During my primary rhinoplasty 5 years ago, bone was removed along my alar nasal base area. I am very unhappy with the way it looks and feels. I was wondering if there is any type of graft that can be placed in the nasal base area. Specifically, between my nasal spine and nostril rim on each side of the nose to fill in this area where the bone once was?
Is It Possible to Place a Graft at the Nasal Base to Replace Bone That Was Shaved Down During Rhinoplasty?
Doctor Answers (7)
Taking out the end of the septum can change the nasal base/upper lip
The bone in the area you are describing is way below the surface and unlikely to change the surface shape; it is also unlikely that the surgeon took any bone out there.
However, much more common is a change in the upper lip where it meets your nose. This change is caused by cutting out part of the end of the septum behind your columella (the skin between your nostrils) in order to shorten the nose.
That septal removal allows the upper lip to drop back in the area you are describing, and can be corrected by adding cartilage or Gore-Tex over the bone of the upper jaw through an incision in your nose. This is the only lace that I use anything artificial in rhinoplasty--and it is not in the nose.
Find a surgeon experienced in the technique, whom you like, and who can show you results that you like.
I would need to see a picture to see exactly what the problem is, but that area can be built up with a crushed-cartiledge graft or hydroxyapetite implant, commonly used in dental restoration.
Premaxillary grafts to nasal base
It sounds like you may benefit from a premaxiallry graft (or implant). Depending on how much augmentation you need you may be able to use Goretex or your own cartilage
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Replacing what is lost
cartilage and/or bone are natural, compatible materials which can give natural and long-lasting results. some surgeons may use gore-tex or medical grade silicone. the main issue is to diagnose what is actually needed to achieve your desired results, then replacing with the most suitable material. frequently this can be performed through a closed rhinoplasty approach.
Grafts at the Nasal Base
Cartilage grafts are frequently used at the base of the nose. Othermaterials include products such as Gortex and silicone. A revision rhinoplasty surgeon will examine you and explain alternative treatments.
Grafting of the nasal base
Photographs would be helpful in understanding your specific area of concern. For nasal spine augmentation (to improve the nasal-labial angle) options include cartilage grafting (ear, septum, or rib), implants (silicone), and injectable fillers. However, the area between the nasal spine and nostril rim consists of soft tissue only so it is not clear if bony deficiency is responsible for altered appearance that you are not happy with. This area may require more than just grafting. Hope this helps,
Grigoriy Mashkevich, MD