Can diced cartilage grafts for nasal bridge be removed a year after operation and placed with fillers?

After diced cartilage is removed can it be replaced with fillers to allow the nasal skin to slowly return to its original shape? As fillers decrease in volume over time, will it work to aid skin to gradually shrink back after excessive dorsal onlay graft inserted? Graft is irregular and has a c shaped deformity. My nose is deformed after DCF, surgeon performed osteotomies for low bridge. Are fillers suitable to fill the removed grafts an option during removal? First rhinoplasty and have a bad result.

Doctor Answers (4)

Dr. Jeffrey Epstein Answer

+1
Tough case, and it sounds like the first step is to either have the graft removed, or possibly it can be salvaged by trimming it then adding some soft tissue coverage to help provide a smoother, more symmetric look. I would try to avoid relying on injectables as an intervention, unless your doctor feels it will help.


Miami Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

Dices cartilage and filleres

+1
Hi there

I'm a little unsure of the question and may misunderstand you.  If there is too much cartilage and some is removed, why would you then want to replace it with filler?  Are you saying the entirety of the diced cartilage would be removed?

With diced cartilage, if you wait a year or so, it can be reduced a small or large amount leaving the rest there to fulfill its function. Then there would be no need for the filler.

Having said that filler is an excellent material to add to the dorsum of the nose for non-structural purposes (ie it has no ability to lift the other parts of the nose with it).  It does however need to be topped up after a time, which can be as much as years. However I would wait for a few months after surgery to allow the tissues to settle in.

All the best.

Peter Callan, MBBS
Geelong Plastic Surgeon
5.0 out of 5 stars 11 reviews

Diced cartilage and removal

+1
When it is removed you probably need to wait until things settle down a bit.  This would allow the tissues to heal. I am not a big fan of filler material for nasal augmentation. You are probably better off with graft.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

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Removal of diced cartilage from nose

+1
Diced cartilage could be remove from the nasal dorsum and replaced with filler but not at the same time.
The tissues would need to settle down for at least 6  weeks

At first a non permanent could be injected and depending on the  result a permanent filler used later.
You could consider a bone graft for the low dorsum if over resection was the initial problem from the first unsuccessful rhinoplasty.

Darryl J. Hodgkinson, MD
Australia Plastic Surgeon
4.5 out of 5 stars 25 reviews

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