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Misshapen Cartilage Graft During Rhinoplasty?

I had cartilage grafts placed on each side of my tip--up above my nostrils. I'm two weeks out from surgery. As the swelling has gone down, one side of the nose the right cartilage graft is more visible and more pronounced.

Will the graft-swelling go down as my nose selling goes down? Could this mean the graft was misshapen or too large?

Doctor Answers (9)

Allow swelling to settle down

+1

Since it has only been two weeks from the time of your surgery it is still impossible to tell if the graft has been misplaced or too large. It is important to wait for at least a year before embarking on any revision rhinoplasty surgery. You are supposed to let the healing scar contracture and lymphatic edema settle down. Occasionally, some cortisone shots can be placed in the tip to enhance the healing process and remove lymphedema.

Web reference: http://www.seattlefacial.com

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Wait, wait, and wait after Rhinoplasty

+1

You can't tell anything about the appearance of your nose yet. Way too early. It will change week to week during the first three months. Just be patient. Quit looking in the mirror. Most likely you'll be fine.

Boston Plastic Surgeon
3.5 out of 5 stars 2 reviews

Nasal Asymmetry after Tip grafting

+1

It is difficult to say without pictures and without knowing the details of the procedure.

In any event, other than the surgeon, most other physcians would recommend waiting prior to undergoing any revisionary procedures.

Discuss your concerns with your surgeon and begin an open dialogue.

Chicago Plastic Surgeon
5.0 out of 5 stars 39 reviews

Cartilage graft problems

+1

As a general rule the thinner your skin the more visible the cartilage grafts. There are many variables at play in your current situation. If the cartilage grafts were actually sown or sutured in place then it is unlikely that they have shifted in position. It is possible that they are too large but it is just too early to tell. Your plastic surgeon will be in the best postion to know the answers to your questions and concerns.

Atlanta Plastic Surgeon
5.0 out of 5 stars 7 reviews

Rhinoplasty results are hard to judge after two weeks

+1

The rule of thumb with nasal shaping is that after one week as the splint comes off the nose should look pretty good. There are exceptions however, and patients with thick skin usually will have to have greater patience to wait out the swelling and stiffness in the skin which can persist for six months or longer. Results can only be judged as the swelling and stiffness have resolved the nasal shape is revealed.

Visible tip grafts can pose special problems. A graft is cartilage tissue usually taken from inside the nose placed to support the airway improving breathing, or to support the shape of the nose as a visible or an invisible graft. Visible means the graft is placed under the skin and is meant to be seen by showing through and setting the shape or appearance. When the nasal skin is thin there is a risk that the graft will show excessively, or appear uneven or unnatural. Still, at two weeks it is too early to tell if the problem will persist, and if it does to determine just how much adjustment is required. You may be right and the graft may not be all that was expected, but it is best to wait it out if you can.

Best of luck,

peterejohnsonmd

Web reference: http://www.peterejohnsonmd.com/rhinoplasty

Chicago Plastic Surgeon
4.0 out of 5 stars 25 reviews

You have to wait for Rhinoplasty results

+1

I agree with what has been said. Your nose will likely look different two weeks from now and then different again 2 months later. PATIENCE is the key when waiting for the swelling to resolve from a rhinoplasty. The tip, being the lowest part of your nose, is often the last place for swelling to resolve. Somewhere in the 3 to 6 month range you will have a better idea if there is going to be any residual asymmetry in your tip. If a revision is recommended it may be wise to wait 10-12 months before doing so.

IF OK'ed by your surgeon you may consider a gentle tip massage program with your fingers or even an electric toothbrush to help your swelling go down. Furthermore take a close look at your pre-operative pictures, sometimes small differences were there to begin with. Sometimes patients are not aware of these differences until after surgery when they scrutinize their nose more. Good luck!

Atlanta Plastic Surgeon
5.0 out of 5 stars 2 reviews

You cannot assess the final result of Rhinoplasty in 2 weeks

+1

Dear Seattle Girl,

I completely agree with Dr. Persky. It's just too soon to tell.

If you're convinced there is a problem in a month, then post your pictures for comments.

I hope all turns out well, and best regards.

West Orange Facial Plastic Surgeon
5.0 out of 5 stars 256 reviews

Rhinoplasty results take time

+1

Resolution of swelling after rhinoplasty is something that takes time. If you are only 2 weeks out from surgery, it is probably too early to truly assess the final positioning of cartilage grafts that were placed. As the skin and soft tissues of the nasal tip heal, the presence of any misplaced grafts will become more apparent.

Much of what you may be seeing at this point is the swelling of the skin and soft tissues overlying the cartilage. I would address your concerns with your doctor, so that he/she may calm your fears.

Chevy Chase Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Rhinoplasty Asymmetry of the Tip Two Weeks Post-Op

+1

Hi Seattle Girl,

Patience, patience, patience. The reward of patience is Patience.

It is too early to access your results. Let the swellling and healing take it's normal course over the next few months. Nothing will be done for at least 6 months.

Let's talk about the graft shape and size in 6 months, but most likely it will not be necessary.

Enjoy your new nose and be well.

Dr. P

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 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.

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