Using Ear Cartilage for Collapsed Botched Rhinoplasty? (photo)

I had a rhinoplasty done by a "top" surgeon rhinoplasty specialists in NYC 7 years ago. Immediately afterward the right nostril was collapsed, I had asymmetrical nostrils, left nostril constantly drips water/exaggerated nostrils carved in the sides of my nose. I have heard I would need to put a graft in the right nostril from ear cartilage and those grafts often rotate or move years later. How can I regain symmetry in my nostrils, lift the right nostril and hide those carved nostrils?

Doctor Answers (11)

Cartilage Grafts For a Retracted Ala

+1

You do indeed have a retracted ala. This will require a graft of some kind, and as you can tell from the previous answers there is no one single graft but a variety of options depending on your specific anatomic issue. Revison rhinoplasty, especially when correcting asymmetry is never a simple procedure and needs to be approached with caution. Good luck.


Denver Facial Plastic Surgeon
4.5 out of 5 stars 11 reviews

revision rhinoplasty for alar retraction

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 Alar retraction can be treated with an alar rim graft taken from nasal cartilage or ear cartilage. A  Composite graft of skin and cartilage can be taken from the ear and grafted into the internal portion of the nose to bring that one-sided nostril rim down to match the opposite side.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Revision of alar retraction

+1

 

You have a retracted ala. One way to prevent this is an alar rim graft. Not all surgeons do this with open rhinoplasty, but many more should. This technique is easy and helps prevent the problem you are experiencing - it also likely has some role in closed rhinoplasty too.

 

with that said, correcting an existing retracted ale is rarely a "minor procedure." to have an enduring result, I believe the scared/retracted tissues need to be dissected free and then supported in a new anatomic location with grafts including alar rim and potentially lateral crural strut. what tissue to used (ear septum rib cartilage) depends on the intraop needs and the availability.

 

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
5.0 out of 5 stars 32 reviews

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You may consider a non-surgical approach to improve your nostril symmetry.

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I read your concern and reviewed your photo which is limited for evaluation:

If you're looking to achieve nostril symmetry on front view, you may consider an injectable filler treatment to attempt to lower your left nostril margin. My personal preference and experience in nostril lowering is with Silikon-1000, an off-label permanent filler for permanent results.

Hope this is helpful for you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 272 reviews

Collapsed Nostril

+1

In my practice, using septal or costal cartilage, will give you a better long term result. I would place a lateral crural strut graft to achieve the symmetry you are looking for.

 

best,

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.5 out of 5 stars 74 reviews

Revision Rhinoplasty question

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Dear LidiaC,

  • Placing grafts inside the nose definitely reinforces the nose so that it does not collapse with breathing
  • You can use ear, rib, or the septum (if it is still present)
  • The watery nose is a little different story, sometimes a spray can be used and eventually it goes away on its own
  • When you are ready, please see a rhinoplasty specialist in your area

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Revision Rhinoplasty

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I'm sorry to hear about your experience.  The asymmetry in the nostrils can likely be improved with cartilage grafts.  The grafts do not migrate years later as they stay in place by the surrounding tissue.  Please consult with a board certified specialist who can assist you in achieving the results you seek.
 

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Revision rhinoplasty

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Cartilage grafts can resorb but don't shift after the initial healing phase.  You appear to need a rim graft on the left and another graft higher on the right where it collapses inward.  Make sure your surgeon is adept at revision rhinoplasties and is board-certified Facial Plastic Surgeon.   Best wishes

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Revision rhinoplasty

+1

you will need revision with some sort of cartilage graft (either ear or septum) to support the nostril and make them more symmetric. You will definitely be able to get good long term improvement, but do not expect to have "perfect" nostrils.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Ear Cartilage in Rhinoplasty Revision Surgery

+1

Although it is possible for cartilage grafts to shift I've never seen it happen in 35 years of doing this work. A cartilage graft is needed to corrected the retracted nostril rim and improve symmetry. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

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.