Revision Rhinoplasty: Q&A
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Can my Collumella Be Fixed
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
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5 Doctor Answers |
Asked by
dakota2010
+2
Columellar Retraction
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.
+2
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...
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+2
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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+1
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
+1
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.
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