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Is Adding Grafts to Nose Tip Safe?

asked 2 years ago by Sam85 in London
Latest answer by Phillip Langsdon, MD
Question viewed 2,561 times
Tags: graft, safety

Would it be safe to add tip grafts (ear/rib) to increase the length and sharpness of the nose tip, without making it bulky because I have thick skin? I recently had alarplasty and alar rim grafts and would be happy if some tip grafts could be added. I do not want to modify any other part of the nose. Please help. I have attached a photo of my previous nose. Sorry about the antibiotic cream on my alar base.

16 answers to Is Adding Grafts to Nose Tip Safe?

Tip grafts are safe but are they right for you.

You should see an experienced revision rhinoplasty surgeon who does many noses like yours. He can examine your nose to see if tip grafting will accomplish what you desire. Look at before/after photos of his work before deciding.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Grafts to nose tip are safe, in theory

Grafts can be quite effective at increasing definition in thick skinned patients. However, as was pointed out by several other surgeons, your result looks quite good in spite of your photos being from the immediate post operative period. I would caution you on trying to improve an already good result. You could suffer a complication or injury to your nasal skin during a fourth rhinoplasty. There are no guarantees and the risks go up with each surgery. Remember, there is no such thing as a... more

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon

Rhinoplasty and tip grafting

Just from the frontal view, it seems that your nose is significantly improved. Revision surgery adds another dimension, and may not give you what you want to achieve. A great example is a famous musician who just recently died. He had a decent looking nose after his first surgery, and then went on to have several more that I thought made it look worse and unnatural. Be careful what you wish for!

Steven Wallach, MD
Manhattan Plastic Surgeon

Nasal tip grafts

You should be able to safely get a tip graft. The septum would be the best first choice for graft material. It appears also that you would benefit from narrowing and refinement as well. Don't get too crazy with the rhinoplasty surgery unless you want to wind up like Michael Jackson. Best to get it all done and move on.

Scott E. Kasden, MD
Dallas Plastic Surgeon

A Fifth Rhinoplasty would be much more difficult

Since you have had 4 rhinoplasties, anyone considering your surgery will be very cautious. That many procedures leaves the nose with low blood supply and hence more at risk for additional procedures. Grafts in these noses have less blood supply and are more likely to have decreased volume and action that they were intended. That needs to be understood. Tip grafts can make your nose more defined but thick skin prevents the details from showing. You can always make the skin less thick by... more

Philip Young, MD
Bellevue Facial Plastic Surgeon

Tip grafting an option

Yes, tip grafting is an option here, but your nose needs to be examined and your expectations discussed at length before any surgery is planned.

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

www.facechange.org

Tip grafts actually give the tip of the nose more definition

Tip grafts were very trendy about a decade ago. Then, it became known that in patients with thin skin, the grafts may become visible through the skin after a number of years. For thick skin, this is less of a chance. Tip grafts are actually one of the ways we create definition in thick skin noses. The graft presses into the skin creating contour where it didn't exist before.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

Proceed with caution

To answer your question about a tip graft; graft material from your own tissue is the best to use when a graft is indicated. One must understand the limits of skin thickness and realize there are risks with any surgery. However, after multiple surgery your "situation" is not like a first time rhinoplasty or first revision rhinoplasty. These are recent post-operative photos with swelling from surgery and do not provide any indication that additional surgery should be... more

Phillip Langsdon, MD
Germantown Facial Plastic Surgeon

Tip grafts to improve definition

Tip grafts are an excellent way to improve definition, especially in noses with thick skin. The best source is the cartilage from your ear(s) -- it is also easy to harvest. Wait at least 6 months after your alar grafts and narrowing.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Safety of adding grafts to nose tip

Having tip cartilage grafts to the nose is a safe alternative, but it needs to be done for the correct reasons. Adding cartilage tip grafts to the nose will add width and bulk depending upon where they are placed. Full healing takes a year for all of the swelling to subside, so this is not an operation that is done lightly. Thick skin will need to be addressed many times in the postoperative phase in ethnic rhinoplasty by placing cortisone injections into the supratip area in an effort... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Use own body tissue when adding grafts to the nose

Any surgical procedure can have complications. Every surgeon should consider the benefit: risk ratio before doing any surgical procedure. When used correctly, cartilage grafts (septum, ear and rib taken from your own tissues) have high benefits and low risks. Cartilage taken from another person or cadaver has much higher risks if implanted in the tip as does bone and artificially made implants. These are more likely to extrude, resorb, or become infected. Grafts added to the tip are... more

Jack P. Gunter, MD
Dallas Plastic Surgeon

www.rhinoplasty-usa.com

Better to avoid tip grafts if possible

Tip grafts in the nose are safe, but not always the best option. I prefer to avoid them in most cases. Grafts can absorb or shift over time. This can occur even several years after surgery. In most cases, suture modification of the existing cartilage is a better choice in my opinion.

Dean Fardo, MD
Atlanta Plastic Surgeon

Tip grafts are safe, but a fifth nose job may be a bad decision.

You appear to have refinement of your tip and narrowing of your nose in your post-op photos. It's too soon from your latest surgery (1/18/10) to even consider more surgery. You'll see refinement of your tip as your swelling resolves. Nasal lengthening surgery is difficult to impossible and should be avoided at all cost. After around 2-3 months, if you feel like you'd benefit from lowering your nostrils, you could consider consultation for a Non-Surgical Rhinoplasty from an experienced... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Nasal Tip Graft

If the grafts are made of cartilage, they are safe and in patients with thick skin, can make tip refinement actually possible. Cartilage can come from the nasal septum or the ear. Rib cartilage is more difficult to harvest and has a higher complication rate. However the more procedures done on the nose, the more difficult and unpredictable the results become.

Lee Robinson, MD
Portland Facial Plastic Surgeon

www.drleerobinson.com

Nose Surgery and Body Dysmorphic Syndrome

Judging by your BEFORE picture and your present picture - despite the swelling it is obvious you have a great result. I am very uneasy to see a patient with a history of 4 operations with a swollen nose with prolene (blue) stitches still along the sills contemplating yet ANOTHER operation. It is obvious that such people seek a level of perfection which is not achievable in this world and MAY have a condition termed BDD - Body Dysmorphic Syndrome. Similar to Anorexia Nervosa where 75 pound... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Be cautious in undertaking your Fourth Rhinoplasty!

This is your third question you have posted and in the most recent two you have not disclosed that you have undergone 3 previous rhinoplasty procedures. I would highly recommend for your ultimate safety and outcome, that you discuss this with any surgeon who considers treating you. You could end up with a Michael Jackson type nose if you continue to seek operations to radically transform the appearance of your nose.