septal, ear, rib, or alloplastic graft over irradiated cadaver cartilage, usually in that order, unless there was some reason that one of these options is no longer available. Age is a relative factor in use of rib cartilage, as there is more ossification (cartilage becoming hard or bone-like) that can make this choice less attractive or an option no longer available.
It is pretty obvious that you are frustrated (after all, the cartilage isn't "stupid," only the choice to keep using something that fails repeatedly), so perhaps it's time for a second or third opinion from another experienced, board-certified plastic surgeon or facial plastic surgeon with extensive background in revision rhinoplasty. It is not only possible, but likely, that your problem can be successfully dealt with. Perfection is a worthy goal, but "good enough" may be the best outcome possible! Good luck!
Web reference: http://www.mpsmn.com/html/nose-surgery.html
Irradiated Columella Graft
Dear Revision Rhinoplasty Patient from Dekota,
Irradiated cadaver cartilage is an excellent choice for most revision rhinoplasty cases. However in your case may not be the proper choice. At this point cartilages harvested from your septum, ears or ribs are required to fix your columella. You may want to have a second opinion with a qualified plastic surgeon specializing in revision rhinoplasty, if all your rhinoplasty surgeries were done by one surgeon. Good luck
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Persistent retracted columella
In addition to structurally strong cartilage from your own body (rib, ear, or septum) you may also need lengthening of the columellar skin using a skin flap - since it appears that you have scar contracture of the columella as well as loss of structural support
Web reference: http://www.seattlerhinoplasty.com/html/index.php
Problems with irradiated cartialge graft and columella
Irradiated cartilage can be a good choice for some patients and many surgeons have a long track record of stable results with it.
However, it may not be the best choice for you. It's difficult to assess your problem fully given the single photographic views given. You may want to obtain additional opinions from other revision rhinoplasty experts regarding your problem to see what can be done.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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