Composite Grafting for Retracted Nostrils?

Composite grafts, which include skin and cartilage, are frequently used for alar retraction. Don't have any cosmetic surgeon do the work; select an individual who is experienced in revision rhinoplasty.  You've already had two operations - try to make this your last.

Dear Sara, Grafting cartilage and mucosal tissue to the alae can help with alar retraction (retracted nostrils). The cartilage provides internal support for the nostrils and the mucosal graft allows the bottom edge of the nostril to move inferiorly (down.) The harvest of cartilage and mucosa is not a particularly dangerous or "scary" operation. The donor sites often heal without obvious sequelae and are not particularly painful in the postop period. Since you have had two... more

Actually, composite grafts (and yes, they are skin and cartilage, not mucosa and cartilage when used for this purpose) can work very well. But because retracted nostrils or alar notching are difficult to correct, the first step is an accurate diagnosis as to why the nostrils appear the way they do. If, after two surgeries so far, you haven't had much success, it makes me wonder whether the problem has been adequately evaluated (such as a hanging columella) and whether proper choices for... more