I had a deviated septum rhinoplasty procedure just over a year ago where unknowingly spreader grafts and strut grafts were placed all inside my nose and mattressed together making it wider and also longer. I had no breathing problems and thought only nasal bone would be slightly shifted during the procedure. My nose is now too physically long for my face and much wider and uglier causing bulbous tip to droop when I speak. Can all grafts be removed and tip refined in revision to reduce size?
Can the placement of spreader graft between left upper lateral cartilage and strut grafts be removed in revision rhinoplasty?
Doctor Answers 4
Revision rhinoplasty for spreader graft removal
Spreader grafts can be removed, but it is very rare to ever need to do so. Removing them may damage the underlying structures such as the upper lateral cartilage which may cause nasal obstruction. A strut graft can be removed as long as compensatory mechanisms are in place to prevent the tip from drooping any further. Releasing of the depressor septi ligament will prevent tip from drooping upon smiling. Chart notes and operative records would be important to have when going in for a consultation
The grafts may not be the issue
Spreader grafts are placed to stabilize the nasal septum in the middle of your nose and to improve breathing. They are there for a reason. Your original surgeon knows why they were placed and whether or not it is safe to remove or trim them. They should not be causing a droop of the tip. Same for the strut grafts. Talk to your surgeon about this.
Graft removal during revision rhinoplasty
Pepper123, it is possible to take out old grafts during revision surgery. It is not clear, however, that they are to blame for the long appearance of your nose and drooping of your bulbous tip when you talk. Spreader grafts can also be placed to correct septal deviations, so perhaps that was the reason for their placement in your case. Operative note from your surgeon would be helpful in understanding why you had spreader grafts. If you desire revision surgery, it is important for you to focus on what you dislike about your nose, and do several consultations with doctors specializing in rhinoplasty surgery.
Grigoriy Mashkevich, MD
New York Facial Plastic Surgeon