My Dorsal Graft Shifted and It Makes my Nose Look Crooked is It Possible to Remove and Replace with Medpor Before 1 Year Wait?
My Dorsal Graft Shifted and It Makes my Nose Look Crooked. is It Possible to Remove and Replace with Medpor Before 1 Year Wait?
Doctor Answers (12)
Cartilage Graft Rhinplasty Revision
You certainly can have the dorsal graft adjusted/changed before one year after surgery. Whether the indwelling graft should be adjusted or replaced with a synthetic alternative is a matter of surgeon perference and some controversy. However, given that you already have vested interest in the cartilage graft in place, I would strongly consider adjusting its positioning as your revisional procedure.
Revision before 12 months......."Yes." Medpor........"NO." Your Rhinoplastic Surgeon will likely use Silastic, Autographs (self) or maybe even carved Cadaveric grafts for implantation.
Removing dorsal implant and possible Medpor.
I would use cartilage and soft tissue to replace what you have. Medpore is difficult to remove and better to use your own tissue! In 35 years of Rhinoplasty I have never had an infection using the patient's own tissue.
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Yes you can remove your shifted graft before 1 year... Consider using a custom carved siliastic implant. The reason your graft shifted is because if wasnt put in right to start or you had rib cartilage that warped. See weblink below which shows many patients with a custom carved silastic dorsal implant. I would stay away from medpor. More importantly, find a surgeon that knows how to put in dorsal grafts (see video below).
Do not put Medpor in nose.
You don't have to wait a year, but how the revision rhinoplasty is done is very important. An implant like Medpor will have a high risk of failure.
It can be removed but Medpor is risky
If it is obviously crooked and it bothers you, then most likely there is no need to wait the full year for removal of the graft. I personally do not like medpor because of risk of infection, extrusion, and difficulty in removing if a problem develops. My approach would be to reposition or replace the graft. I would start by expressing your concerns to your primary surgeon.
Dorsal Nasal Graft Shits After Rhinoplasty
Based on the description you provided, you can have a corrective surgery at about 6-7 months post-op and you do not have to wait one full year to address the situation.
With that perspective, a revision procedure could readjust the graft without removing it and reinvesting in a new one unless it is necessary; the details of the procedure can only be determined through an in-person evaluation.
That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.
Thank you for your inquiry.
The best of luck to you.
Revise rather than replace
Once your nose has healed review your results with your surgeon. If its possible to revise your original graft that is preferable to using a medpore graft. I would suggest you wait a minimum of 6 months before considering revision. Best of luck
The general consensus here is against medpor but I have used it many times and like it. Without photos or knowing exactly what was done it is impossible to say what should be done or when exactly it should be done. If your previous surgery was your first and was not too extensive there is no reason to wait a year. A cheaper option may just be to reposition your current graft and suture it in place. It is impossible to say for sure because there is also the possibility that the graft was not the right size or shape or even in the right position from the start but you could not see that till the swelling resolve. There is also the possibility that your cartilage graft warped and you perceive that as a change in position.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Adjustment of nasal graft position
Grafts to the nasal dorsum can certainly be repositioned if they have shifted out of position. There should be no particular problem with doing this before one year after your original surgery. I would recommend seeing your surgeon to make sure the graft has indeed shifted and you are not seeing an area of swelling. Also, medpore is not a good material to use for nasal grafts, your own cartilage is far superior.